January 14, 2013
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Influenza vaccination rates remain lower than expected

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Despite recommendations that all children aged at least 6 months should be immunized against influenza, data from 2004 to 2009 indicate lower-than-expected coverage rates.

Katherine A. Poehling, MD, MPH, of the department of pediatrics, Wake Forest School of Medicine, Winston-Salem, N.C., and colleagues from the New Vaccine Surveillance Network concluded that seasonal influenza remains an important cause of hospitalizations, ED visits and outpatient visits among children. In addition, the use of vaccination and antiviral medications were substantially underused.

The researchers analyzed population-based surveillance data on laboratory-confirmed influenza among children aged younger than 5 years during those years. Data from more than 8,000 children seen in inpatient and clinic settings, as well as EDs, were included in the analysis.

During the five study seasons, fewer than 45% of influenza-negative children aged 6 months and older were fully vaccinated against influenza. The study findings also indicated that single-season influenza hospitalization rates were 0.4 to 1.0 per 1,000 children aged younger than 5 years; hospitalization rates were highest for infants aged younger than 6 months.

The proportion of outpatient children with influenza ranged from 10% to 25% annually.

The researchers said testing for influenza among outpatients was low (approximately 7%), but higher in inpatient settings (approximately 58%). Rates of antiviral use were similar for inpatients, at 1% for outpatients, and 2% for children hospitalized with influenza.

“Additional efforts are needed for greater dissemination and use of the existing recommendations for influenza vaccination of children ≥6 months and of pregnant women, which partially protects younger infants,” the study researchers concluded.

The Advisory Committee on Immunization Practices expanded influenza vaccination recommendations from children aged 6 months and older with underlying medical conditions, to all children aged 6 to 23 months in 2004. In 2006, the recommendation changed to all children aged 6 to 59 months and then to all children aged 6 months and older in 2008.

“Both this study and the current influenza season highlight the burden of influenza among children and the importance of influenza vaccination to protect children and their families,” Poehling told Infectious Disease News.

Disclosure: Poehling reports receiving research support from BD Diagnostics.

Katherine A. Poehling, MD, MPH, can be reached at Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, at kpoehlin@wakehealth.edu.