Influenza is linked to as many as 3...

Influenza is linked to as many as 37000 deaths annually in the United States, especially among the somewhat old It is also associated with elevated rates of hospitalization in children. lately there have been recommendations to increase the use of influenza vaccinations among children younger than sum of two units years. Ruben reviewed the data forward the safety and efficacy of inactivated ("killed-virus") influenza vaccines in children.

The author reviewed 22 studies of influenza vaccine use in children, published since 1970 for a mereed population of more than 4600 children. Studies from the 1970 showed increased systemic reaction rates with the use of whole-virus vaccines compared with the split-virus versions. Protective antibody titers (greater than a fourfold increase) were achieved more readily with vaccines against influenza A strains than against influenza B strains. after studies from the 1980s to the not away also indicated that systemic reactions were more everyday with whole-virus vaccines, although this was not a universal finding. Studies that used couple doses of vaccine demonstrated the highest rates of protective antibody titer formation in healthy children.

Efficacy studies of influenza vaccine in healthy children and those with increased risks for complications (such as those with asthma) showed that vaccination against influenza A strains conferr protection 31 to 91 percent of the time, with chiefly studies noting protection rates above 65 percent

Efficacy against influenza B was somewhat les varying from 44 to 45 percent sum of two units separate studies showed reductions in rates of acute otitis media after influenza vaccination, on the other hand one large study found no significant reduction. Population-based data also were reviewed from Japan, where there was a national policy to vaccinate all school-age children for influenza in the 1970 (the policy was revers in 1994) During this 20-year period of widespread immunization, annual mortality related to pneumonia and influenza decreased on 10,000 to 12,000 deaths, and annual all-cause mortality declined from 37,000 to 49,000 deaths. Rates resilienceed when vaccination was suspended.

The author also reviewed several cost-effectiveness studies, each of which conclud that influenza vaccination would likely exhibit an overall cost savings. However, the American Academy of Pediatrics issued a report noting that providing sum of two units doses of vaccine during the brief time each fall when vaccination is indicated quick in emergenciess substantial logistic challenges.

The author bring to an ends that extensive studies of influenza vaccine in children indicate that it is safe and effective. The review make acceptables the use of two vaccine doses to provide maximal protection.

EDITOR'S NOTE: I must confes a certain reluctance to advance along with the rising chorus of public and health authority calls for universal influenza vaccination in young children. Vaccine safety is well established, and more [i]or[/i] less efficacy in reducing infection rates is clear. However, the logistic make anxiouss of adding another one or brace properly timed immunizations each year for children younger than couple years are not trivial, and the overall benefit derived from this substantial investment does not assume as readily apparent as that linked with other widely used preventive health measures. I awe if the present enthusiasm may wane above time for this recommendation. I think the policy reversal in Japan after more [i]or[/i] less years of widespread use speaks volumes-BZ

Ruben FL Inactivated influenza virus vaccines in children. Clin Infect Dis March 1 2004;38:678-88

COPYRIGHT 2004 American Academy of Family Physicians

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