INFLUENZA IN CHILDREN
Influenza in children results in increased visits to clinics, emergency departments, and hospitals, increased use of antibiotics, school absenteeism, and lost parental work time (12,13). Children aged 6 through 59 months and children with certain medical conditions such as asthma and neurologic/developmental disorders are among those at higher risk for severe complications of influenza (Box 2) (11). Even without high-risk medical conditions (14), children younger than 5 years old, especially those younger than 2 years old, are at increased risk for hospitalization from flu (9,11).
Children in day care and school are a major source of influenza transmission in the community and should be vaccinated as early as possible (8-11). Vaccinated children in day care spread 42% less febrile respiratory illness to their unvaccinated household contacts--and 80% less to unvaccinated household contacts aged 5 through 17 years--compared with unvaccinated children in day care (10). School-aged children have the highest incidence of influenza (9,11), although the illness is often not diagnosed (15). It is estimated that a vaccination rate as low as 20% in school-aged children could potentially reduce mortality in adults aged 64 years and older more effectively than a vaccination rate of 90% in older adults (8).
Per recommendations from the Centers for Disease Control and Prevention (CDC), all children aged 6 months and older should receive at least 1 dose of seasonal influenza vaccine. Children aged 6 months through 8 years may also require a second dose of vaccine, administered at least 4 weeks after the first dose, for optimal protection against influenza disease. Children requiring a second dose include (16):
- All children who have not received at least 2 doses of seasonal influenza vaccine in the past.
- Children who have received 2 or more doses of seasonal influenza vaccine in the past, but did not receive at least 1 dose of seasonal influenza vaccine in either the 2010-11 or 2011-12 season or 1 dose of monovalent 2009 (H1N1) vaccine.