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The 2008 recommendations include five principal changes or updates:
Beginning with the 2008--09 influenza season, annual
vaccination of all children aged 5--18 years is recommended. Annual
vaccination of all children aged 5--18 years should begin in September or as
soon as vaccine is available for the 2008--09 influenza season, if feasible,
but annual vaccination of all children aged 5--18 years should begin no
later than during the 2009--10 influenza season.
Annual vaccination of all children aged 6 months--4 years
(59 months) and older children with conditions that place them at increased
risk for complications from influenza should continue. Children and
adolescents at high risk for influenza complications should continue to be a
focus of vaccination efforts as providers and programs transition to
routinely vaccinating all children.
Either TIV or LAIV can be used when vaccinating healthy
persons aged 2--49 years. Children aged 6 months--8 years should receive 2
doses of vaccine if they have not been vaccinated previously at any time
with either LAIV or TIV (doses separated by 4 or more weeks); 2 doses are
required for protection in these children. Children aged 6 months--8 years
who received only 1 dose in their first year of vaccination should receive 2
doses the following year. LAIV should not be administered to children aged
<5 years with possible reactive airways disease, such as those who have
had recurrent wheezing or a recent wheezing episode. Children with possible
reactive airways disease, persons at higher risk for influenza complications
because of underlying medical conditions, children aged 6--23 months, and
persons aged >49 years should receive TIV.
The 2008--09 trivalent vaccine virus strains are A/Brisbane/59/2007 (H1N1)-like, A/Brisbane/10/2007 (H3N2)-like, and B/Florida/4/2006-like antigens.
Oseltamivir-resistant influenza A (H1N1) strains have been identified in the United States and some other countries. However, oseltamivir or zanamivir continue to be the recommended antivirals for treatment of influenza because other influenza virus strains remain sensitive to oseltamivir, and resistance levels to other antiviral medications remain high.
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