DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS 
The AAP’s 2025-2026 influenza policy statement addresses concerning vaccination coverage gaps, with only 49% of US children receiving vaccines by April 2025—14.5% lower than 2020 levels. Updated guidance simplifies antiviral protocols while expanding recombinant vaccine eligibility to children aged 9 years and older, emphasizing equity-focused approaches to reduce disparities in influenza-related hospitalizations and deaths.
⚕️ Key Clinical Considerations ⚕️
- Vaccination timing: Complete immunization by October using any available trivalent formulation without delays for specific products or thimerosal-free options.
- High-risk identification: Children under 5 (especially under 2) and those with chronic conditions face increased hospitalization risk requiring prioritized vaccination.
- Health disparities: Black, Hispanic, and Asian/Pacific Islander children experience 3-4 fold higher in-hospital influenza deaths compared to White children.
- Antiviral indications: Oseltamivir recommended for all hospitalized children, severe illness cases, and high-risk outpatients within 48 hours of symptom onset.
- Coverage expansion: RIV3 now approved for children 9+ years; live attenuated vaccine available for caregiver home administration in eligible children 2+ years.
🎯 Clinical Practice Impact 🎯
- Patient Communication: Emphasize early vaccination benefits and address vaccine hesitancy while discussing simplified antiviral treatment options for high-risk patients.
- Practice Integration: Implement systematic identification of high-risk pediatric patients and establish protocols for timely antiviral initiation without requiring positive influenza testing.
- Risk Management: Document vaccination status in medical records and registries; ensure household contacts of immunocompromised children receive vaccination.
- Action Items: Advocate for healthcare personnel vaccination mandates and coordinate with community vaccination sites to improve access in underserved populations.
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