CDC recommends flu shots for toddlers

Apr 30, 2004 (CIDRAP News) – It's official: federal health authorities say that from now on, all children between the ages of 6 months and 23 months should receive an annual influenza shot.

Previously, flu shots were "encouraged" for all children in this age-group because of their increased risk of flu-related hospitalization. The new children's immunization schedule from the Centers for Disease Control and Prevention (CDC) changes the encouragement to a recommendation.

The CDC's Advisory Committee on Immunization Practices (ACIP) voted in favor of the recommendation for 6- to 23-month-olds last October. The CDC published the ACIP's annual recommendations on preventing influenza today, and the revised immunization schedule for children appears in the Apr 30 Morbidity and Mortality Weekly Report.

"Studies have shown that infants and children younger than 2 years old are at increased risk for influenza-related hospitalizations," the CDC said in a news release today. "Preliminary reports of pediatric deaths from influenza during the 2003-04 influenza season indicated that among 143 deaths, 58 were in children younger than two years of age."

"As last year's experience reminds us, many children suffer serious harm from influenza and would benefit from vaccination," said CDC Director Dr. Julie Gerberding. "Influenza vaccination is a simple and effective step parents can take to help protect their children from a potentially life-threatening disease."

The CDC report says babies under a year old are hospitalized for flu-related reasons about as often as people 65 years and older are. The flu-related hospitalization rate for children age up to age 4 and without special risk factors is about 100 per 100,000 children.

The new recommendations also say everyone in close contact with children under 2 years old should receive a flu shot. Flu vaccines are not recommended for babies younger than 6 months because no flu vaccines are licensed for that age-group, the CDC said.

With the addition of the flu shot, the CDC now recommends that children receive a total of 12 immunizations by the age of 2. (The other recommended vaccines are hepatitis B, diphtheria-tetanus-pertussis, Haemophilus influenzae type b, polio, measles-mumps-rubella, varicella, and pneumococcal.)

Children who are receiving their first flu shot (and are younger than 9 years old) should receive it in two doses spaced more than a month apart, the CDC said. Subsequent annual flu vaccinations can be given in one dose.

The CDC continues to recommend an annual flu shot for children older than 23 months if they have certain risk factors, such as asthma, heart disease, sickle cell disease, HIV, or diabetes.

Another change in this year's recommendations pertains to people who care for immunosppressed patients. The CDC says that inactivated flu vaccine is preferred over the live attenuated vaccine (the intranasal vaccine FluMist) for people who are in close contact with severely immunosuppressed patients when those patients require care in a protected environment. Healthcare workers who receive the live attenuated vaccine are advised to avoid contact with severely immunosuppressed patients for 7 days afterward.

See also:

CDC. Prevention and control of influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Early Release, Apr 30, 2004
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr53e430a1.htm

CDC. Recommended childhood and adolescent immunization schedule—United States, July-December, 2004. MMWR 2004;53(16)[Full text]

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