ATLANTA (AP) - All children - not just those under 5 - should
get vaccinated against the flu, a federal advisory panel said
The panel voted to expand annual flu shots to virtually all
children except infants younger than 6 months and those with
serious egg allergies.
That means about 30 million more children could be getting
vaccinated. If heeded, it would be one of the largest expansions in
flu vaccination coverage in U.S. history. The flu vaccine has been
available since the 1940s.
The Advisory Committee on Immunization Practices said all
children should start getting vaccinated as soon as possible,
acknowledging that many doctors have already ordered their vaccine
for the 2008-2009 season and may not be able to give the shots
until 2009-2010. The flu season generally starts in the fall and
continues through spring.
The panel's advice is routinely adopted by the Centers for
Disease Control and Prevention, which issues vaccination guidelines
to doctors and hospitals.
Flu shots were already recommended for those considered to be at
highest risk of death or serious illness from the flu, including
children ages 6 months to 5 years, adults 50 and older, and people
with weakened immune systems
The panel said that should be expanded to include children up to
Children ages 5 to 18 get flu at higher rates than other age
groups, but they don't tend to get as sick. Of the 36,000 estimated
annual deaths attributed to the flu, only 25 to 50 occur in
children in that age bracket, CDC officials said.
But children who stay home sick from school cause parents to
stay home, so reducing the illness in this group should cut down
days of lost work, some experts said.
Experts believe giving flu shots to more children may also
prevent the illness from spreading to adults and the elderly,
although studies haven't clearly established that will happen.
Shots are not the only option. A nasal spray vaccine, FluMist,
is approved for healthy people ages 2 to 49.
Panel members waffled a bit on whether to make the
recommendations kick in immediately. Some public health
professionals pushed them to make the clearest endorsement possible
of the flu vaccine, concerned that the public is losing faith in
flu shots because this year's vaccine was not well matched to
Indeed, a few argued that the committee should recommend flu
shots for every healthy person, rather than adding another set of
children now and maybe young adults in a few years.
"Creeping incrementalism, I believe, continues to foster
confusion" about who should get the shot and how important it is,
said Dr. Gregory Poland, a Mayo Clinic infectious diseases expert.
The head of the panel, Dr. Dale Morse, asked for a report on
universal vaccination of adults.
Meanwhile, vaccine makers said they expect to be able to produce
enough doses next season to accommodate an extra 30 million
children, but panel members had concerns about how the doses would
be given to so many.
There's no other vaccine that's given to nearly all kids every
year. Most schools aren't set up to do it, and physicians groups
said they weren't sure if doctors were ready to handle a flood of
children seeking vaccinations every year.
"This is the only vaccination that pediatricians in my
community don't want to have to give," said Dr. Carol Baker, a
Baylor College of Medicine professor who sits on the panel.
Baker said she still felt the recommendation should go into
effect for the next flu season. But groups representing
pediatricians and family physicians said they wanted more time to
plan for a possible crush.
Maybe they shouldn't worry. Some experts noted that only a
fraction of people recommended to get flu vaccinations actually go
through with it.
"We probably will need to have low expectations for coverage in
the first few years of implementation" of the ages 5-through-18
recommendation, said Dr. Tomy Fiore, a CDC epidemiologist.
Before the vote, the panel heard a presentation of a study that
found the vaccine was 75 percent effective in preventing
hospitalizations from the flu in children 6 months to 23 months.
"We haven't had data showing prevention of severe outcomes like
that in that age group before," Fiore said.
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(Copyright 2008 by The Associated Press. All Rights Reserved.)