Why your child needs a flu shot

[Guest guest]

Opinion: Why your child needs a flu shot

By Marc Siegel Tue Dec 5, 6:32 AM ET

With the approach of flu season, I, like every other practicing

internist, usually focus on giving flu shots to the elderly, thousands

of whom die each year from the virus. But this year, I've had reason

to expand my approach.

The Centers for Disease Control and Prevention has only in the past

few years begun to recommend shots for children ages6 months to 2

years. Now the

CDC says kids up to 5 years old should be inoculated, and it has

indicated that within a few years, the recommendation might include

all school-age children. Why the change? Recent studies, including one

by Poehling at Vanderbilt University School of Medicine,

have shown that children younger than 5 have been contracting and

spreading the flu at prodigious rates. So the danger is twofold: to

the child and to the greater community.

The risks to the young are like those faced by seniors. The immune

system might be overwhelmed from fighting the flu and made more

susceptible to powerful bacteria that cause pneumonia, sinus and ear

infections. This is especially true for very young children who don't

yet have fully developed immune systems, children with chronic

illnesses, or the elderly, in whom the immune system is often worn down.

Jeanne Santoli, a pediatrician and deputy director of the Immunization

Services Division at the CDC, told me that " children under 2 are

nearly as likely to be hospitalized from complications due to

influenza as those aged 65 and older. " In fact, the rate of urgent

care visits for flu and its related illnesses for kids ages 2 to 5 is

higher than for any other disease.

About 36,000 Americans die each year from the flu, and 200,000 are

hospitalized. Though a relatively small number of the deaths - 100 -

are children 5 or younger, 20,000 hospitalizations include children in

this age group. Inoculating children won't end this annual misery, but

if more kids receive the vaccine, the impact of the flu virus could be

softened considerably.

Compliance problems

So parents, armed with this information, are eager to get flu shots

for their kids, right? Actually, that hasn't been the case. According

to last year's national Behavioral Risk Factor survey, only 48% of

children in the 6 months to 2-year-old category received a flu shot.

The underutilization of the flu shot is an unfortunate, though perhaps

explainable, phenomenon:

•Thimerosal The use of this unnecessary mercury-based preservative in

some childhood vaccines has given parents and some consumer groups

pause. In fact, several states have banned vaccines that use

thimerosal, despite the fact that the CDC, the American Academy of

Pediatrics and other health advocacy groups say there is no proof that

the small amounts of mercury used in vaccines are harmful to children.

•Efficacy In addition, the flu shot's effectiveness in children has

been questioned. Indeed, recent studies have indicated that the shot

might be less effective in children younger than 2 because of weaker

immune reactions. Two shots appear to be necessary to achieve

comparable results. Does this mean these children shouldn't receive

the shot - or shots? No, it means parents and the children's doctors

need to be vigilant in ensuring that these infants build up the

required immunity. As for older children, the flu vaccine has proved

highly effective. A 2001 study in the Journal of Pediatric Infectious

Diseases showed a 77%-91% effectiveness against influenza in

inoculated children ages 1-15.

•Adverse reactions. A recent report in the

Journal of the American Medical Association studied the side effects

of flu shots on 45,000 children younger than 2 and found no

significant problems. There were no increased doctor's visits or

hospitalizations. Likewise, for children older than 2, no reports of

substantial side effects have been documented.

•Myths. The National Foundation of Infectious Diseases found that

nearly half of the people surveyed this year believed erroneously that

the flu vaccine, which uses a dead virus, can cause influenza. Another

myth: A shot must be administered by November for it to be effective

during the flu season, which generally runs from October through May.

Because it takes less than a month for most patients to develop

antibodies, and because flu season tends to peak in most parts of the

USA in January, December is still a reasonable time to get the shot.

What we do know

Ultimately, what it comes down to for parents is weighing the known

benefits of receiving the flu shot against the perceived risks.

We know that children younger than 2 are at great risk of being harmed

by the flu virus.

We know that these children often come into contact with other

children and, therefore, are exposed to great risks of transmission,

even within one's own family.

We know that more children generally die from flu than from chicken

pox, whooping cough and measles combined.

We know that the CDC and other reputable organizations have weighed

these risks and have still recommended that children 5 and younger

receive the flu shot.

As a father of three young children, I understand the instinct to

protect your child. But medical evidence clearly shows that benefits

of the flu shot outweigh any known risks. If you still have doubts or

concerns, ask your doctor.

Flu shots and parents have one thing in common: They are both designed

to protect.

Marc Siegel is an associate professor of medicine at New York

University School of Medicine and author of Bird Flu: Everything You

Need to Know About the Next Pandemic. He is also a member of USA

TODAY's board of contributors.

http://news./s/usatoday/20061205/cm_usatoday/whyyourchildneedsaflushot