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AAP Recommends Flu Vaccine For All Children and All Health Care Workers

9/7/2015

As flu season approaches, the American Academy of Pediatrics (AAP) urges annual flu vaccine to protect children from this common and unpredictable virus, which can cause serious health problems for otherwise healthy children. The AAP also reaffirms its support for mandatory influenza vaccination for all health care workers nationwide.

The updated recommendations from the AAP are contained in two policy statements in the October 2015 Pediatrics. The statements, “Recommendation for Prevention and Control of Influenza in Children, 2015-2016” and “Influenza Immunization for All Health Care Personnel: Keep It Mandatory,” will be published online Sept. 7.

“Flu vaccine is the best way we have to protect children against this virus,” said Henry Bernstein, DO, MHCM, FAAP, author of both policy statements. “The flu virus is unpredictable. We cannot always anticipate how severely it will affect different groups of people. Being immunized with the flu vaccine every year significantly reduces the risk of your child being hospitalized due to flu, and it protects other vulnerable members of your family and community.”
 
In previous years, an estimated 90 percent of pediatric deaths have occurred in unvaccinated children. During the 2014-2015 flu season, 145 children died from influenza-related illness, and many of these children had no underlying medical condition.

“Parents must consider flu vaccine an essential vaccine for their children,” said pediatrician Wendy Sue Swanson, MD, MBE, FAAP, a spokesperson for the AAP. “Now is the time to call your pediatrician and make an appointment, or find out when flu clinics start. Flu vaccine is a critically important, every-year vaccine that can protect your child from very serious illness and death due to a virus that is so often common in our communities, and so common in childhood.”

The flu season may start early in the fall or winter, have more than one disease peak and extend into late spring, so the AAP urges parents to seek the earliest opportunity to have their children immunized.

Two types of influenza vaccines are available for children:
  • The inactivated influenza vaccine (IIV) is given by injection and is approved for children 6 months of age and older. It is available as a trivalent vaccine, which protects against three strains of the flu virus, and as a quadrivalent vaccine, which protects against four strains.

  • Also available is the quadrivalent live attenuated influenza vaccine (LAIV), which is given by intranasal spray and is approved for healthy patients 2 through 49 years of age.
“Parents should not delay immunization in order to receive a specific vaccine,” Dr. Bernstein said. “It’s more important to have children vaccinated as early as possible so they are protected.”
 
The AAP also recommends:
  • Everyone who is 6 months of age and older should receive annual influenza vaccine.

  • Children ages 6 months through 8 years need two doses this flu season, if they have had less than 2 doses of flu vaccine before July 2015.

  • Special efforts should be made to vaccinate household contacts and out-of-home caregivers of children with high-risk conditions, and all children under the age of 5.

  • Parents should not delay immunization in order to receive a specific vaccine formulation. It is more important to be vaccinated at the earliest opportunity.

  • Pregnant women, who are at high risk of influenza complications, can safely receive influenza vaccine at any time during pregnancy. This also provides protection for their infants during their first 6 months of life.

  • Mandatory influenza immunization programs for all health care personnel should be implemented nationwide.
In the 2013-14 influenza season, 75 percent of health care personnel were immunized against influenza. This represents significant improvement compared to 2009 – before many health care systems began making the vaccine mandatory for health care workers – but it remains below the Healthy People 2020 objective of 90 percent coverage. Voluntary immunization programs are less effective than mandated vaccination; coverage among health care workers whose employers mandate the vaccine has exceeded 94 percent.

Many people at high-risk of influenza and its associated complications are in frequent, close contact with health care workers because of their need to seek medical services, and immunizing health care workers will reduce transmission of the virus to these vulnerable patients, according to the AAP.

“Employees of health care institutions have an ethical and professional obligation to act in the best interest of their patients’ health,” Dr. Bernstein said. “For the prevention and control of influenza, we must continue to put the health and safety of the patient first.”

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The American Academy of Pediatrics is an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. (www.aap.org)


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