Health

Should the Flu Shot Priority Level for Preschoolers be Expanded?

By Marilyn Clark, League City Area News Online

December 9, 2005

A study recently completed at Harvard Medical School and Children’s Hospital Boston suggests that toddlers and preschoolers may drive flu (influenza) outbreaks and that preschoolers should be added to the flu vaccination priority list.

“This flu season we will be watching the 3 and 4-year-olds very closely, since they serve as sentinels and predict future flu activity, three weeks in advance,” said Dr. John Brownstein, lead author of the study reported in the Oct. 1 issue of the “Journal of Epidemiology” and faculty member of the Children’s Hospital informatics program at the Harvard-MIT Health Sciences and Technology program.

Researchers analyzed medical visits in the Greater Boston area between 2000 and 2004 and found that children with respiratory infections came in for medical care, as soon as late September, followed by children 0-2 years old, one to two weeks later.

They reported that the Centers for Disease Control and Prevention database showed that medical visits by children 0-2 years old, followed closely by 3 to 4-year-olds, correlated the best with death from the flu and that this data may indicate that infants, toddlers and preschoolers are important spreaders of infection to those most vulnerable to the flu — the very young and the very old.

“The data makes sense because preschools and daycares, with their close quarters, are hotbeds of infection,” said Brownstein. “The data suggests that when kids are sneezing, the elderly begin to die.”

“The CDC estimates that annually, 5 to 20 percent of the population become infected with influenza, with approximately 36,000 deaths and 200,000 hospitalizations,” said Christine Pearson, public affairs officer for the CDC.

Current flu vaccination programs focus on people who are at high risk: senior citizens, children 6 to 23 months, and those with chronic health problems said senior investigator Dr. Kenneth Mandl, a physician in the Children’s Department of Emergency Medicine and an informatics program faculty member.

Mandl and Brownstein suggest expanding the flu vaccination priority list to include children from 6 months old through 4 years old, especially if the avian flu becomes pandemic to increase protection for high-risk people and the general populace.

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