Abstract

The National Advisory Committee on Immunization (NACI) provides the Public Health Agency of Canada with ongoing and timely medical, scientific, and public health advice relating to immunization. To summarize the update of the 2015-2016 recommendations by NACI regarding the use of seasonal influenza vaccines. Annual influenza vaccine recommendations are developed by the Influenza Working Group for consideration by NACI, based on NACI's evidence-based process for developing recommendations, and includes: a consideration of the burden of influenza illness and the target populations for vaccination; efficacy and effectiveness, immunogenicity, and safety of influenza vaccines; vaccine schedules; and other aspects of influenza immunization. NACI continues to recommend influenza vaccination for all individuals aged 6 months and older, with particular focus on people at high risk of influenza-related complications or hospitalization, people capable of transmitting influenza to those at high risk, and others as indicated. For the 2015-2016 influenza season, the Statement has been updated to identify children and adolescents with neurologic or neurodevelopment conditions as a group at high risk for influenza-related complications or hospitalization. Several changes to product availability in Canada have also been noted. A new adjuvanted, trivalent influenza vaccine (Fluad Pediatric™ [Novartis]) will be available for use in children aged 6 to <24 months. The recommended choice of product for this age group, however, is quadrivalent inactivated influenza vaccine (QIV), because children are more likely to be affected by influenza B, and the QIV provides broader protection against both lineages of influenza B. If QIV is not available, either unadjuvanted or adjuvanted trivalent inactivated influenza vaccine (TIV) should be used. Only the quadrivalent formulation of the live attenuated influenza vaccine (LAIV) (FluMist® Quadrivalent [AstraZeneca]) will be available, and the recommendation for preferential use of LAIV in children 2 to 17 years of age who do not have contraindications to this vaccine remains unchanged following a review of information pertaining to reports of decreased effectiveness of LAIV in the United States during the 2013-2014 season. Finally, the intradermal trivalent influenza vaccine (Intanza® [Sanofi Pasteur]) will no longer be available for use in Canada. Other updates to the Statement include additional information reaffirming the safety of LAIV use in children with cystic fibrosis who are not considered immunosuppressed or receiving immunosuppressive treatment, as well as a revised definition for oculo-respiratory syndrome which, when it occurs, should be reported as an adverse event following immunization (AEFI) to local public health officials. Vaccination is the safest, longest lasting and most effective way to prevent influenza.

Highlights

  • Every year, the National Advisory Committee on Immunization (NACI) provides the Public Health Agency of Canada with recommendations on seasonal influenza vaccines for the upcoming season as part of its mandate to develop evidence-based medical, scientific, and public health advice relating to immunization

  • Annual influenza vaccine recommendations are developed by the Influenza Working Group for consideration by NACI, based on NACI’s evidence-based process for developing recommendations, and includes: a consideration of the burden of influenza illness and the target populations for vaccination; efficacy and effectiveness, immunogenicity, and safety of influenza vaccines; vaccine schedules; and other aspects of influenza immunization

  • The recommended choice of product for this age group, is quadrivalent inactivated influenza vaccine (QIV), because children are more likely to be affected by influenza B, and the QIV provides broader protection against both lineages of influenza B

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Summary

Methods

Annual influenza vaccine recommendations are developed by the Influenza Working Group (IWG) for consideration by NACI, based on NACI’s evidence-based process for developing recommendations (3). NACI recommends live attenuated influenza vaccine (LAIV) use for healthy children and adolescents 2 to 17 years of age who do not have contraindications to this vaccine. LAIV is contraindicated for: children less than 24 months of age, due to increased risk of wheezing; individuals with severe asthma[2]; children and adolescents

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