CDC Reports Pediatric Flu Deaths Were High This Season

The 2017-2018 flu season was severe, resulting in 172 pediatric deaths across the country.¹ This number could potentially increase as reporting to the CDC can be delayed. Alarmingly, approximately 80% of the deaths occurred in children that did not receive the influenza vaccine this season.¹ This further emphasizes the importance of an annual influenza vaccine as well as patient education. Studies have demonstrated that individuals who receive the influenza vaccine are less likely to die from flu complications.²

Pediatric Flu Deaths

Approximately half of the pediatric deaths occurred in children with a medical condition that placed them at high risk of developing serious flu-related complications.¹ About 60% of these children died after hospital admission, and approximately 40% died at home or the emergency department. Additionally, most children died within 7 days of symptom onset. The influenza vaccine is recommended for everyone 6 months and older, and children younger than 5 years (especially younger than 2 years) are at an increased risk of flu-related complications.¹

Intranasal Flu Vaccine Recommendations for 2018-2019 Season

The CDC’s Advisory Committee on Immunization Practices has recommended the option of using the intranasal live attenuated influenza vaccine (LAIV4) for the 2018-2019 flu season.³ The LAIV4 was not recommended during the previous two flu seasons due to its lack of efficacy. The manufacturer claims that the LAIV4 FluMist has been reformulated, and the CDC will continue to monitor its efficacy in the upcoming flu season. However, the American Academy of Pediatrics (AAP) recommends the inactivated influenza vaccine as the primary choice for all children due to the lack of efficacy of the LAIV4 in previous flu seasons and unknown effectiveness for the upcoming season. The AAP recommends that the LAIV4 can be offered to children that would not otherwise receive a flu vaccine, which may be an option for vaccine hesitant families. Children younger than 2 years of age cannot receive the LAIV4.³

Pharmacist’s Role in the Upcoming Season

Pharmacists play an important role in flu prevention through vaccination and education. With expanding state laws, pharmacists have the authority to vaccinate children in some states.⁴ With pharmacists being so accessible, this can ultimately lead to increased influenza vaccine rates among the pediatric population. Pharmacists can also clear up common misconceptions regarding the flu vaccine. Patients should be educated that it takes about 2 weeks for the influenza vaccine to become effective once it is administered. The CDC recommends that individuals receive the flu vaccine once it becomes available, especially by the end of October as it is unpredictable when the season will begin. Pharmacists should continue to recommend the influenza vaccine to pregnant patients as this can pass protective antibodies to their babies. Patient education over the summer months can help prepare the community for the upcoming flu season.

References

• Centers for Disease Control and Prevention. CDC reported flu deaths in children exceeds seasonal high. https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm. Accessed June 11, 2018.
• Shang M, Blanton L, Brammer L, et al. Influenza-associated pediatric deaths in the United States, 2010-2016. Pediatrics. 2018;141(4): doi:10.1542/peds.2017-2918.
• American Academy of Pediatrics. AAP influenza immunization recommendations revised for 2018-’19 season. http://www.aappublications.org/news/2018/06/07/influenza060718. Accessed June 11, 2018.
• Schmit CD, Penn MS. Expanding state laws and a growing role for pharmacists in vaccination services. J Am Pharm Assoc. 2017;57(6):661-669.