ACIP remains opposed to LAIV

Issue: July 2017

The CDC’s Advisory Committee on Immunization Practices, or ACIP, is continuing to advise against using the live-attenuated influenza vaccine.

The ACIP voted unanimously to approve the latest update to its recommendations on influenza vaccination during its meeting at CDC headquarters in Atlanta. That update includes the continued recommendation against the live-attenuated influenza vaccine (LAIV), which is offered as a nasal spray.

“The draft recommendation extends the [advice] that LAIV not be used into the 2017-2018 season,” Lisa Grohskopf, MD, MPH, medical officer in the CDC’s Influenza Division, said during a presentation. “We’re awaiting further data on [quadrivalent LAIV] and anticipate that we will be getting some in October 2017.”

ACIP rejected LAIV in June 2016 by a 13-1 vote, citing data that the group said indicated it was ineffective against influenza A(H1N1) in children aged 2 to 17 years and in active military personnel. That decision was a reversal of the committee’s embrace of LAIV the previous year.

During the latest ACIP meeting, Grohskopf said there were concerns that abandoning LAIV could reduce influenza vaccination among children. Its nasal delivery was a desirable alternative to injection. But Grohskopf cited data, including preliminary figures for 2016-2017, indicating that coverage changed little after ACIP’s reversal.

Among all children in the United States aged between 6 months and 17 years, 59% received vaccinations in the 2015-2016 season, compared with 58.2% in the 2016-2017 season. Among children aged 6 months to 4 years, 69.7% received vaccinations in the 2015-2016 season, compared with 69.4% in 2016-2017. Among those aged 5 to 12 years, there was a statistically significant decrease in vaccinations during the 2016-2017 season. In that age group, 61.5% of children received vaccinations in 2015-2016 compared with 59.2% in 2016-2017. – by Joe Green

Disclosure: Grohskopf reports no relevant financial disclosures.