Should healthy children be vaccinated against influenza ?

Influenza is often regarded as an illness of the elderly portion of the population because most of the excess mortality associated with influenza epidemics occurs in that age group. However, evidence derived from a large number of clinical studies carried out in different countries and various settings has clearly demonstrated that the burden of influenza is also substantial in children. The attack rates of influenza during annual epidemics are consistently highest in children, and young children are hospitalized for influenza-related illnesses at rates comparable to those for adults with high-risk conditions. Especially among children younger than 3 years of age, influenza frequently predisposes the patient to bacterial complications such as acute otitis media. Children This report is based on the evaluation of data and discussions at and following the Summits of Independent European Vaccination Experts that were held in Oxford, UK, Nierstein, Germany, Valencia, Spain, between September 2003 and May 2005. The sole financial supporter of the meetings was Stiftung Präventive Pädiatrie, Johannes Gutenberg University, Mainz, Germany. No pharmaceutical company or vaccine manufacturer had any role in the initiation, design, data collection, data analysis or interpretation, or writing of the report. The decision to submit this report for publication was made solely by the authors. T. Heikkinen (*) Department of Pediatrics, Turku University Hospital, 20520 Turku, Finland e-mail: terho.heikkinen@utu.fi Tel. : +358-2-3130000 Fax: +358-2-3131460 R. Booy . S. Teo Centre for Child Health, Institute of Community Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London, London, UK M. Campins Servicio de Medicina Preventiva y Epidemiologia, Hospital Universitari Vall d’Hebron, Barcelona, Spain A. Finn Institute of Child Health, UBHT Education Centre, University of Bristol, Bristol, UK P. Olcén Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden H. Peltola Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland C. Rodrigo Department of Paediatrics, University Hospital “Germans Trias I Pujol’’, Barcelona, Spain H. -J. Schmitt Centre for Preventive Paediatrics, Johannes Gutenberg University, Mainz, Germany F. Schumacher Clinica Pediatrica, Università degli Studi di Brescia, Brescia, Italy C. Weil-Olivier Service de Pádiatria Générale, Hôpital Louis Mourier, Colombes, France also serve as the main transmitters of influenza in the community. A safe and effective vaccine against influenza has been available for decades, but the vaccine is rarely used even for children with high-risk conditions. Despite several existing problems related to influenza vaccination of children, the current evidence indicates that the advantages of vaccinating young children would clearly outweigh the disadvantages. Considering the total burden of influenza in children, children younger than 3 years of age should be regarded as a high-risk group for influenza, analogously with the age-based definition of high risk among persons 65 years of age or older. Annual influenza vaccination should be recommended to all children from 6 months to 3 years of age.