AAP: No flu preference for 2020-21 season

In March of this year, the AAP released a statement saying that once again pediatricians can use either flu shots or nasal spray flu vaccines for their patients. This guidance applies to the 2020-21 flu season, and is the same recommendation issued for the 2019-20 season. The AAP and CDC did not recommend using the nasal spray in 2016-17 or 2017-18 due to poor effectiveness against H1N1 strains. LAIV manufacturer AstraZeneca has since changed the formulation of the vaccine.

According to a report issued by the CDC in April, 166 children died during the 2019-20 flu season. The CDC estimates about 39 million people have gotten sick with flu, 410,000 have been hospitalized and 24,000 have died this season. Hospitalization rates for children remain unusually high. Children ages 4 and under have been hospitalized at a rate of 94.1 per 100,000 children, the highest the CDC has on record for this age group. Last season’s vaccine was 55% effective for children and teens according to the CDC.

2019/2020 Flu Immunization Guide

Flu vaccine efficacy varies from year to year depending on the similarity of the flu viruses the vaccine is designed to prevent and the flu viruses in the community. However, recent studies show that have supported the conclusion that flu vaccination benefits public health. The CDC recommends that everyone age 6 months and older receive a flu vaccine yearly by the end of October.  Benefits of vaccination include:

  • Preventing contracting the flu. In seasons where the vaccine is well matched, it reduces the risk of having to visit the doctor with flu by 40 percent to 60 percent.
  • Reducing the chance of flu-associated hospitalizations. Flu vaccines have reduced the number of adults hospitalized with flu by about 40 percent. A 2014 study showed the vaccine reduced the risk of flu-related pediatric intensive care unit admission by 74 percent.
  • Reducing the severity of flu if contracted. A 2018 study showed that among adults hospitalized with flu vaccinated patients were 59 percent less likely to be admitted to the ICU.

Fluzone Quadrivalent Influenza Vaccine is an injectable immunization approved for patients 6 months and up. Fluzone is an inactivated vaccine protecting against four strains of the flu. In addition, Fluzone is approved for pregnant women.

Another option for flu is FluMist Quadrivalent, which is a nasal-spray flu vaccine approved for ages 2 through 49. FluMist is a live attenuated influenza vaccine and is not for use in pregnant women.

Older Adults

For some, the flu is a mild illness. For older adults, especially those with chronic health conditions such as diabetes or heart disease, the flu can be far more serious. Older adults are at high-risk to develop serious complications from the flu such as pneumonia. It’s estimated that between 70 and 90 percent of flu related dates occurred in people over 65, and between 50 and 70 percent of seasonal-flu related hospitalizations occur in that age group. Adults age 50 to 64 can choose from any available flu vaccine. For adults 65 and older, the CDC recommends one of two vaccines developed specifically for that age group: the high dose flu vaccine and the adjuvanted flu vaccine.

The high dose vaccine, Fluzone High Dose, delivers 4X the amount of antigen as the regular dose Fluzone vaccine. Compared to Fluzone, Fluzone High dose provides between 24%1 and 51%2 better protection from influenza.

The adjuvanted vaccine, Flublok Quadrivalent, is approved for persons ages 18 and older. Flublok has 3X the HA of a standard-dose quadrivalent inactivated influenza vaccine. Flublock also prevents more cases of flu in adults 50+ than a standard-dose quadrivalent vaccine. People over 65 should talk to their doctor about the pneumococcal vaccination, which can help prevent pneumococcal pneumonia, a serious flu-related complication.

AAP Recommendations

Earlier this month, the AAP released their updated recommendations for the use of influenza vaccines and antiviral medications in children. These include no preference for the inactivated or live attenuated vaccine, updated guidelines for children receiving their first flu vaccine, and information about a new antiviral medication. The recommendations can be viewed online.


1 24.2% Primary endpoint: the occurrence of laboratory-confirmed, protocol-defined, influenza-like illness caused by viral strains regardless of their antigenic similarity to vaccine components.

2 51.1% Secondary endpoint: the occurrence of culture-confirmed influenza caused by viral types/subtypes antigenically similar to those contained in the respective annual vaccine formulations in association with a modified Centers for Disease Control and Prevention-defined influenza-like illness.

2019-2020 Flu Season Coding Help

Sanofi Pasteur has put together a wealth of coding resources for the 2019-2020 flu season. Coding and billing for vaccinations can be complicated, so these resources are designed to save your practice time.

Coding Webinars

Sanofi has scheduled two webinars to assist in flu coding. One is targeted at coding for patients of any age, and the other is specifically for pediatric patients. The all ages webinar is scheduled for August 20 and September 12, 18, and 19. The pediatric webinar is scheduled for August 21 and September 10. The webinar will cover essential coding and billing information, Medicaid billing and VFC, Medicare billing, and payment benchmarks.

More information can be found here, and registration is available at http://www.crackingthecodestraining.com/

Coding Guides

Sanofi has put together two coding guides to help with this year’s influenza season. The first is The Code to Success: Your Complete Guide to Coding and Billing for Sanofi Pasteur Influenza Vaccinations. This detailed guide will help you understand coding and billing, roster billing, Medicare payment and timelines, and quality reporting measures.

The second guide, 2019-2020 Proper Codes of Sanofi Pasteur Products, includes product codes, NDCs in billing format, IDC-10 codes, administration codes, and CVX codes for each vaccine. It has been updated to include this year’s flu vaccinations.

We hope these resources help you have a successful flu season. As always, feel free to reach out to CPP for more information or to find out how we can save you money on your vaccine purchases.

2015-2016 Season Flu Vaccine Announcement

CPP is pleased to announce two programs our member practices can utilize to access flu vaccine discounts and benefits for the upcoming 2015-2016 flu season:

  • Sanofi Pasteur – The pre-book period is now open so book your flu reservation by going to www.VaccineShoppe.com
    • If your practice purchased Fluzone® last season (2014-2015), Sanofi Pasteur has allocated to you the total doses of each flu presentation that shipped to your practice.
    • This allocation can be adjusted up or down, depending on your practice’s anticipated need for the upcoming season (2015-2016), however you must confirm your reservation by March 31, 2015.
    • Because prefilled syringes are in higher demand, it is recommended that you confirm your reservation for this type of presentation by the end of February 2015.
  • MedImmune – CPP member practices can receive 5% off all orders of FluMist® throughout the entire 2015-2016 flu season, whether the doses are part of a pre-book or a part of subsequent reorders.
    • For CPP members that submitted the MedImmune Declaration Form last flu season you can place your FluMist® order with your distributor right now.   You do not need to submit a new declaration form in 2015.
    • For CPP members who want access to the CPP – MedImmune contract discount, please contact the CPP office at 614-722-2149 or email cpp@nationwidechildrens.org to obtain a copy of the declaration form.
    FluMist® doses must be pre-booked by April 17, 2015.

For pricing information and additional information, please contact CPP at 614-722-2149 or cpp@nationwidechildrens.org.