CDC notes flu vaccine uptake down a bit in young kids

Child receiving flu shot
Child receiving flu shot

Judy Schmidt / CDC

In an annual event to take stock of seasonal flu vaccination coverage trends and build support for immunization ahead of the upcoming flu season, health officials speaking at a National Foundation for Infectious Diseases (NFID) media briefing today said vaccination levels fell a bit last year in younger children, a worry, given they are at high risk for flu complications.

The 2017-18 flu season was a severe one that led to a record-breaking 900,000 hospitalizations and 80,000 deaths, according to the latest estimates from the US Centers for Disease Control and Prevention (CDC). Of the fatal cases, 180 were in children, the highest ever for a nonpandemic flu year since the CDC began tracking the data in 2004.

US Surgeon General Jerome Adams, MD, MPH, one of the top federal health officials at today's briefing, said, "Last season illustrated what every public health official knows—influenza can be serious in people of all ages, even in the healthiest children and adults. It is critical that we focus national attention on the importance of influenza vaccination to protect as many people as possible every season."

Manufacturers expect to make up to 168 million doses of vaccine for the upcoming flu season, consisting of a range of options that includes the return of FluMist, the live-attenuated nasal-spray vaccine.

Today's group also put in a plug for vaccination against pneumococcal disease, which can lead to sepsis, a flu complication. William Schaffner, MD, NFID's medical director, said in an NFID news release, "Influenza and pneumococcal vaccination are an important part of managing chronic diseases. By getting vaccinated against flu and pneumococcal disease, we can all do our part to stay healthy and interrupt the spread of these serious diseases."

Vaccine coverage estimates for last season

Health officials today covered the CDC's latest flu vaccine coverage estimates for specific groups, including health workers, children, and pregnant women. The CDC published more information on the coverage estimated today in the latest issue of Morbidity and Mortality Weekly Report (MMWR) and on the CDC's FluVaxView website.

In children ages 6 months to 17 years, vaccine coverage levels have held steady for the last several seasons, though they still fall short of national public health goals, the NFID said. Last season saw a small decline of 1.1 percentage points to 57.9%, but the decline was a little steeper (2.2 percentage points) in the youngest group, those ages 6 months through 4 years. That group still had the highest coverage level, at 67.8%; adolescents and teens lagged, at 47.4%.

The new analysis found large regional variations in children's flu vaccine coverage, from a low of 43.2% in Wyoming to a high of 76.2% in Rhode Island.

Wendy Swanson, MD, MBE, chief of digital innovation and digital health at Seattle Children's Hospital, one of several speakers at today's briefing, said in the release, "Even one preventable death is a tragedy, but last year at least 180 families lost a child to flu. Getting more people vaccinated each year will help prevent cases of flu and related hospitalizations and deaths."

Flu, Tdap vaccine uptake in pregnant women

According to the CDC's estimated for last season, nearly half (49.1%) of pregnant women were vaccinated against the flu. The findings were based on an Internet panel survey conducted in March and April. The most common reason for not getting vaccinated was the perception that the vaccine is not effective.

Pregnant women most likely to be vaccinated included those whose provider offered it, followed by those who got a referral and were immunized elsewhere.

The MMWR report on flu vaccination also covered the pertussis vaccine—also recommended during pregnancy—and the findings indicate that coverage of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine was slightly higher, at 54.4%. The second most common concern for both vaccines was safety risks to the baby.

Laura Riley, MD, professor and chair of the department of obstetrics and gynecology at Weill Cornell Medicine, said in the NFID release that flu vaccination during pregnancy is safe. "Studies show that, in addition to helping to protect pregnant women, a flu vaccine given during pregnancy helps protect babies from flu infection for their first several months of life, before they are old enough to be vaccinated."

Healthcare worker trends hold steady

For healthcare workers, flu vaccination levels remained the same as the past four seasons at 78.4%, maintaining a 15-percentage-point increase since the 2010-11 season. The findings were based on an Internet survey conducted in March and April.

As in past years, coverage in health professionals varied, from a high of 91.9% in hospital settings to a low of 67.4% among those working in long-term care facilities.

At 94.8%, vaccination coverage was highest in health workers who were required to get the flu shot and lowest (47.6%) in settings where the vaccine wasn't required, promoted, or offered.

See also:

Sep 27 NFID press release

Sep 28 MMWR report on flu and Tdap vaccine uptake in pregnant women

Sep 28 MMWR report on flu vaccine uptake in health workers

CDC FluVaxView website

This week's top reads