September 3, 2020

September 3, 2020

ACIP Influenza Update – Lisa Grohskopf (CDC)

Lisa presented an overview of this season’s ACIP flu recommendations, as published in Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2020–21 Influenza Season. A four-page summary of this year’s recommendations also is available online.

Many of the recommendations for the 2020–21 season are unchanged from prior years. The primary updates involve changes to the vaccines’ viral composition and the addition of two recently licensed vaccines. Updates also were made to the contraindications and precautions, recommendations for use of LAIV when antiviral medications are being used, and updated guidance for vaccines given to persons with egg allergies.

The composition of the 2020–21 vaccine has been updated for three of the four vaccine components, i.e., influenza A(H1N1) pdm09, influenza A(H3N1), and influenza B/Victoria lineage. Quadrivalent vaccines will include an additional component from the B/Yamagata lineage, which is unchanged from the quadrivalent vaccines used during the 2019–20 season. Fluad (aIIV3) remains the only U.S.-licensed flu vaccine available in a trivalent formulation. For the first time this year, both the FDA and the WHO listed egg-based and cell-based flu vaccines separately. However, this was done simply to provide clarity and does not represent actual changes in the vaccines themselves.

Two new influenza vaccines, Fluzone High-Dose Quadrivalent (HD-IIV4) and Fluad Quadrivalent (aIIV4), have been licensed for this season. Both vaccines are approved for use in persons age 65 years and older.

Two updates have been made to use of Live Attenuated Influenza Vaccine (LAIV4). The intervals between receipt of LAIV4 and certain influenza antiviral medications have been increased due to the potential that these medications might reduce the effectiveness of the vaccine. Specifically, this involves receipt of oseltamivir and zanamivir with the previous 48 hours, peramivir within the previous 5 days, or baloxavir within the previous 17 days. Certain medical conditions (e.g., renal insufficiency) might further prolong these intervals. LAIV4 use is now also contraindicated for persons with cochlear implants, because of the potential for CSF leaks.

Information for persons with egg allergies was clarified to indicate person who have experienced only hives after exposure to egg may receive any licensed, recommended, age-appropriate influenza vaccines. Persons reporting symptoms other than hives after egg exposure may also receive any licensed and recommended influenza vaccine that is otherwise appropriate. However, a previous severe allergic reaction to influenza vaccine, regardless of the component suspected of causing the reaction, is a contraindication to future receipt of any influenza vaccine.

In response to questions, Lisa noted that no updates are expected for this year’s influenza vaccine information statements. In addition, she reported that an MMWR will soon be released focusing on influenza activity in the Southern Hemisphere. Reports indicated relatively low incidence of influenza, but it was noted that COVID-19 prevention measures are also under consideration for flu. L.J reported that there also was a huge increase in flu vaccination in this part of the world this year.

CDC Influenza Campaign for 2020-21 Season – Erin Burns (CDC)

Erin provided a presentation on communications plans for the upcoming influenza season. Research indicates that general population participants preferred messaging that highlighted the importance of being vaccinated to protect your community and family. In addition, messages which noted the importance of protecting EMTs resonated the most for people who do not plan to be vaccinated this year. CDC will continue to look at additional data and subgroups of interest to best tailor relevant messages about the importance of flu vaccination this season.

Using this information, CDC has blended several core messages for their digital campaign, including the concepts that flu vaccine is more important than ever this season and the more people vaccinated, the more people protected. Additional research is being conducted on motivational messaging around the benefits of receiving flu vaccine, with a particular emphasis on parents, older adults, and persons with chronic conditions. Erin reported that it is anticipated this campaign will go live in mid-September. In addition, a radio media tour is planned for September 24.

L.J asked whether test messaging had involved the idea of quality of life impacts suffered by persons who have developed flu. Erin said there is a lack of data in this area, but this type of messaging is being considered by CDC.

Erin also reported that updated information on vaccine distribution is reported each Friday. As of last week, approximately 20 million doses have influenza vaccine have been distributed in the U.S.

  • American Nurses Association (ANA) update – Holly Carpenter announced that the ANA has joined the Keep Up the Rates campaign coordinated by the National Foundation of Infectious Diseases (NFID). The ANA campaign, which is set to launch on September 17, is targeted to persons over the age of 50 and those with underlying health conditions. Another partnership involves messaging for minorities and underserved communities.


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