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Flu vaccine scrutiny stepped up as focus turns to young

By Cato Pedder

Official monitoring of influenza vaccine uptake in younger patients is set to be launched next winter after the most recent data suggested GPs are immunising as few as one in 20 at-risk children.

Scientists at the Health Protection Agency see monitoring as the precursor to setting a national uptake target in at-risk under-65s.

The news comes as figures released by the Department of Health showed GPs reached the 70 per cent immunisation target for over-65s this winter.

By the end of December 70.8 per cent of over-65s had been vaccinated ­ well beyond the 68.4 per cent level reached at the same stage the previous winter.

But experts have expressed fears that younger at-risk patients are being neglected as GPs focus their efforts on the high-profile campaign to vaccinate the elderly.

The department recommends vaccinating at-risk

under-65s and GPs are paid an item-of-service fee for doing so. But the agency said the latest available data ­ covering 1999/2000 ­ suggested just 4.6 per cent of children in at-risk groups are immunised.

Dr Carol Joseph, clinical scientist at the agency's communicable disease surveillance centre, said: 'Uptake doesn't take off until adults over 50. All the other at-risk groups below that age have low rates of uptake. The plan is to start monitoring next year. This year people have been asking for the figures and we didn't know them.'

She said the uptake target for at-risk under-65s would have to be much lower than for the over-65s as identifying eligible patients was much more difficult for GPs.

A department spokesman said: 'With GPs this year setting up disease-based registers, it will help to identify the number of children in at-risk groups who we need to target.'

The issue came under the spotlight this winter because children were particularly vulnerable to the new Fujian H3N2 flu strain. Concerns over poor vaccine uptake led the agency, the RCGP and the Royal College of Paediatrics and Child Health to join forces and issue a statement encouraging urgent immunisation of children in at-risk categories.

The Joint Committee on Vaccination and Immunisation will meet in the spring to debate the cost-effectiveness of mass vaccination of healthy under-65s.

This winter's flu vaccine 'was ineffective'

This winter's influenza vaccine may have conferred little or no protection against flu, according to a study from the US Centers for Disease Control and Prevention (CDC).

Dr Susan Dolan and colleagues asked more than 1,800 health workers at a children's hospital, 71 per cent of whom had been vaccinated, if they had had a flu-like illness, defined as a fever with a sore throat or cough.

The researchers' estimates of the vaccine's effectiveness against influenza-like illness ­ calculated as the attack rate in the vaccinated group/attack rate in unvaccinated group ­ ranged from 3-14 per cent.

The results reported in the CDC's Morbidity and Mortality Weekly Report cast further doubt on the suitability of the strains selected for the vaccine, although researchers said it may have been more

effective against laboratory-confirmed influenza.

The Health Protection Agency said the Panama strain in the vaccine gave some protection against the Fujian flu that was predominant this winter.

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