ATLANTA — In a 13-1 vote, the CDC’s Advisory Committee of Immunization Practices recommended that the live attenuated influenza vaccine (LAIV, sold as FluMist Quadrivalent) ought to not be used for the 2016-2017 influenza season — along with a lot of members adding, “along with excellent regret.”
The committee likewise recommended LAIV’s removal from the federally-funded Vaccines for Children routine by the exact same vote.
Citing “evidence for bad effectiveness of LAIV in the U.S. over the last 3 influenza seasons,” the inactivated influenza vaccine or recombinant influenza vaccine will certainly be used for all of people ages ≥6 months this coming influenza season.
This was an interim recommendation, as the data could be subject to modification in future years. Previously, ACIP language expressed no preference for either the live or inactivated vaccine.
Preliminary data presented to the CDC in might showed that vaccine effectiveness of LAIV was 3% (95% CI -49% to 37%) versus any type of flu virus, while the inactivated influenza vaccine effectiveness was 63% (95% CI 52%-72%) throughout the 2015-2016 influenza season.
Particularly concerning to the committee was data presented here, which showed that LAIV effectiveness was significantly lesser in Kids ages 2-17, along with no substantial effectiveness of LAIV versus influenza A(H1N1)pdm09 or B viruses. The H1N1 strain tends to disproportionately affect children.
Data from the 2014-2015 season likewise showed no substantial effectiveness for LAIV (or the inactivated virus products) versus the drifted A(H3N2) viruses.
The American Academy of Pediatrics’ liaison came out strongly versus LAIV. “This has actually severe impact on pediatric practices,” said David Kimberlin, MD, at the meeting. “The science merely shows that one product does not job or has actually not worked for the last 3 years.”
But there were others “programmatic” comes to for such a durable recommendation. While LAIV comprises just 8% (14 million projected doses) of the total influenza vaccine supply, over half (55%) of school-based influenza vaccination services usage LAIV. There were likewise comes to concerning shortages for providers that have actually currently ordered their influenza vaccines for the year.
“This ought to not depend at all of on programmatic issues,” said William Schaffner, MD, liaison for the National Foundation for Infectious Diseases. “The committee must decide if this is an ineffective or insufficiently efficient vaccine, and if that is the decision, after that [not using it] is the clear choice.”
The committee discussed a much less draconian option that it ended up rejecting, which was that LAIV not be “routinely used,” except in certain situations, such as the refusal of an injectable vaccine by a parent, a shortage of age-proper IIV or RIV and school-based services along with no alternative vaccine. Ultimately, it was decided that this could appear as though Kids were obtaining an “inferior product” at school, and the CDC would certainly deal along with provider shortages.
The AAP currently pledged its support for the decision in a statement released to the media.
“[We] will certainly be functioning along with CDC and vaccine manufacturers to guarantee pediatricians and families have actually access to proper vaccines, and to suggestions pediatricians that have actually currently ordered intranasal vaccines,” said Karen Remley, MD, CEO/executive director of the AAP.
Committee member Cynthia Pellegrini cast the lone dissenting vote on the two recommendations. She urged the committee to delay the vote, saying that it was a great deal of short article to absorb on short notice to make a pretty essential decision.
“I have actually not had sufficient time to think about this short article fully,” she said.
There was one abstention from each vote, as a result of conflict of interest along with a vaccine manufacturer.
ACIP recommendation ought to be reviewed and approved by CDC’s director prior to it comes to be CDC policy. The agency usually follows ACIP recommendations. Its last placement will certainly be published in a CDC Morbidity and Mortality Weekly Report advice and Reports in late summer or early fall.
from Influenza – NewsBlog http://ift.tt/28ZwjcY
