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CDC committee releases 2008 flu recommendations; Tamiflu, Relenza remain recommended antivirals

Wednesday, July 30 2008 | Comments

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What's This? The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) released its 2008 recommendations for the prevention and control of influenza.

The recommendations, which were approved in February, include 5 principal changes or updates.

First, the ACIP recommends that, beginning with the 2008-09 flu season, all children aged 5 to 18 years be vaccinated annually. The committee noted that annual vaccination should begin in September (or as soon as the vaccine is available for the 2008-09 season), if possible. No matter what, annual vaccination of all children aged 5 to 18 years should begin no later than during the 2009-10 flu season.

The second update is that annual vaccination of all children aged 6 months to 4 years as well as of older children with conditions that increase their risk of flu-related complications should continue. The committee recommended that these young and at-risk children be a focus of vaccination efforts as the transition to routine vaccination of all children is made. Previously, the CDC had recommended that children aged 6 months to 5 years be vaccinated.

Third, the ACIP said that either trivalent inactivated influenza vaccine (TIV) or live attenuated influenza vaccine (LAIV) can be used in healthy people aged 2 to 49 years. However, LAIV should not be given to children aged <5 years who have possible reactive airways disease, to people who are at a higher risk of flu complications because of underlying medical conditions, to children aged 6 to 23 months, or to adults aged >49 years; these patients should receive TIV.

The committee noted that children aged 6 months to 8 years should be given 2 doses (separated by ≥4 weeks) of vaccine if they have not been vaccinated previously with either LAIV or TIV. Also, children in this age group who were given only 1 dose of the vaccine in their first year of vaccination should be given 2 doses the next year.

Fourth, the committee noted what the 2008-09 trivalent vaccine virus strains are: A/Brisbane/59/2007 (H1N1)-like, A/Brisbane/10/2007 (H3N2)-like, and B/Florida/4/2006-like antigens.

And, finally, the ACIP said that although some influenza A (H1N1) strains that are resistant to Roche's Tamiflu (oseltamivir phosphate) have been identified in the United States and elsewhere, Tamiflu and GlaxoSmithKline Plc's Relenza (zanamivir) continue to be the recommended antivirals for treating the flu. This is because other strains of the flu are still sensitive to Tamiflu and other antiviral drugs have high resistance levels.

These recommendations were published July 17, as an early release of the Morbidity and Mortality Weekly Report.

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