The Advisory Committee on Immunization Practices (ACIP) has updated its seasonal flu vaccine guidance for the 2020-2021 flu season.

As flu season nears, hospitals, pharmacies, and healthcare practitioners will be inundated with more patients and care needs as flu converges with COVID-19. Effective flu prevention is paramount in reducing overall hospital admissions, intensive care admissions, outpatient illness, and stress on the healthcare system that is already overburdened during the COVID-19 pandemic.

Updates to the flu vaccine recommendations include the vaccine virus composition for 2020-2021 and two new flu vaccine licensures.

Vaccination of all individuals without contraindications and aged 6 months and older continues to be recommended, and there is no preferential recommendation for one vaccine over another in individuals for whom more than one licensed, recommended, and appropriate product is available.

The composition of the 2020-2021 US influenza vaccine includes updates to the influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B/Victoria lineage components. For this season the vaccines available are: (1) eEgg-based influenza vaccines that will contain hemagglutinin (HA) derived from an influenza A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus, an influenza A/Hong Kong/2671/2019 (H3N2)-like virus, an influenza B/Washington/02/2019 (Victoria lineage)-like virus, and (for quadrivalent egg-based vaccines) an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus and (2) cell culture-based inactivated (ccIIV4) and recombinant (RIV4) influenza vaccines that will contain HA derived from an influenza A/Hawaii/70/2019 (H1N1)pdm09-like virus, an influenza A/Hong Kong/45/2019 (H3N2)-like virus, an influenza B/Washington/02/2019 (Victoria lineage)-like virus, and an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus.

Two new influenza vaccine licensures are described in the updated guidance: (1) Fluzone High-Dose Quadrivalent (HD-IIV4) is approved for use in individuals aged 65 years and older. For the 2020-2021 season, Fluzone High-dose Quadrivalent is expected to replace the previously available trivalent formulation of Fluzone High-Dose (HD-IIV3) and (2) Fluad Quadrivalent (aIIV4) is approved for use in individuals aged 65 years and older. Both Fluad Quadrivalent and the previously licensed trivalent formulation of Fluad (aIIV3) are expected to be available for the 2020-2021 season.

Additionally, additions to the contraindications and precautions list include: anatomic and functional asplenia; active communication between cerebrospinal fluid (CSF) and oropharynx, nasopharynx, nose, or ear or any other cranial CSV leak; and cochlear implant. Also, recommendations concerning vaccination of individuals with egg allergy who receive either cell culture-based inactivated or recombinant influenza quadrivalent vaccine now state additional measures are needed only if a vaccine other than ccIIV4 or RIV4 is used.

Source: DrugTopics.com, August 25, 2020