Influenza vaccination administration: When is it too early?

Abstract

Each year, the Advisory Committee on Immunization Practices (ACIP) publishes recommendations on the appropriate use of influenza vaccine. Over the years, there have been concerns about the optimal time when the vaccine should be given owing to the possibility of waning immunity if administered too early in the influenza season. The ACIP recommendations for the 2015-2016 influenza season state that the vaccine should be given before the onset of influenza activity in the community and should be offered by October if possible. 1 Grohskopf L.A. Olsen S.J. Sokolow L.Z. et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2015-16 influenza season. MMWR Morb Mortal Wkly Rep. 2015; 64: 818-825 Crossref PubMed Scopus (244) Google Scholar The 2013-2014 recommendations had changed the wording to state that patients should be vaccinated “soon after vaccine becomes available and, if possible, by October.” 2 Centers for Disease Control and PreventionPrevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2013-14. MMWR Recomm Rep. 2013; 62: 1-43 Google Scholar The 2012-2013 guidelines were worded slightly differently, stating that the vaccine should be given “as soon as vaccine is available.” 3 Centers for Disease Control and PreventionPrevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2012-2013 influenza season. MMWR Morb Mortal Wkly Rep. 2012; 61: 613-618 PubMed Google Scholar The 1990 recommendations suggested November as the optimal time for organized clinics. 4 Centers for Disease Control and PreventionPrevention and control of influenza: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Recomm Rep. 1990; 39: 1-15 Google Scholar These changes in wording reflect the difficulty in deciding the optimal time, based on conflicting literature regarding the duration of protection after vaccination. With newer preparations of influenza vaccine (e.g., influenza high-dose, cell culture, live attenuated, or intradermal influenza vaccine) as well as improvements in vaccine production (vaccine manufacturers are shipping influenza vaccine to clinicians in late summer), vaccine is now available earlier than ever. Chasity M. Shelton, PharmD, BCPS, BCPPS, Assistant Professor, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN Brandon M. Ladd, Student Pharmacist, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN Stephan L. Foster, PharmD, FAPhA, Professor, College of Pharmacy, APhA Liaison Representative to the Advisory Committee on Immunization Practices, University of Tennessee Health Science Center, Memphis, TN