COMMENTARY

Flu Vaccine Saves Kids' Lives: What to Tell Reluctant Parents

Brendan Flannery, PhD

Disclosures

September 19, 2017

As a clinician, what do you say to parents faced with the decision of whether to vaccinate their children against influenza? A new study may provide the answer to that question. You can now say, "Did you know that the seasonal influenza vaccine could save a child's life?"

A new study from the Centers for Disease Control and Prevention (CDC)[1] is the first of its kind to show that influenza vaccination reduced children's risk of dying from influenza and its complications. The study, published in Pediatrics, reinforces the CDC Advisory Committee on Immunization Practices' (ACIP's) and the American Academy of Pediatrics' (AAP's) recommendation that all children aged 6 months or older be vaccinated with the seasonal influenza vaccine each year. The findings of this study may prove helpful for conversations with parents unsure about whether to have their child vaccinated against influenza.

Researchers found that US children who died from influenza-related illness were less likely to have received an influenza vaccination. During the 4-year study period (2010-2014), influenza vaccination status was determined for 291 of 358 influenza-associated pediatric deaths in the United States reported to the CDC. Among the children who died, only 75 (26%) received influenza vaccine before becoming ill. This contrasts with influenza vaccine coverage of 48% among all children in the United States. Among the 153 pediatric deaths that occurred in children with an underlying high-risk medical condition, only 47 (31%) had been vaccinated, compared with 47% of all US children with high-risk conditions.

The study showed that influenza vaccination offered significant protection against death among children aged 6 months to 17 years, across several influenza seasons and infecting influenza virus types. Overall vaccine effectiveness against influenza-associated pediatric deaths in this study was 65% (95% confidence interval [CI], 54%-74%). In other words, on average, children who died from influenza were two thirds less likely to have been vaccinated than similarly aged children in the United States. The study also showed that this protection extended to children with underlying medical conditions. Vaccine effectiveness against influenza-associated death for children with high-risk medical conditions was 51% (95% CI, 31%-67%).

These findings reinforce the importance of annual influenza vaccination, and of improving influenza vaccine coverage among US children. For years, CDC, ACIP, and AAP have recommended a yearly influenza vaccination as the first and most important step in protecting children against influenza.

Some final take-home points:

  • CDC recommends that children and adults receive an influenza vaccine by the end of October if possible. However, as long as flu viruses are circulating, vaccination should continue throughout the flu season (January or later).

  • Again for the 2017-2018 season, CDC recommends use of injectable influenza vaccines only. CDC does not prefer one injectable influenza vaccine over another. However, we continue to recommend against the use of the live attenuated influenza vaccine (LAIV), also known as the "nasal spray flu vaccine," because of concerns about how well it works.

  • Previously unvaccinated children aged 6 months to younger than 9 years need two doses of influenza vaccine spaced 1 month apart when receiving influenza vaccine for the first time.

Influenza can be fatal, even in healthy children. Less than one third of the children who died with confirmed influenza had been vaccinated, and vaccination rates among adolescents and children without high-risk conditions were even lower. Increasing influenza vaccine coverage can save more children's lives. Please share this study's findings with colleagues, including nursing staff and those involved in administering influenza vaccine to children. CDC's and ACIP's influenza vaccine recommendations for the 2017-2018 season are now available.

For more information, including updates on influenza activity this season, see CDC's influenza website at www.cdc.gov/flu.

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