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 Young children are at increased risk of serious complications such
as hospitalization and even death from seasonal influenza, but few
centers charged with caring for young children require them to be
immunized, Dr. Timothy Shope of UPMC Children's Hospital of
Pittsburgh and colleagues report in the Journal of the Pediatric
Infectious Diseases Society.
In the United States, nearly 1 in 4 children under age 5 attend
large group childcare or preschool programs.
According to Shope, flu spreads quickly among these children, and
methods that can protect older children, such as frequent
handwashing, isolating sick children or urging them to cough or
sneeze into their elbow or shoulder, don't work for young children.
Dr. Deborah Lehman, a professor of clinical pediatrics at the David
Geffen School of Medicine at the University of California, Los
Angeles, and an infectious disease expert who was not involved in
the study, agreed.
"Young children are the shedders and the spreaders," Lehman said in
a telephone interview. "They don't always have the best personal
hygiene. Flu is spread through secretions and touches of hands. As
you can imagine, in a daycare setting, it allows the virus to
spread."
That's why vaccination is important, Shope said in a telephone
interview.
Shope and colleagues based their findings on a 2016 telephone survey
of 518 childcare center directors in 48 states that were randomly
chosen from a national database of licensed U.S. childcare centers.
Only 24.5% of center directors said they required children to have a
flu shot, and even fewer, 13.1%, said they required caregivers on
their staff to be vaccinated.
To better understand why, the team looked at a number of factors
such as the director's years of experience, prior experience with
flu outbreaks and state laws requiring immunization. State laws were
the only factor that appeared to influence immunization
requirements, the researchers report. For staff, centers that had
mandatory vaccination requirements for children were more likely to
also require that caregivers be vaccinated.
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"The reported requirements for flu vaccine by childcare directors
for both children and adults are really low. The only factor that
influenced that was the very low number of states that had laws
requiring flu vaccines," Shope said.
In the study, only four states required flu shots for children
attending childcare centers, and only two states required adult
caregivers to be vaccinated. As a result, many of these decisions
are left up to the center director.
Parents "shouldn't rely on the childcare center's entry requirements
for what is the best, safest thing for their child. They should take
matters into their own hands prior to entry," he said.
The U.S. Centers for Disease Control and Prevention (CDC), which
funded the research, recommends flu shots for everyone age 6 months
or older, but many go unvaccinated.
"A lot of families I've spoken to don't see the need to get a flu
vaccine because they've heard it doesn't work that well," Lehman
said.
Unlike many childhood vaccinations, which can provide lifelong
immunity, the influenza vaccine needs to be given each year. That's
because the virus mutates quickly, and flu shots must be adapted to
protect against the strains circulating each season.
Nevertheless, Lehman said, the vaccine is "very safe" and has been
shown to prevent the most severe complications of influenza, which
can include pneumonia, viral infections of the heart and death.
"We really do not put enough emphasis on how important influenza
vaccine is," Shope said. "Every year, 100 children on average die of
influenza in the United States."
Although the 2019-2020 flu season in the United States is just
getting underway, already six children have died, according to the
CDC.
SOURCE: http://bit.ly/2LKzeKM Journal of the Pediatric Infectious
Diseases Society, online December 12, 2019
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