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Immunization Updates

Immunization - Vaccine Updates

(Last updated October 8, 2019)

CDC releases ACIP recommendations on the use of influenza vaccines for the 2019–20 influenza season

CDC has released Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2019–20 Influenza Season in the August 23 MMWR Recommendations and Reports. The Summary section is reprinted below.

This report updates the 2018–19 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2018;67[No. RR-3]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2019–20 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent formulations (IIV4s). High-dose (HD-IIV3) and adjuvanted (aIIV3) inactivated influenza vaccines will be available in trivalent formulations. Recombinant (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations.

Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2018; February 27, 2019; and June 27, 2019. Primary updates in this report include the following two items. First, 2019–20 U.S. trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/Brisbane/02/2018 (H1N1)pdm09–like virus, an A/Kansas/14/2017 (H3N2)–like virus, and a B/Colorado/06/2017–like virus (Victoria lineage). Quadrivalent influenza vaccines will contain HA derived from these three viruses, and a B/Phuket/3073/2013–like virus (Yamagata lineage). Second, recent labeling changes for two IIV4s, Afluria Quadrivalent and Fluzone Quadrivalent, are discussed. The age indication for Afluria Quadrivalent has been expanded from ≥5 years to ≥6 months. The dose volume for Afluria Quadrivalent is 0.25 mL for children aged 6 through 35 months and 0.5 mL for all persons aged ≥36 months (≥3 years). The dose volume for Fluzone Quadrivalent for children aged 6 through 35 months, which was previously 0.25 mL, is now either 0.25 mL or 0.5 mL. The dose volume for Fluzone Quadrivalent is 0.5 mL for all persons aged ≥36 months (≥3 years).

This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2019–20 season in the United States. A brief summary of these recommendations and a Background Document containing additional information are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to U.S.-licensed influenza vaccines used within Food and Drug Administration–licensed indications. Updates and other information are available from CDC’s influenza website (https://www.cdc.gov/flu). Vaccination and health care providers should check this site periodically for additional information.


CDC publishes ACIP's 2018–19 influenza vaccination recommendations

CDC published Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season in an August 24 MMWR Recommendations and Reports. The Summary section is reprinted below.

This report updates the 2017–18 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2017;66[No. RR-2]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2018–19 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent (IIV4) and trivalent (IIV3) formulations. Recombinant influenza vaccine (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations. High-dose inactivated influenza vaccine (HD-IIV3) and adjuvanted inactivated influenza vaccine (aIIV3) will be available in trivalent formulations.

Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2017; February 21, 2018; and June 20, 2018. New and updated information in this report includes the following four items. First, vaccine viruses included in the 2018–19 U.S. trivalent influenza vaccines will be an A/Michigan/45/2015 (H1N1)pdm09–like virus, an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus, and a B/Colorado/06/2017–like virus (Victoria lineage). Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage). Second, recommendations for the use of LAIV4 (FluMist Quadrivalent) have been updated. Following two seasons (2016–17 and 2017–18) during which ACIP recommended that LAIV4 not be used, for the 2018–19 season, vaccination providers may choose to administer any licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). LAIV4 is an option for those for whom it is appropriate. Third, persons with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). Additional recommendations concerning vaccination of egg-allergic persons are discussed. Finally, information on recent licensures and labeling changes is discussed, including expansion of the age indication for Afluria Quadrivalent (IIV4) from ≥18 years to ≥5 years and expansion of the age indication for Fluarix Quadrivalent (IIV4), previously licensed for ≥3 years, to ≥6 months.

This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2018–19 season in the United States. A background document containing further information and a brief summary of these recommendations are available here.


IAC develops "Don’t Be Guilty of These Preventable Errors in Vaccine Administration," a new resource for healthcare professionals

IAC has developed Don’t Be Guilty of These Preventable Errors in Vaccine Administration, a 4-page print resource describing common but preventable errors made in vaccine administration. This resource also provides information about what to do when errors are made and links to resources that will help prevent errors in the future.

This new resource is a companion piece to IAC's Don't Be Guilty of these Preventable Errors in Vaccine Storage and Handling!  


IAC revises "Screening Checklist for Contraindications to Vaccines for Children and Teens" and "Screening Checklist for Contraindications to Vaccines for Adults"

IAC recently revised the following two screening checklists:

The changes to the screening checklist for contraindications to vaccines for children and teens were: 1) to incorporate a history of thrombocytopenia or thrombocytopenia purpura as an additional precaution to MMR/MMRV vaccines and 2) to modify the T-lymphocyte criteria for HIV-infected children and receipt of varicella vaccine from counts to percentage at the 6th birthday (The checklist previously read "at the 8th birthday.")

A change to the screening checklist for contraindications to vaccines for adults was made to incorporate a history of thrombocytopenia or thrombocytopenia purpura as an additional precaution to administering MMR/MMRV vaccines.


IAC's screening checklists for vaccines have been updated

Immunization Action Coalition (IAC) recently updated the following checklists for vaccine contraindications.

  1. Screening Checklist for Contraindications to Inactivated Injectable Influenza Vaccination
  2. Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination 
  3. Screening Checklist for Contraindications to Vaccines for Adults
  4. Screening Checklist for Contraindications to Vaccines for Children and Teens

Seasonal Influenza Vaccination Resources for Health Professionals

The most current information for health care professionals regarding influenza vaccine recommendations (including persons with egg allergy), vaccine supply, and recommendations for using antiviral agents for influenza can be found on the CDC website at www.cdc.gov/flu/professionals/vaccination/index/htm.


CDC Releases Updated Vaccine Storage and Handling Toolkit

ICDC's Vaccine Storage and Handling Toolkit web page for healthcare professionals now contains a link to the newly updated Vaccine Storage and Handling Toolkit PDF guide for 2019. The Vaccine Storage and Handling Toolkit reflects best practices for vaccine storage and handling from Advisory Committee on Immunization Practices (ACIP) recommendations, product information from vaccine manufacturers, and scientific studies.

The Toolkit is designed to help health care providers find the information they need quickly and easily. The beginning chapters address the three main elements of an effective cold chain: a well-trained staff, reliable storage and temperature monitoring equipment, and accurate vaccine inventory management. The remaining chapters focus on emergency management of vaccine and developing plans and standard operating procedures for routine and emergency storage and handling.

Note: For more detailed information on storage and handling recommendations and guidance for individual vaccines, please refer to manufacturers’ package inserts found on the Immunization Action Coalition (IAC) website.

Related Links


Draft Immunization Protocols

OPA annually drafts immunization protocols in compliance with the Ohio State Board of Pharmacy’s rules.  Updated protocols for 2019 are now available. Use the following link to purchase the protocol package: Immunization Protocol Package form


HealthMap Vaccine Finder

HealthMap Vaccine Finder (http://flushot.healthmap.org) is a free, online service where users can search for locations offering flu vaccines, as well as other adult vaccines. This service partners with clinics, pharmacies, and health departments to provide accurate and up-to-date information about receiving the flu vaccine. 

In 2012, Google passed the baton to HealthMap when it retired Google Flu Vaccine Finder. If you previously provided data to Google Flu Vaccine Finder and would like to still be included in the list of vaccine providers, you will need to register and upload your location data to HealthMap.


Additional Updates:

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