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Influenza update 2019-2020

By: Chad Rittle, DNP, MPH, RN, FAAOHN, and Holly Carpenter, BSN, RN

Protect yourself and your patients with timely vaccinations.

WITH FLU SEASON beginning, your yearly flu shot is more important than ever. The Centers for Disease Control and Prevention (CDC) recommends that everyone over 6 months old should be vaccinated annually, unless contraindicated by age, health, or applicable allergies. The American Nurses Association (ANA) supports these recommendations through our immunization position statement.

While it’s best to be vaccinated in September and October, vaccination, is appropriate at any time during flu season. This is especially crucial for nurses—for themselves and the patients in their care. The most effective influenza prevention is an annual flu vaccination, along with scrupulous infection prevention practices, including frequent handwashing and disinfection of items and surfaces that may have been contaminated.

Flu facts

CDC research reports that, on average, 8% of the U.S. population comes down with the flu each year. Children between 0 to 17 years old are most likely to get influenza (9.3% of the age group). Adults 18 to 64 years old follow closely at 8.8%; those 65 years and older at 3.9%, are somewhat less likely to get the flu. Those most at risk for complications from flu include adults 65 years and older, children younger than 5 years old, those suffering from specific chronic conditions, and pregnant women.

Most people are familiar with flu symptoms: cough, runny nose, muscle and body aches, fatigue, sore throat, and fever. But many are unaware of potential complications, which can include pneumonia, myocarditis, encephalitis, organ failure, muscle inflammation, ear and sinus infections, and worsening of chronic medical conditions (such as heart failure, asthma, or diabetes), which can be life-threatening. According to the CDC, a mild case of flu may need only rest, clear liquid hydration, and seclusion from others (except to get needed medical care) to prevent virus spread, but those who are very ill or in a highrisk category should contact their healthcare provider immediately. Treatment may include antiviral drugs and possible hospitalization to help control and manage symptoms.

The CDC estimates that between October 1, 2018, through May 4, 2019, there may have been as many as 42.9 million flu illnesses resulting in up to 20.1 million medical visits and possibly as many as 647,000 hospitalizations. They also estimate that there were between 36,400 and 61,200 flu deaths.

Composition of U.S. flu vaccines

Flu vaccine compositions change yearly to reflect current viruses. The CDC’s recommendation for the 2019-2020 trivalent vaccine includes:

• A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated)
• A/Kansas/14/2017 (H3N2)-like virus (updated)
• B/Colorado/06/2017-like (Victoria lineage) virus.

The quadrivalent vaccine includes the above and B/Phuket/3073/2013-like (Yamagata lineage) virus (cdc.gov/flu/season/flu-season-2019-2020.htm).

Providers may choose to administer any licensed, age-appropriate influenza vaccine. The American Academy of Pediatrics has approved inactivated (IIV) and the quadrivalent live attenuated influenza vaccine (LAIV4) for children in whatever form their pediatrician recommends.

Want to learn more? Visit ANA’s Immunize page nursing world.org/practice-policy/work-environment/health-safety/ immunize, cdc.gov/flu, or immunize.org (a site sponsored by the Immunization Action Coalition with resources to help nurses educate patients and families about flu and other vaccines recommended by the Advisory Committee on Immunization Practices). Also visit ANA Immunization Resources.


Chad Rittle is an associate professor at Chatham University in Pittsburgh, Pennsylvania, and a Pennsylvania State Nurses Association member. Holly Carpenter is a senior policy advisor for ANA.

Selected references

American Academy of Pediatrics. AAP updates vaccine recommendations for 2019-2020 flu season. March 14, 2019. aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Updates-Vaccine-Recommendations-for-2019-2020-Flu-Season.aspx

Centers for Disease Control and Prevention. Influenza (flu). 2019. cdc.gov/flu

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