The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) has issued updated recommendations regarding the use of seasonal influenza vaccines for the 2014–2015 influenza season. The updated recommendations are based on a review of data on the relative efficacy and safety of live attenuated influenza vaccines (LAIV) and inactivated influenza vaccines (IIVs).

The U.S.-licensed influenza vaccines for the 2014–2015 season will contain the same vaccine virus strains as those in the 2013–2014 vaccine. Trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/California/7/2009 (H1N1)-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like (Yamagata lineage) virus. Quadrivalent influenza vaccines will contain these antigens plus a B/Brisbane/60/2008-like (Victoria lineage) virus. A list of anticipated influenza vaccine products for the 2014–2015 season is available here.

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The updated recommendations for children ages 6 months–8 years state that two doses of influenza vaccine, given ≥4 weeks apart, should be administered during their first season of vaccination or if previous vaccination history is unknown to optimize immune response. Only one dose is required for children ages 6 months–8 years who previously received ≥1 dose of a 2013–2014 influenza vaccine due to the unchanged strains in the 2014–2015 vaccines.

While studies have shown similar efficacy in LAIV and IIVs for adults, research has indicated that LAIV is superior in efficacy in younger children compared to IIVs. The ACIP recommends the use of LAIV, when available, for healthy children ages 2–8 years of age who have no contraindications or precautions.

For individuals who report prior reactions to egg involving such symptoms as angioedema, respiratory distress, lightheadedness, or recurrent emesis, or who required epinephrine or another emergency medical intervention, the ACIP now advises that they may receive IIVs if trivalent recombinant hemagglutinin [rHA] influenza vaccine (RIV3) is not available or if the recipient is not within the indicated RIV3 age range. IIV can be administered by a physician with experience in the recognition and management of severe allergic conditions. The patient should be observed for at least 30 minutes after vaccination for any reactions.

The ACIP recommendations apply to all licensed influenza vaccines used within FDA-licensed indications.

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