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Julia A. McMillan, MD, editor-in-chief of Contemporary Pediatrics, is professor of pediatrics, vice chair for pediatric education, and director of the residency training program, Johns Hopkins University School of Medicine, Baltimore.
This season, pediatric offices and clinics will work to meet the challenges posed by the new influenza vaccination.
Autumn is upon us, and with it comes another change in recommendations for pediatric influenza vaccination. In 2003, pediatricians were "encouraged" to vaccinate all infants and toddlers between 6 and 23 months old annually, as well as household and out-of-home caregivers of all children younger than 2 years. In 2004, that encouragement became a firm recommendation and, beginning with the 2006-2007 influenza season, the recommendation has been extended to include children between 6 and 59 months and the contacts of all children younger than 5 years.
This expanded recommendation will add 5.3 million children and 11.4 million siblings, parents, and other contacts to the list of people for whom annual vaccination is recommended.
We have been assured by the Centers for Disease Control and Prevention and by vaccine manufacturers that plenty of vaccine will be available to meet anticipated need. Early this autumn, it appeared that demand was exceeding the available vaccine that had been distributed to practices in many parts of the country, but distributors were expected to ship the bulk of their vaccine stocks later-in October and November.
As for this flu season, pediatric offices and clinics will work to meet the challenges posed by the new recommendation. During the 2004-2005 season, the first year that annual vaccination was recommended for 6-to 23-month-olds, nearly one half of that target group was vaccinated. Regrettably, during that same season, only about one third of older children at risk of severe infection because of a chronic condition such as asthma, cardiac disease, or sickle cell disease, were vaccinated. These at-risk children are five times more likely to be hospitalized because of influenza infection than are their healthy counterparts.
So, this flu season, remember several important points: