Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021-22 Influenza Season.
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021-22 Influenza Season.
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DOI：
10.15585/mmwr.rr7005a1
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发表时间：
2021-08-27
期刊：
影响因子：
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通讯作者：
Fry AM
中科院分区：
文献类型：
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作者：
Grohskopf LA;Alyanak E;Ferdinands JM;Broder KR;Blanton LH;Talbot HK;Fry AM
本报告更新了免疫实践咨询委员会 (ACIP) 关于在美国使用季节性流感疫苗的 2020-21 年建议（MMWR Recomm Rep 2020；69[No. RR-8]）。建议所有年龄≥6 个月且无禁忌症的人每年常规接种流感疫苗。对于每个接受者，应使用经过许可且适合年龄的疫苗。当有不止一种许可、推荐和适合年龄的疫苗可用时，ACIP 不会对特定疫苗做出优先推荐。在2021-22流感季节，预计将提供以下类型的疫苗：灭活流感疫苗（IIV4）、重组流感疫苗（RIV4）和减毒流感疫苗（LAIV4）。 2021-22 年流感季节预计将与引起 COVID-19 的病毒 SARS-CoV-2 的持续传播同时发生。为 6 个月以上的人群接种流感疫苗以降低流感引起的疾病患病率，从而减少可能与 COVID-19 混淆的症状。通过流感疫苗接种来预防和减轻流感疾病的严重程度以及减少门诊、住院和重症监护病房的入院次数也可以减轻美国医疗保健系统的压力。有关大流行期间疫苗规划的指南，请访问 https://www.cdc.gov/vaccines/pandemic-guidance/index.html。有关使用 COVID-19 疫苗的建议，请访问 https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19.html，其他临床指南请访问 https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html。本报告中描述的更新反映了 2020 年 10 月 28 日举行的 ACIP 公开会议期间的讨论； 2021 年 2 月 25 日； 2021年6月24日。本报告主要更新内容包括以下六项。首先，美国 2021-22 季可用的所有季节性流感疫苗预计都是四价疫苗。其次，2021-22 年美国流感疫苗的成分包括对甲型流感 (H1N1)pdm09 和甲型流感 (H3N2) 成分的更新。美国许可的流感疫苗将含有源自甲型流感/维多利亚/2570/2019 (H1N1)pdm09 类流感病毒（用于基于鸡蛋的疫苗）或甲型流感/威斯康星/588/2019 (H1N1)pdm09 类流感病毒（用于基于细胞培养和重组的疫苗）的血凝素、流感病毒A/柬埔寨/e0826360/2020 (H3N2) 样病毒、乙型流感/华盛顿/02/2019（维多利亚系）样病毒和乙型流感/普吉岛/3073/2013（山形系）样病毒。第三，基于细胞培养的灭活流感疫苗Flucelvax四价（ccIIV4）的批准年龄适应症已从≥4岁扩大到≥2岁。第四，流感疫苗与其他疫苗联合接种的讨论包括流感疫苗和 COVID-19 疫苗联合接种的考虑因素。提供者还应参考当前的 ACIP COVID-19 疫苗建议和 CDC 关于这些疫苗与流感疫苗联合给药的指南。同时接种的疫苗应在不同的解剖部位接种。第五，关于流感疫苗接种时间的指南现在规定，妊娠晚期的孕妇可以考虑在疫苗上市后立即接种疫苗。根据之前的建议，需要接种 2 剂的儿童（从未接种过流感疫苗或之前未接种过 2 剂以上的 6 个月至 8 岁儿童）应在疫苗上市后尽快接种第一剂，以便在 10 月底之前接种第二剂（必须在 ≥4 周后接种）。对于非怀孕的成年人，应避免在七月和八月接种疫苗，除非担心以后可能无法接种疫苗。第六，修改了使用 ccIIV4 和 RIV4 的禁忌症和预防措施，特别是对于有流感疫苗严重过敏反应（例如过敏反应）史的人。对先前剂量的任何基于鸡蛋的 IIV、LAIV 或任何价的 RIV 有严重过敏反应史是使用 ccIIV4 的预防措施。对先前剂量的任何基于鸡蛋的 IIV、ccIIV 或任何价的 LAIV 的严重过敏反应史是使用 RIV4 的预防措施。在这种情况下，应在住院或门诊医疗环境中使用 ccIIV4 和 RIV4，并在能够识别和处理严重过敏反应的医疗服务提供者的监督下进行；提供者还可以考虑咨询过敏症专家，以帮助确定导致反应的疫苗成分。对于 ccIIV4，对任何价的任何 ccIIV 或 ccIIV4 的任何成分的严重过敏反应（例如过敏反应）史是未来使用 ccIIV4 的禁忌症。对于 RIV4，对任何价的任何 RIV 或 RIV4 的任何成分的严重过敏反应（例如过敏反应）史是未来使用 RIV4 的禁忌症。 本报告重点介绍美国 2021-22 流感季节期间使用疫苗预防和控制季节性流感的建议。有关建议的简要摘要以及包含其他信息的最新背景文件的链接，请访问 https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html。这些建议适用于根据美国食品和药物管理局许可的适应症使用的美国许可的流感疫苗。更新信息和其他信息可从 CDC 流感网站 (https://www.cdc.gov/flu) 获取；疫苗接种和医疗保健提供者应定期查看此网站以获取更多信息。
This report updates the 2020–21 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2020;69[No. RR-8]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. For each recipient, a licensed and age-appropriate vaccine should be used. ACIP makes no preferential recommendation for a specific vaccine when more than one licensed, recommended, and age-appropriate vaccine is available. During the 2021–22 influenza season, the following types of vaccines are expected to be available: inactivated influenza vaccines (IIV4s), recombinant influenza vaccine (RIV4), and live attenuated influenza vaccine (LAIV4). The 2021–22 influenza season is expected to coincide with continued circulation of SARS-CoV-2, the virus that causes COVID-19. Influenza vaccination of persons aged ≥6 months to reduce prevalence of illness caused by influenza will reduce symptoms that might be confused with those of COVID-19. Prevention of and reduction in the severity of influenza illness and reduction of outpatient visits, hospitalizations, and intensive care unit admissions through influenza vaccination also could alleviate stress on the U.S. health care system. Guidance for vaccine planning during the pandemic is available at https://www.cdc.gov/vaccines/pandemic-guidance/index.html. Recommendations for the use of COVID-19 vaccines are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19.html, and additional clinical guidance is available at https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html. Updates described in this report reflect discussions during public meetings of ACIP that were held on October 28, 2020; February 25, 2021; and June 24, 2021. Primary updates to this report include the following six items. First, all seasonal influenza vaccines available in the United States for the 2021–22 season are expected to be quadrivalent. Second, the composition of 2021–22 U.S. influenza vaccines includes updates to the influenza A(H1N1)pdm09 and influenza A(H3N2) components. U.S.-licensed influenza vaccines will contain hemagglutinin derived from an influenza A/Victoria/2570/2019 (H1N1)pdm09-like virus (for egg-based vaccines) or an influenza A/Wisconsin/588/2019 (H1N1)pdm09-like virus (for cell culture–based and recombinant vaccines), an influenza A/Cambodia/e0826360/2020 (H3N2)-like virus, an influenza B/Washington/02/2019 (Victoria lineage)-like virus, and an influenza B/Phuket/3073/2013 (Yamagata lineage)-like virus. Third, the approved age indication for the cell culture–based inactivated influenza vaccine, Flucelvax Quadrivalent (ccIIV4), has been expanded from ages ≥4 years to ages ≥2 years. Fourth, discussion of administration of influenza vaccines with other vaccines includes considerations for coadministration of influenza vaccines and COVID-19 vaccines. Providers should also consult current ACIP COVID-19 vaccine recommendations and CDC guidance concerning coadministration of these vaccines with influenza vaccines. Vaccines that are given at the same time should be administered in separate anatomic sites. Fifth, guidance concerning timing of influenza vaccination now states that vaccination soon after vaccine becomes available can be considered for pregnant women in the third trimester. As previously recommended, children who need 2 doses (children aged 6 months through 8 years who have never received influenza vaccine or who have not previously received a lifetime total of ≥2 doses) should receive their first dose as soon as possible after vaccine becomes available to allow the second dose (which must be administered ≥4 weeks later) to be received by the end of October. For nonpregnant adults, vaccination in July and August should be avoided unless there is concern that later vaccination might not be possible. Sixth, contraindications and precautions to the use of ccIIV4 and RIV4 have been modified, specifically with regard to persons with a history of severe allergic reaction (e.g., anaphylaxis) to an influenza vaccine. A history of a severe allergic reaction to a previous dose of any egg-based IIV, LAIV, or RIV of any valency is a precaution to use of ccIIV4. A history of a severe allergic reaction to a previous dose of any egg-based IIV, ccIIV, or LAIV of any valency is a precaution to use of RIV4. Use of ccIIV4 and RIV4 in such instances should occur in an inpatient or outpatient medical setting under supervision of a provider who can recognize and manage a severe allergic reaction; providers can also consider consulting with an allergist to help identify the vaccine component responsible for the reaction. For ccIIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any ccIIV of any valency or any component of ccIIV4 is a contraindication to future use of ccIIV4. For RIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency or any component of RIV4 is a contraindication to future use of RIV4. This report focuses on recommendations for the use of vaccines for the prevention and control of seasonal influenza during the 2021–22 influenza season in the United States. A brief summary of the recommendations and a link to the most recent Background Document containing additional information are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to U.S.-licensed influenza vaccines used according to Food and Drug Administration–licensed indications. Updates and other information are available from CDC’s influenza website (https://www.cdc.gov/flu); vaccination and health care providers should check this site periodically for additional information.