Influenza vaccination for children 6 months through 18 years of age

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A panel of immunization experts voted to expand the recommended ages for annual influenza vaccination of children to include all children from 6 months through 18 years of age. The previous recommendation was for vaccination of children from 6 months to 59 months of age.

The expanded recommendation is to take effect as soon as feasible, but no later than the 2009 ? 2010 influenza season.

The Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC) on vaccine issues, voted on the new recommendation during its February 27-28, 2008 meeting in Atlanta. The new recommendation increases the number of children recommended for vaccination by approximately 30 million.

Studies have shown that healthy children bear a significant burden from influenza disease and are at increased risk of needing influenza-related medical care. In addition, there is evidence showing that reducing influenza transmission among children has the potential to reduce influenza among their household contacts and within the community.

“This new recommendation should reduce the risk of influenza infections among children of all ages, and their consequent need for medical visits and missed time from school,” said Dr. Anne Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases. Full implementation by Fall 2009 at the latest will allow time to plan for the vaccination of this large group of children. However, immunization providers should begin efforts to offer influenza vaccination to all children aged 6 months through 18 years in the 2008-09 influenza season if feasible, consistent with the current recommendation that all persons who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others should be vaccinated.

“This new recommendation will help parents understand that all children can benefit from vaccination and further encourages providers to start vaccination of children through age 18 next year,” said Dr. Schuchat.

The ACIP continues to recommend vaccination of all children who have certain chronic medical conditions such as asthma, diabetes, kidney disease or weakened immune systems. In addition, vaccinating children younger than 5 years old should continue to be a priority because they are at higher risk for more severe influenza complications compared to older children. Household contacts of children younger than 6 months old should be vaccinated because children younger than six months cannot be given influenza vaccine, but they are the pediatric group at highest risk of influenza complications.

In addition, results from a vaccine efficacy study among children 6 months to 23 months of age were presented at the meeting. The study findings indicated vaccine efficacy of about 75 percent in preventing influenza hospitalizations among fully vaccinated children in this age group during the 2005-06 and 2006-07 seasons. In contrast, the study found that children who received only one dose of vaccine did not receive statistically significant protection. This new data underscores the importance of existing ACIP recommendation that children younger than nine years of age who will be receiving the influenza vaccine for the first time need two doses.

The 2008-09 influenza vaccine for the United States will include three new strains: an A/Brisbane/10/2007 (H3N2)-like virus, a B/Florida/4/2006-like virus and A/Brisbane/59/2007 (H1N1)-like virus strain. The H3N2 and B virus vaccine components in the U.S. vaccine are included in the 2008 vaccine for the Southern Hemisphere. Influenza vaccine manufacturers produced as many as 130 million doses of influenza vaccine for the 2007-08 influenza season and have discussed expanding current production capacity in the coming years.

Recommendations of the ACIP become recommendations of CDC once they are accepted by the director of CDC and the Secretary of Health and Human Services and are published in the Morbidity and Mortality Weekly Report.

Source: Centers for Disease Control and Prevention, USA


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