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Study sparks new calls for child flu vaccination

Ministers are facing renewed calls from GP experts for the seasonal flu vaccination programme to be widened to include young children, after a study in North America showed the vaccination cut hospital admissions sharply.

The Department of Health faced intense criticism at the height of last winter's flu crisis for not introducing flu jabs for healthy children. Ministers defended the decision and healthy children – of any age – have not been included in this year's flu vaccination campaign.

But the DH has promised a ‘major review' of the policy for 2012/13, and a GP Government adviser told Pulse the latest evidence, published online in the Canadian Medical Association Journal, made ‘a good case' for its introduction.

A comparison of data on hospital admissions in children in the US – where all healthy children aged six to 18 years are vaccinated – and Canada, where it is recommended children aged two to four years old are immunised but it is not national policy, showed vaccination reduced admissions by up to a third.

Researchers examined data for emergency admissions for influenza-like illness at two paediatric hospitals in Boston and Montréal, for the 2000/01 flu season through to 2008/09, and adjusted for virological factors, seasonal trends and all-cause utilisation of the hospital's emergency departments.

Of 1.4 million visits to the emergency departments of the two hospitals for any reason during the study period, 115,000 were related to influenza-like illness. The adjusted models estimated a 34% decline in rates of flu among immunised children aged two to four years old, and falls of 11% to 18% for other age groups.

Dr Doug Fleming, director of the RCGP's flu research unit and a member of the Joint Committee on Vaccination and Immunisation's flu sub-group, said: ‘This group is disproportionately affected. But what this paper does not address is what proportion of admissions is down to other viruses. There's a good case for vaccinating young children and it certainly on the sub-committee's agenda.

Dr George Kassianos, a GP in Bracknell, Berkshire, and RCGP spokesperson for immunisation, said: ‘This and a plethora of more evidence supporting the same, surely should allow the JCVI to do the right thing and recommend introduction of flu vaccination for children. This can only be a win-win situation for children, parents, schools, the elderly and the NHS as a whole.'

A DH spokesperson: ‘The JCVI will keep its advice under review. Later this year, the committee will consider a Health Protection Agency study on the impact of the seasonal flu vaccination programme and possible extensions to it.'

Reductions in hospital admissions

Age group                   Reduction*

0-1                               11%

2-4                               34%

5-9                               18%

10-18                           18%

(*Adjusted rate ratio)

CMAJ 2011, online September 19

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