인플루엔자 불활화백신, 접종 허가 연령, Inactivated influenza vaccine (IIV), approved age

Inactivated influenza vaccine (IIV)의 접종 가능 연령은 제제에 따라 다를 수 있지만 보통 생후 6개월 이상이고 플루아릭스테트라(GSK), 지씨플루(녹십자)는 생후 6개월 이상, 스카이셀플루(SK)는 만 3세 이상입니다.

 

 

 

 

 

 

 

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Live-attenuated influenza vaccine (LAIV) compared with inactivated influenza vaccine (IIV) and recombinant influenza vaccine (RIV) for seasonal influenza, United States formulations

Factor	LAIV	IIV	RIV
Recommended by the ACIP for use during 2019-2020 Northern Hemisphere influenza season in the United States	Yes	Yes	Yes
Route of administration	Intranasal spray	Intramuscular injection	Intramuscular injection
Type of vaccine	Live virus	Killed virus	Recombinant hemagglutinin proteins
Number of included virus strains	4 (2 influenza A, 2 influenza B)	3 (2 influenza A, 1 influenza B) or 4 (2 influenza A, 2 influenza B)	3 (2 influenza A, 1 influenza B)
Vaccine virus strains updated	Annually*	Annually*	Annually*
Frequency of administration	Annually¶	Annually¶	Annually¶
Approved age	Persons aged 2 to 49 yearsΔ	Persons aged ≥6 months◊	Persons aged ≥18 years
Interval between 2 doses recommended for children aged ≥6 months to 8 years who require 2 doses¶	≥4 weeks	≥4 weeks	Not applicable
Can be given to persons with risk factors for serious influenza-related complicationsΔ	Depends upon the risk factorΔ	Yes	Yes
Can be given to children with asthma or children aged 2 to 4 years with wheezing in the past year§	No	Yes	Not applicable
Can be administered to family members or close contacts of immunosuppressed persons not requiring a protected environment	Yes	Yes	Yes
Can be administered to family members or close contacts of immunosuppressed persons requiring a protected environment (eg, hematopoietic cell transplant recipient)	No	Yes	Yes
Can be administered to family members or close contacts of persons with risk factors for influenza-related complications other than immunosuppression requiring a protected environment, as described in the previous row	Yes	Yes	Yes
Can be administered simultaneously with other vaccines	Yes	Yes	Yes
If not administered simultaneously, can be administered within 4 weeks of a live vaccine	Prudent to space ≥4 weeks apart	Yes	Yes
If not administered simultaneously, can be administered within 4 weeks of an inactivated vaccine	Yes	Yes	Yes
Can be given to persons who have been given influenza antiviral medications within the previous 48 hours	No	Yes	Yes

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* A decision is made annually regarding which virus strains will be targeted in the vaccine for the upcoming influenza season. Even in years in which the vaccine composition is the same as the previous season, annual vaccination is necessary since immunity wanes.

¶ Refer to UpToDate topic on seasonal influenza vaccination in children for details of the schedule for children 6 months through 8 years.

Δ Contraindications to LAIV include pregnancy, immune suppression from any cause (including medications or HIV infection), and, in children and adolescents <19 years, concomitant aspirin or salicylate-containing therapy. Other medical conditions that may predispose to complications of influenza are a precaution for LAIV. These conditions include chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, neurologic (including disorders of the brain and spinal cord, cerebral palsy, epilepsy, stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, spinal cord injury), hematologic, or metabolic (including diabetes mellitus) disorders.

◊ Approval varies by formulation.

§ Clinicians and vaccination programs should screen for possible reactive airways diseases when considering use of LAIV for children aged 2 through 4 years and should avoid use of this vaccine in children with asthma or a recent wheezing episode. Health care providers should consult the medical record, when available, to identify children aged 2 through 4 years with asthma or recurrent wheezing that might indicate asthma. In addition, to identify children who might be at greater risk for asthma and possibly at increased risk for wheezing after receiving LAIV, parents or caregivers of children aged 2 through 4 years should be asked: "In the past 12 months, has a health care provider ever told you that your child had wheezing or asthma?" Children whose parents or caregivers answer "yes" to this question and children who have asthma or who had a wheezing episode noted in the medical record within the preceding 12 months should not receive LAIV.

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Data from:

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, 2019-20 influenza season. MMWR Recomm Rep 2019; 68:1.

Centers for Disease Control and Prevention. People at high risk for flu complications. Available at: http://www.cdc.gov/flu/about/disease/high_risk.htm (Accessed on August 24, 2019.)

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REF. UpToDate 2019.11.02