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Panel: All Kids Should Get Flu Vaccine
Feb. 27, 2008 -- Every child aged 6 months to 18 years should get a yearly flu vaccine, the CDC's immunization advisory panel said today.
What's more, the Advisory Committee on Immunization Practices (ACIP) panel sent a strong signal that it is ready to recommend annual flu vaccination for everyone.
ACIP Chairman Dale Morse, MD, director of the office of science and public health at the New York State Department of Health, officially asked an ACIP subcommittee to come up with a proposal for universal flu vaccination "within the year."
A vote on that proposal could come as soon as the ACIP's next scheduled meeting this June.
Today's vote to immediately extend childhood flu vaccination came as something of a surprise. The ACIP subcommittee charged with coming up with the recommendation originally proposed that the change take place during the 2009-2010 flu season.
"Most of our working-group members felt that waiting until 2009 would better allow for planning, as many providers already have ordered their vaccine for the 2008-2009 flu season," said committee chairwoman Kathleen Neuzil, MD, MPH, clinical associate professor at the University of Washington, Seattle.
But the full panel apparently was swayed by arguments such as the one made by Carol J. Baker, MD, professor of pediatrics at Baylor College of Medicine. Baker noted that doctors have managed to fully vaccinate only half of kids aged 6 months to 23 months, despite the high risk of serious flu complications in that age group.
"The argument is that practitioners need time to prepare. Well, they have had three years to for the 6-month-old to 23-month-old kids, and they are not yet there," Baker said. "We are not getting the job done."
When it was time for a vote, Baker surprised many of her fellow panel members by moving to immediately recommend annual flu vaccination for all kids. She accepted amended language that gives health authorities until 2009 to implement child vaccination programs. Her proposal passed by a 10-0 vote, with two abstentions.
The panel's advice does not include plans for how all children are to be vaccinated. State and local authorities likely will implement school-based immunization programs.
The recommendation to vaccinate all kids against influenza is based on a perceived benefit for children. Data presented at today's ACIP meeting showed that though children younger than 2 months of age are most at risk of flu complications, older kids are more likely to get the flu.
"Studies clearly show the burden of flu illness is actually highest in the 5- to14-year-old group," said CDC flu expert Anthony Fiore, MD. "Even though the burden of hospitalizations and deaths is highest in the under-5-years and under-2-years groups, the highest rates of illness are in the older age groups."
Despite moving forward more quickly with extending childhood flu vaccine recommendations, some medical experts attending the ACIP meeting were frustrated at the slow progress toward a universal recommendation.
One such expert is Gregory Poland, MD, the American College of Physicians representative to the ACIP. Poland is professor of infectious diseases at Mayo Medical School.
"Whether a 17-year-old brings flu into the home of a person at high risk, or a 34-year-old office worker or a 50-year-old frequent flyer, it is the same," Poland said. "We should make a recommendation for universal flu vaccination. You cannot leap a chasm in two leaps. This creeping incrementalism fosters confusion."
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