Updated Recommendations for the Pediatric Influenza Vaccine, 2022-2023

The Committee on Infectious Diseases from the American Academy of Pediatrics continues to recommend annual influenza vaccination of infants and children without medical contraindications starting at 6 months of age in the latest yearly policy statement for the 2022-2023 influenza season.

Furthermore, antiviral treatments for influenza is again recommended for children with a suspected or confirmed case of influenza who are hospitalized, have severe or progressive disease, or have any underlying conditions that increase the risk of complications. The committee recommends any US Food and Drug Administration-approved, age-appropriate antiviral medication. 

The key recommendations and updates include:

  • Influenza A (H3N2) and influenza B Victoria lineage components are new to the composition of the influenza vaccines for this season. The influenza A (H1N1) pmd09 and influenza B Yamagata lineage components are unchanged.
  • The vaccine formulations available for children have not been changed from the previous season. The age indication for the cell culture-based inactivated influenza (IIV) vaccine (Flucelvax Quadrivalent) has been lowered from 2 years and older to 6 months and older.
  • A section on evidence-based strategies for increasing influenza vaccine uptake has been added and includes approaches for provider and care teams, practice and health systems, and public health initiatives.
  • The age indication for the neuraminidase inhibitor peramivir has been lowered to 6 months of age.
  • The age indication for the cap-endonuclease inhibitor baloxavir has been lowered to 5 months of age for the treatment of acute uncomplicated influenza in healthy children who have symptoms for no more than 48 hours and for chemoprophylaxis of influenza following contact with someone with influenza.

“Children consistently have the highest attack rates of influenza in the community during seasonal influenza epidemics,” the committee wrote. “Efforts to increase influenza vaccination, including strategies to decrease health disparities, address influenza vaccine hesitancy, and increase influenza vaccine coverage, are urgently needed.”


—Jessica Ganga


O’Leary ST, Campbell JD, Ardura MI, et al; Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2022-2023. Pediatrics. Published online September 6, 2022. doi:10.1542/peds.2022-059274.