Wider Flu Vaccination Urged - Target Group Includes Kids Age 2 to 5 and Their Households - then everyone

[Guest guest]

*Wider Flu Vaccination Urged*

Target Group Includes Kids Age 2 to 5 and Their Households

By Brown

Washington Post Staff Writer

Thursday, February 23, 2006; A04

wp-dyn/content/article/2006/02/22/AR2006022202080.html

The committee that sets federal immunization policy recommended

yesterday that children 2 to 5 years old be vaccinated against influenza

every year, expanding the " target population " for flu shots and inching

toward the day when they will be recommended for everyone.

The government had previously recommended yearly flu vaccination only

for children age 6 months to 23 months. The new recommendation also

includes " household contacts " of children between their second and fifth

birthdays. This group -- parents and older siblings not covered by other

recommendations -- outnumbers the children in the new recommendation.

Flu vaccination has been urged for years for everyone older than 50,

with special attention to people over 65 and those with chronic

illnesses. Children older than 6 months with chronic illnesses should

also be immunized.

Although the number of serious illnesses and deaths from flu in the

2-to-5 age group is small, the virus is responsible for much use of

health care and much lost work time by parents, the Advisory Committee

on Immunization Practices found. For that reason alone, it decided,

broader use of the vaccine is justified.

The decision may have secondary benefits, as well. Recent studies show

that vaccinating children may help protect the elderly and chronically

ill, who are at highest risk from flu complications. Children are

principally responsible for spreading the germ, and with less of it

circulating, fewer people will become infected.

Boosting demand for flu shots may also encourage more pharmaceutical

companies to enter the flu vaccine business or expand existing plant

capacity -- both considered important steps in preparing for a possible

pandemic, or global outbreak, of a new flu strain.

The committee is made up of epidemiologists, infectious-disease

specialists and public health officials, most from outside the

government. Its recommendations help determine which children can

receive free vaccine through federal programs, and they are generally

followed by private practitioners as well.

The decision demonstrated " something of a paradigm shift " in the

committee's usual rationale for expanding immunization, said

Schaffner, a physician who is a nonvoting member of the committee. He

represents the National Foundation for Infectious Diseases and the

Infectious Diseases Society of America.

" The committee was persuaded more by the doctor's office visits, the

emergency room visits and the use of antibiotics in this age group, " he

said. " Those considerations played an even larger role than

hospitalizations and deaths in the committee's decision. "

Data presented to the committee, which met at the Atlanta headquarters

of the Centers for Disease Control and Prevention, showed that about 85

out of every 1,000 4-year-olds are taken to a doctor for influenza each

year, and about 65 are prescribed antibiotics.

Antibiotics do not kill influenza virus. It is sometimes difficult,

however, to differentiate flu from bacterial infections that may require

antibiotics.

In the 2003-2004 flu season, 153 children up to age 17 died of confirmed

influenza infection, and 70 percent of them were not in one of the

high-risk categories.

Including healthy children 24 months to 59 months old and the people

they live with will add 16.7 million people to the count of potential

vaccine recipients -- 5.3 million children and 11.4 million household

contacts, said , a CDC epidemiologist.

Children who have never been vaccinated against flu require two shots to

be protected. Consequently, the new recommendation would require 20

million to 30 million more doses of vaccine.

Nobody expects anything close to the entire target population to be

reached in the immediate future. In the flu season a year ago -- the

first in which all children age 6 months to 23 months were supposed to

be vaccinated -- about 48 percent were immunized, according to a

government survey.

The new recommendation was made, in part, on the assurances by vaccine

makers that they could fill the expected demand.

This season, 86 million doses of flu vaccine were made and 81 million

doses have been shipped, said. Manufacturers say they can make 100

million to 120 million doses next year.

Three companies made flu shots this year, and one -- MedImmune, based in

Gaithersburg -- made a nasal-spray vaccine containing live weakened

virus. Next year, a fourth maker of injected vaccine is expected to be

selling flu vaccine in the United States.

[Can a state's National Guard protect militarily against the ACIP? The

notion is increasingly credible. How can we protect ourselves against

the ACIP, the likes of Offitt, local injectors who blindly follow

Vaccinology's Orthodoxy? -]

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