ACIP endorses flu shots for 2-, 3-, and 4-year-olds

Feb 23, 2006 (CIDRAP News) – A federal advisory committee recommended yesterday that children aged 2 through 4 and their household contacts and caregivers get annual influenza shots, a move that increases the number of people included in official flu-immunization recommendations by more than 16 million.

Since 2004 the Centers for Disease Control and Prevention (CDC) has recommended flu shots for children aged 6 to 23 months. Yesterday the CDC's Advisory Committee on Immunization Practices (ACIP) voted to recommend expanding this recommendation to include ages 24 through 59 months (2-, 3-, and 4-year-olds), the CDC announced. ACIP recommendations are routinely adopted by the CDC.

The expanded recommendation will cover about 5.3 million children and 11.4 million household contacts and caregivers, the CDC said in a news release.

"This new recommendation takes into consideration a broader view of the burden of illness than the earlier recommendation for vaccination of children, which was based upon the prevention of hospitalization among children 6 months to 23 months old," the CDC said in a news release today.

Dr. Anne Schuchat, director of the CDC's National Immunization Program, commented in the release, "Vaccination of children 24 to 59 months old will likely reduce the risk of influenza-related complications for all children in this age group, not just those identified as those with the highest risk of complications from influenza."

CDC officials at a flu vaccine conference in Atlanta last month had said they expected a decision this year on recommending flu shots for 2- to 6-year-olds. But a report in the Atlanta Journal-Constitution described the ACIP vote as a "surprise move" that followed a little more than an hour of debate. The panel had planned to vote on whether to "encourage" flu shots for 2- to 5-year-olds, a move that would have no regulatory impact, the story said.

The ACIP heard reports that children 24 to 59 months old with flu are nearly as likely to visit physicians and emergency rooms as children 6 to 23 months old, the CDC said. The committee was told that "rates of medical outpatient visits for influenza-related illnesses are high in all childhood ages."

The Journal-Constitution said the panel was told about unpublished research showing that 1 of every 1,000 children under age 5 is hospitalized for flu each year and another 60 to 164 per 1,000 visit an emergency department or clinic.

The ACIP also seemed to be moved by emotional testimony from Families Fighting Flu, a group of young parents of children who died of the illness, the newspaper reported.

The recommendation will become the standard of practice for physicians caring for young children and will signal insurance programs to pay for the vaccinations, the story noted.

The ACIP continues to "strongly" recommend vaccination of children who have chronic medical conditions such as asthma, diabetes, kidney disease, or weakened immunity, the CDC said.

The panel will continue to consider new flu vaccination strategies, "including the possibility of expanding routine influenza vaccination recommendations to the entire US population," the agency said.

The CDC said manufacturers have indicated that they plan to produce between 100 million and 120 million doses of flu vaccine for the 2006-07 season.

Besides 6- to 23-month-old children, people for whom the CDC already recommends flu immunization because of an increase risk of flu complication include those aged 50 and older, those with certain chronic medical conditions, nursing home residents, children and adolescents on long-term aspirin therapy, and pregnant women. Immunization is also advised for healthcare workers and household contacts and caregivers of people at increased risk for flu complications.

See also:

Feb 23 CDC news release
http://www.cdc.gov/media/pressrel/r060223.htm

CDC flu vaccination recommendations for current season (2005-06)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5408a1.htm

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