PEDIATRICS Vol. 118 No. 2 August 2006, pp. 841-842 (doi:10.1542/peds.2006-1423)
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LETTER TO THE EDITOR |
Influenza Vaccine for School-Aged Children: In Reply
Ram Yogev, MDDivision of Infectious Diseases
Children’s Memorial Hospital
Chicago, IL 60614
Since the publication of my commentary calling for a change in the influenza recommendations to include immunization of infants and children of child care/school age,1 the Advisory Committee on Immunization Practices revised its previous recommendation to include only children 6 to 23 months of age. They now recommend immunization of a wider group of children (ie, those 6–59 months of age).2 There was no explanation why older healthy children have not been included in the new recommendations, but the committee stated that it "is working toward the goal of annual universal influenza vaccination in the US."2 Undoubtedly, the new recommendations will be welcomed by Greene et al, who appropriately suggest that immunization of children 3 to 4 years old, early in the season, would likely have a great impact on the spread of the disease in the community. Of interest, a recent study (presented at a national meeting3) compared the efficacy of live attenuated influenza vaccine to that of triple influenza vaccine in infants 6 to 59 months of age and suggested that live attenuated influenza vaccine was significantly more effective than triple influenza vaccine in protecting children 6 to 59 months of age from the disease (54.7% reduction in attack rate). Such higher efficacy would not only reduce the disease burden in infants but also should be more effective in reducing influenza-related disease in the entire community. Although yearly immunization of children 6 to 59 months of age is a move in the right direction, we need to widen the age range even more to include school-aged children. By doing so, we would not only further reduce community-wide transmission of influenza but also increase the cost-effectiveness of such a program.4
Greene et al raise the very important issue of how to organize and promulgate a yearly vaccination program for children. Although numerous logistic issues remain, experience in several communities has demonstrated its feasibility. Monto et al were able to do it in Michigan,5 as were Piedra et al in Texas6 and King et al in Baltimore, Maryland.7
We should have nationwide mobilization of federal and state health agencies, similar to that for the polio and measles vaccines, with involvement of not only school health personnel and nurses but also pediatricians and family physicians. If needed, participation of paramedical personnel (eg, pharmacies, as done now with influenza vaccine for the general population, or medical students volunteering to give injections in day care or school settings) should be encouraged after liability and fair compensation for patients’ vaccinations are quickly established.
There would be another major benefit of starting the day care/school-aged immunization program sooner than later: if we plan and execute such a program successfully, we should be better prepared to combat a more serious outbreak (epidemic or pandemic) such as the potential avian influenza A.
REFERENCES
1. Yogev R. Influenza vaccine confusion: a call for an alternative evidence-based approach [commentary].
Pediatrics. 2005;116
:1214
–1215
2. Centers for Disease Control and Prevention. National Immunization Program Advisory Committee on Immunization Practice meeting record; February 21–22, 2006. 2006:66 . Available at: www.cdc.gov./nip/ACIP/minutes/acip_min_feb_06.pdf. Accessed June 30, 2006.
3. Centers for Disease Control and Prevention. National Immunization Program Advisory Committee on Immunization Practice meeting record; February 21–22, 2006. 2006:68 . Available at: www.cdc.gov./nip/ACIP/minutes/acip_min_feb_06.pdf. Accessed June 30, 2006.
4. Belshe RB. Comparison of the efficacy and safety of cold-adapted influenza vaccine, trivalent with trivalent inactivated influenza vaccine in young children 6 to 59 months of age [abstract]. Presented at: Pediatric Academic Societies 2006 annual meeting; May 1, 2006; San Francisco, CA. Abstract LB-15
5. Salo H, Kilpi T, Sintonen H, Linna M, Peltola V, Heikkinen T. Cost-effectiveness of influenza vaccination of healthy children. Vaccine. 2006;24 :4934 –4941[CrossRef][Medline]
6. Monto AS, Koopman JS, Longini IM Jr. Tecumseh study of illness. XIII. Influenza infection and disease, 1976–1981.
Am J Epidemiol. 1985;121
:811
–822
7. Piedra PA, Gaglani MJ, Kozinetz AA, et al. Herd immunity in adults against influenza-related illness with use of the trivalent-live attenuated influenza vaccine (CAIV-T) in children. Vaccine. 2005;23 :1540 –1548[CrossRef][Web of Science][Medline]
8. King J, Gaglani M, Moore K, et al. Impact of a school-based influenza vaccination intervention on influenza outcomes within households [abstract]. Presented at: Pediatric Academic Societies’ 2006 annual meeting; April 30, 2006; San Francisco, CA. Abstract 2747.8
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics
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- Influenza Vaccine for School-Aged Children: In Reply
- Ram Yogev
Pediatrics 2006 118: 841-842.[Extract] [Full Text]
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