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Flu Vaccine May Be Especially Good Idea for Kids

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WebMD Health News

Jan. 26, 2000 (Los Angeles) -- Should you vaccinate your child against the flu? Two new studies suggest that the flu puts a significant number of children in the hospital each year, but the researchers raise important questions about the logistics and ultimate value of having each child vaccinated.

"It is difficult to make policy for the entire country," investigator Kathleen Neuzil, MD, MPH, tells WebMD. "As a parent, I immunize my children, but each individual parent must make their own decisions. I'm not willing to say that we should give all children the flu vaccine."

Noting that parents and doctors may see the flu as a relatively benign disease, Neuzil and her colleagues studied healthy children in Tennessee who were under the age of 15 to determine the rates of hospitalization for respiratory conditions, outpatient visits, and courses of antibiotics that could be attributed to the flu over 19 consecutive years.

The researchers found that 104 hospitalizations annually per 10,000 children younger than 6 months old were linked to the flu virus. In children aged 6-12 months, 50 hospitalizations per 10,000 children occurred due to influenza. The number of hospitalizations due to the flu continued to decrease in the older age groups examined, with 4 hospitalizations per 10,000 kids occurring in those ages 5-14.

The researchers also found that a significant number of doctors' visits and courses of antibiotics -- which treat bacterial infections and do not work on viruses, such as the flu -- were attributable to influenza. Approximately 10% of all outpatient visits were due to the flu, and approximately 5% of all courses of antibiotics prescribed were given to kids with the flu.

Hector S. Izurieta, MD, and his colleagues at the CDC obtained similar results in a study they performed on children living in Washington state and northern California. The rates of excess hospitalization "were approximately 12 times as high [among children younger than 6 months] as the rates among children ... who were 5-17 years of age," they write.

According to Neuzil, an infectious disease specialist and assistant professor of medicine at the University of Washington in Seattle, the children in this study came from a higher socioeconomic background than those in Tennessee. The results of both studies are published in the Jan. 27 issue of The New England Journal of Medicine.

In an editorial accompanying the two reports, Kenneth McIntosh, MD, and Tracy Lieu, MD, MPH, write that the validity of studies like these hinges on the investigators' ability to distinguish the effects of the flu from those of another, more serious disease: respiratory syncytial virus (RSV). "Both studies, but particularly that of Izurieta and colleagues, leave considerable uncertainty about whether influenza is responsible for all, or even most, of the excess morbidity that is attributable to it," they write. And even if it is, they write, "at most, only 20% of the excess number of hospitalizations in winter were attributed to influenza infection." In other words, these studies do not prove that all of the excess hospital stays were due to the flu. Unfortunately, this leaves unanswered the real question: Is it worth the extra time and stress to give your child the flu vaccine?

McIntosh and Lieu have a valid point, says Neuzil. "We have to realize that these are estimates and must be careful how we use these data. We've identified the risk of a disease. Now we need to look at the second half of the equation: Is giving everyone a vaccine a benefit? That study still needs to be done," she says. "[But] parents should recognize that very young children can get sick from influenza. This is not a minor disease."

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