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Trivalent inactivated influenza vaccine (TIV) can be used for any person aged ≥6 months, including those with high-risk conditions (Box).
These studies often use electronic medical records from large linked clinical databases and medical charts of persons who are identified as having a vaccine adverse event (19--21).
In the United States, annual epidemics of influenza occur typically during the late fall through early spring.
Influenza viruses can cause disease among persons in any age group, but rates of infection are highest among children (1--3).
For example, population-based estimates of influenza disease burden supported by laboratory-confirmed influenza virus infection outcomes contribute the most specific data.
The best evidence for vaccine or antiviral efficacy comes from randomized controlled trials that assess laboratory-confirmed influenza infections as an outcome measure and consider factors such as timing and intensity of influenza viruses' circulation and degree of match between vaccine strains and wild circulating strains (17,18).
During these annual epidemics, rates of serious illness and death are highest among persons aged ≥65 years, children aged 99% of viruses characterized were the 2009 pandemic influenza A (H1N1) virus (11).
Data from epidemiologic studies conducted during the 2009 influenza A (H1N1) pandemic indicate that the risk for influenza complications among adults aged 19--64 years who had 2009 pandemic influenza A (H1N1) was greater than typically occurs for seasonal influenza (12).
No preference is indicated for LAIV or TIV when considering vaccination of healthy nonpregnant persons aged 2--49 years.
Because the safety or effectiveness of LAIV has not been established in persons with underlying medical conditions that confer a higher risk for influenza complications, these persons should be vaccinated only with TIV.
The ACIP Influenza Work Group (the Work Group)* meets every 2--4 weeks throughout the year to discuss newly published studies, review current guidelines, and consider revisions to the recommendations.
As the Work Group reviews the annual recommendations for consideration by the full ACIP, its members discuss a variety of issues, including the burden of influenza illness; vaccine effectiveness, vaccine safety, and coverage in groups recommended for vaccination; feasibility; cost-effectiveness; and anticipated vaccine supply.
Published, peer-reviewed studies are the primary source of data used by ACIP in making recommendations for the prevention and control of influenza, but unpublished data that are relevant to issues under discussion also are considered.