Call for increase in flu vaccination among young children

Authors of a review in the February issue of THE LANCET INFECTIOUS DISEASES conclude that current research supports a widening of influenza vaccination to specific groups of young children-including infants between six months and two years of age, children with recurrent ear infection or upper respiratory-tract infection, and healthy children attending day-care centres or elementary school.

Recent studies have suggested that paediatric influenza is a greater medical problem than usually thought because it can cause excess hospitalisations, medical visits, and antibiotic prescriptions even in healthy children, especially those under 2 years. Furthermore, influenza in otherwise healthy children may have substantial socioeconomic consequences for the children and their household contacts.

Nicola Principi and Susanna Esposito from the University of Milan, Italy, review the current research into paediatric influenza vaccination and of the logistical and economic considerations that will influence the implementation of more widespread vaccination programmes.

Outlining the main conclusions of the review, Nicola Principi comments: "Increased efforts are needed to identify and recall high-risk children because their rate of vaccination coverage is still much lower than it should be. Second, the immunisation of infants aged 6-23 months and their close contacts should be encouraged as much as possible because of the substantially increased risk of influenza-related hospitalisations. Third, children with recurrent acute otitis media [middle-ear infection] or respiratory-tract infections, and healthy children attending day-care centres or elementary schools, should be included among the paediatric groups requiring vaccination to reduce the direct and indirect costs of influenza in the children themselves and their unvaccinated household contacts.

Susanna Esposito adds: "The issues that need to be addressed include educating physicians and parents about influenza-related morbidity, the safety and cost-effectiveness of licensed vaccines, the adequacy of vaccine supplies, and the availability of intranasal products insofar as the greater compliance to nasal administration should make it possible to increase the use of influenza vaccination."

Contact: Dr Nicola Principi, Paediatric Department University of Milan, Via Commenda 9, 20122 Milan, Italy; T): 39-3356-561739; E): Nicola.Principi@unimi.it.

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