Pediatric influenza burden remains high despite new vaccination recommendations

Jan 13th – Influenza vaccination rates for children aged 6 months to 5 years remained < 45% in the years 2004-2009.

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Image: PD/CDC.

1. Despite new recommendations for expanding coverage, influenza vaccination rates for children aged 6 months to 5 years remained < 45% in the years 2004-2009.

2. Antiviral use was also low during this period.

This study suggests that, despite expanded influenza vaccination recommendations to all children > 6 months, vaccination remained low and disease burden remained high during the seasonal epidemics of 2004 to 2009. Additionally, use of antivirals among children aged 6 months to 5 years remained limited during the study period. These data suggest that greater effort to disseminate and increase uptake of the updated influenza vaccination recommendations may be necessary.

Click to read the study in Pediatrics

 

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Image: PD/CDC.

1. Despite new recommendations for expanding coverage, influenza vaccination rates for children aged 6 months to 5 years remained < 45% in the years 2004-2009.

2. Antiviral use was also low during this period.

Primer: The influenza virus is responsible for winter outbreaks of respiratory illness in temperate climates worldwide. Disease incidence varies yearly, but the majority of influenza is uncomplicated and self-limiting. Among young children, however, influenza is linked to a significant social burden (school absence, clinic office visits requiring parental work absence), as well as to medical complications including otitis media, pneumonia, and secondary bacterial infection, and increased mortality. The CDC Advisory Committee on Immunization Practice (ACIP) previously recommended influenza vaccination only for children > 6 months with an underlying medical condition. In 2009 this was expanded to all children > 6 months. This paper evaluates the healthcare burden of influenza outbreaks among children aged 6 months to 5 years in the years 2004-2009 with a specific focus on vaccination, diagnostic testing, and antiviral use. Oseltamivir, though not necessary, can shorten the duration of influenza symptoms.

Background reading:

1.  Up To Date: Clinical features and diagnosis of seasonal influenza in children

2. ACIP 2008 Influenza Vaccination Recommendations

This [cross-sectional] study: enrolled 8,588 children aged < 5 years in three US counties who presented with acute respiratory symptoms and/or fever to either the emergency department or outpatient clinic during the influenza season (November-April) from 2004 to 2009. The average influenza admission rate was 0.58 per 1000 with discharge diagnosis of influenza ranging from 30 to 44% for the study population. Overall, < 45% of eligible children were vaccinated during the study period. Influenza vaccination rates only increased in clinic-based participants from 2004 through 2009. Finally, although 43% of influenza patients were admitted within 48 hours of symptom onset, antivirals were infrequently administered (only to 2%).

In sum: This study suggests that, despite expanded influenza vaccination recommendations to all children > 6 months, vaccination remained low and disease burden remained high during the seasonal epidemics of 2004 to 2009. Additionally, use of antivirals among children aged 6 months to 5 years remained limited during the study period. These data suggest that greater effort to disseminate and increase uptake of the updated influenza vaccination recommendations may be necessary.

Click to read the study in Pediatrics

 

By [EH] and [DB]

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Emilia Hermann: Emilia is a 3rd year MD candidate at the University of Pennsylvania.

 

 

 

 

Devika Bhushan: Devika is a 4th year M.D. candidate at Harvard Medical School.

 

 

 

 

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