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Prevention and control of seasonal influenza with vaccines : recommendations of the Advisory Committee on Immunization Practices — United States, 2020–21 influenza season
  • Published Date:

    August 21, 2020

  • Source:
    MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports ; v. 69, RR-08
  • Language:
Filetype[PDF-437.35 KB]

  • Description:
    Influenza viruses typically circulate in the United States annually, most commonly from the late fall through the early spring. Most persons who become ill with influenza virus infection recover without serious complications or sequelae. However, influenza can be associated with serious illnesses, hospitalizations, and deaths, particularly among older adults, very young children, pregnant women, and persons of all ages with certain chronic medical conditions (1–7). Influenza also is an important cause of missed work and school (8–10). Routine annual influenza vaccination for all persons aged ≥6 months who do not have contraindications has been recommended by CDC and CDC’s Advisory Committee on Immunization Practices (ACIP) since 2010 (11). The effectiveness of influenza vaccination varies depending on several factors, such as the age and health of the recipient; the type of vaccine administered; the types, subtypes (for influenza A), and lineages (for influenza B) of circulating influenza viruses; and the degree of similarity between circulating viruses and those included in the vaccine (12). However, vaccination provides important protection from influenza illness and its potential complications. During the six influenza seasons from 2010–11 through 2015–16, influenza vaccination prevented an estimated 1.6–6.7 million illnesses, 790,000–3.1 million outpatient medical visits, 39,000–87,000 hospitalizations, and 3,000–10,000 respiratory and circulatory deaths each season in the United States (13). During the recent severe 2017–18 season, notable for an unusually long duration of widespread high influenza activity throughout the United States and higher rates of outpatient visits and hospitalizations compared with recent seasons, vaccination prevented an estimated 7.1 million illnesses, 3.7 million medical visits, 109,000 hospitalizations, and 8,000 deaths (14), despite an overall estimated vaccine effectiveness of 38% (62% against influenza A[H1N1]pdm09 viruses, 22% against influenza A[H3N2] viruses, and 50% against influenza B viruses). n late 2019, a novel coronavirus, SARS-CoV-2, emerged as a cause of severe respiratory illness (15). In March 2020, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a global pandemic (16). The common signs and symptoms of COVID-19 (e.g., fever, cough, and dyspnea) (17) can also occur with influenza illness. As of August 2020, SARS-CoV-2 continues to circulate and cause severe illness in the United States and worldwide. The extent to which SARS-CoV-2 will circulate over the course of the 2020–21 influenza season is unknown. However, during the continued or recurrent circulation of SARS-CoV-2 concurrently with influenza viruses during the upcoming fall and winter, influenza vaccination of persons aged ≥6 months can reduce prevalence of illness caused by influenza, and can also 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 illnesses, 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 This report updates the 2019–20 ACIP recommendations regarding the use of seasonal influenza vaccines (18) and provides recommendations and guidance for vaccine providers regarding the use of influenza vaccines in the United States for the 2020–21 season. Various formulations of influenza vaccines are available (Table 1). Contraindications and precautions for the use of influenza vaccines are summarized (Table 2). Abbreviations are used in this report to denote the various types of vaccines (Box). This report focuses on recommendations and guidance for the use of seasonal influenza vaccines for the prevention and control of influenza in the United States. A summary of these recommendations and a Background Document containing additional information on influenza, influenza-associated illness, and influenza vaccines are available at Suggested citation for this article: Grohskopf LA, Alyanak E, Broder KR, et al. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2020–21 Influenza Season. MMWR Recomm Rep 2020;69(No. RR-8):1–24. rr6908a1.htm?s_cid=rr6908a1_w rr6908a1-H.pdf
  • Content Notes:
    Introduction -- Methods -- Primary Changes and Updates in the Recommendations -- Recommendations for the Use of Influenza Vaccines, 2020–21 -- Influenza Vaccine Composition and Available Vaccines -- Storage and Handling of Influenza Vaccines -- Additional Sources of Information Regarding Influenza and Influenza Vaccines -- Advisory Committee on Immunization Practices (ACIP), July 1, 2019–June 30, 2020 -- ACIP Influenza Vaccine Work Group.
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