At the 2025 NAPNAP National Conference on Pediatric Health Care in Chicago, Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP, chair of the Scientific Advisory Board for Vaccinate Your Family and clinical assistant professor at Stony Brook University, provided updates on immunizations for pediatric patients. Her session covered key changes to influenza, COVID-19, and respiratory syncytial virus (RSV) vaccines, along with guidance on improving vaccine uptake among families.

Influenza vaccine changes

"All of the influenza vaccines this year, and going forward, for the time being, will have 3 strains in it because it was determined that the Yamagata strain was no longer circulating." she explained.

READ MORE: ACIP's seasonal influenza vaccine recommendations²

Another major update involves expanding the eligibility for the high-dose influenza vaccine. According to the CDC, Fluzone High-Dose is not approved for people aged younger than 65 years, though it is recommended as an acceptable option for those aged 18 to 64 years who have a solid organ transplant and are taking immunosuppressive medications.¹

"For the first time, we can give the high-dose vaccine to certain populations [that are] 18 years of age. [Previously,] that was always for 65 years and older. Solid organ transplant recipients and HIV-positive adolescents can receive that high dose as an alternative," Koslap-Petraco noted.

"They may have more of a sore arm. They may have more of those mild flu-like symptoms because we're giving them more antigen. But tell them that's a good thing, because what that says is, your immune system is working."

COVID-19 vaccine guidance

Koslap-Petraco addressed COVID-19 vaccination, emphasizing the importance of consistency in vaccine brands while also acknowledging practical challenges.

"The recommendation is to give the same brand of COVID-19 vaccine to the children. But there is the caveat that if the only thing you have in the refrigerator, or you don’t know what the child had previously, just give them whatever you have." She reinforced the importance of continued vaccination efforts, noting that while "COVID deaths were lower than the influenza deaths" this year, the virus still poses risks, including long COVID.

RSV vaccine and monoclonal antibody recommendations

Regarding RSV prevention, Koslap-Petraco praised the uptake of maternal RSV vaccination.

"A lot of moms did get RSV vaccine this year, and if those moms got the RSV vaccine at least 2 weeks before they delivered their babies, they didn’t need the monoclonal antibody (nirsevimab). If the mom got the RSV vaccine after 1 pregnancy and became pregnant again, her later pregnancies, those babies would then get the monoclonal antibody."

She strongly recommended administering the monoclonal antibody before newborns leave the hospital or at their first pediatric visit.

Building trust with parents

Koslap-Petraco concluded with a reminder about the importance of provider-parent relationships in increasing vaccine acceptance.

"Vaccines don’t work in the bottle. They only work in the children," she said, quoting Dr. Walter Orenstein, and stressed, "vaccines don’t save children. It’s vaccinations that save children."

Reference:

1. Fluzone High-Dose Seasonal Influenza Vaccine. CDC. Updated September 6, 2024. Accessed March 13, 2025. https://www.cdc.gov/flu/vaccine-types/flu-zone.html

2. Fitch, J. ACIP's seasonal influenza vaccine recommendations. Contemporary Pediatrics. August 27, 2024. Accessed March 13, 2025. https://www.contemporarypediatrics.com/view/acip-seasonal-influenza-vaccine-recommendations