Kids With Asthma Skipping Flu Shots

Only 3 out of 10 children with asthma get vaccinated against flu, U.S. health officials said March 8. Kids and adults with asthma should get flu vaccine every year. This is because they are more likely to have complications from flu, such as pneumonia. Researchers from the U.S. Centers for Disease Control and Prevention looked at data from a national survey. They found that only 29% of children with asthma got flu shots for the 2004-05 season, the Associated Press reported. A vaccine shortage occurred that season. However, the effect was unclear. That's because kids with asthma got priority for the shots, researchers said.

What Is the Doctor's Reaction?

Only about 3 in 10 children from ages 2 through 17 with current asthma got a flu shot in the 2004-2005 influenza season. The number was even lower for children without current asthma — only 1 in 10.

(Children with "current asthma" were those whose parents said that a doctor had ever told them the child had asthma, and also said that the child still had asthma.)

These results are much too low and hugely disappointing. About 6.5 million kids under 18 had asthma in 2005. That's about 9% of all U.S. children. The flu vaccination rate was the lowest rate for any recommended childhood vaccine in the United States.

These data come from the first national estimates of influenza vaccination coverage among children with asthma. The study was released in the March 9 issue of Morbidity and Mortality Weekly Report.

The U.S. Centers for Disease Control and Prevention studied data from the 2005 National Health Interview Survey to learn how common it was for kids to get vaccinated.

The lowest vaccination rate for children with current asthma was among 5- to 12-year-olds who had not had an asthma attack or episode in the last year. Younger kids may have been more likely to get a flu shot because they are more likely to have regular well-child visits with doctors.

On the other hand, nearly 70% of children with asthma do not receive an annual immunization. This puts them at increased risk for severe complications, hospital stays, and sometimes death.

These findings underscore the need to increase flu vaccination in children with asthma. We need to identify and overcome barriers to vaccination.

What Changes Can I Make Now?

Getting flu is dangerous because it makes asthma worse. Remember, high-risk children are five times more likely than healthy children to require a hospital stay with flu-related illnesses.

We know that getting the flu vaccine helps to lower flu rates in asthmatic children. Yet, some people have questions, misunderstandings or misgivings about whether the flu vaccine is really necessary and safe.

Let me assure you that the flu vaccine is most definitely necessary and safe for children as young as 6 months of age.

You should learn as much as you can about flu vaccine. The two types are "killed" (inactivated) and "live-attenuated" (weakened).

• A vaccine usually is made up of the infectious germ itself. Killed vaccines contain dead viruses or parts of virus that have been completely disabled. These viruses can no longer cause disease.
• "Live-attenuated" vaccines contain weakened forms of the virus. These attenuated viruses can infect the body's cells. This produces a much stronger immune response against the virus than the inactivated type. However, such a vaccine cannot cause a full case of the flu.
• Before deciding which type of vaccine to get, think about the child's age, overall health and the strength of her immune system.
• Your child's doctor will help you decide which vaccine is best for him or her.

Parents can take other steps to protect their children from flu. Remember to vaccinate household contacts (for example, grandparents, siblings and parents) and out-of-home caregivers of all at-risk children. This includes children with asthma. Vaccinating contacts helps to prevent flu from spreading to at-risk children.

Don't forget that close contacts of all children younger than 6 months must be immunized. These youngest patients cannot be vaccinated themselves to protect against the flu.

What Can I Expect Looking to the Future?

You can expect public health groups to continue monitoring national trends in flu vaccine. Public health officials will explore how best to target groups with the lower rates of vaccination.

There is no doubt that increasing flu vaccination coverage in this population will help decrease influenza and the complications associated with it.

In addition, flu vaccine makers will work to improve production. This should help avoid supply shortages, so we can reach the ultimate goal of vaccinating as many people as possible.

- Added to Medpedia December 2008