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Protect high-risk children from flu with vaccine or 'cocoon'. (Only About 30% Get Yearly Shop).

SAN DIEGO -- High-risk children--such as those with asthma, malignancies, or sickle cell disease--have just as great a risk of being hospitalized for influenza as adults over 65, yet they are far less likely to get flu shots.

This was the message Dr. Kathryn Edwards delivered at a meeting sponsored by the Los Angeles Pediatric Society.

"Almost always, we as pediatricians or family practitioners who take care of kids do a much better job of immunizing patients than our colleagues who take care of adults.

"But this is one time where that's not the case," said Dr. Edwards, professor of pediatrics and vice chair of research at Vanderbilt University in Nashville, Tenn.

Within the past decade, great strides have been made in immunizing older adults during influenza season, with about 70% of those Americans over 65 now receiving the vaccine each year.

By comparison, only about 30% of high-risk children receive flu shots each year.

In a small study conducted in Nashville, Dr. Edwards explored influenza vaccination patterns in 88 high-risk children, in-cluding those with asthma, malignancy, heart disease, cystic fibrosis, metabolic disease, or sickle cell anemia.

None of the eight children with malignancies were vaccinated.

Less than a third of those with asthma or heart disease and just half of those with metabolic diseases or sickle cell anemia had been immunized.

Interestingly, all six cystic fibrosis patients were regularly vaccinated against influenza.

"What does that tell us? That tells us the physicians who take care of kids with cystic fibrosis make it a point to immunize their kids," Dr. Edwards said.

When 159 parents of high-risk children were asked why their children hadn't gotten an influenza vaccine, 47 didn't realize children could get the vaccine, 41 said their physicians hadn't recommended it, and 15 said they forgot. Just 12 expressed concern about side effects.

The remaining parents were evenly divided among those who thought their physicians discouraged it and those who personally believed the vaccine was not needed.

"Rates of immunization ... totally depend on the motivation of the doctor and really not the patient or family" Dr. Edwards said.

Infants at high risk, including those who were born prematurely, should not receive influenza vaccines, but they should be protected by immunizing family members.

"I tell people, let's make a cocoon around this baby by immunizing the family and sort of keeping them out of the enormous population during respiratory syncytial virus and flu season," she said.

Dr. Edwards convinces them that protecting babies during the first influenza season of their lives will significantly reduce their chances of an avoidable hospitalization later.

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Author:Bates, Betsy
Publication:Pediatric News
Geographic Code:1USA
Date:Dec 1, 2002
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