The ACIP previously stated that influenza immunization of this age group should occur when feasible during the 2008-09 season. The more recent action is part of the transition to making this a routine part of child and adolescent care.

"It moves it from a 'should be considered seriously' to 'it should be done,' " said William Schaffner, MD, president-elect of the National Foundation for Infectious Diseases. He is the liaison between the committee and his organization, although he was speaking personally.

With vaccine supplies now stable, the committee's influenza vaccine working group also has been charged with examining whether recommendations should be made universal for all. Some vaccine advocates support this because it would simplify identifying who should receive the preventive. Others want to concentrate first on increasing uptake among already targeted groups.

Current recommendations cover about 80% of the population.

The committee also recommended that those who come into close contact with children adopted from overseas should receive hepatitis A shots. "The ACIP recommended that, from the moment the adoption is planned, ... people who are anticipating close contact should be vaccinated against hepatitis A and that the first dose, at the very minimum, be administered before the adoptee reaches the U.S.," said Dr. Schaffner who also is chair of the Dept. of Preventive Medicine at Vanderbilt University School of Medicine in Nashville, Tenn.

The ACIP is a panel of experts the Dept. of Health and Human Services convened to advise the Centers for Disease Control and Prevention. Several medical societies are represented, including the American Medical Association. Recommendations become policy after they are accepted by the director and published in Morbidity and Mortality Weekly Report.