Wednesday, 31 July 2013

Influenza vaccination for children - Fluenz

Sorry - not even August and another influenza story but this is a big one.

It has been a busy few days in the world of childhood vaccination.  Fresh on the heels of advice from the Joint Committee on Vaccination and Immunisation (JCVI), the body that advise the Department of Health about vaccination policy not to introduce meningococcal type B vaccine yet, we now have details from the Department of Health about routine influenza vaccination for children over the age of 2 years.
Essentially it is to be offered to all children who are aged 2 and 3 years on the 1st September; and to older children up to the age of 10 years in some pilot areas.  There are a number of things about this that need to be highlighted:
  • Influenza is not always a mild illness, and it can lead to more serious infections.
  • Vaccination has two effects, it protects the individual, but by reducing the risk of them catching the disease it also protects other people.  So if your child doesn’t get the flu then they can’t give it to siblings, grandparents…etc.  This is the same thing that I discussed previously with regards to taking time off work reducing the spread of influenza.  So even if you are not worried about your child, what about their grandparents and other contacts?  What about that child at nursery who has asthma?  I don’t want to lay it on too thick, but there are a lot of people around who can become very ill with the flu.
  • This is not the same as the normal seasonal flu vaccine.  That is an inactivated vaccine (note inactivated – it can’t give you the flu!); this is a cold attenuated live vaccine.  This means that it is alive (as much as viruses can be described as ‘alive’) but has been altered so that it can only grow in cool environments – such as the nose, which is much cooler than the lungs and respiratory tract.  This also raises the interesting prospect of the altered strain circulating in the community, that people could ‘catch’ the vaccine virus and become immune that way (which would be a good thing!)
  • It is not an injection but a squirt up the nose (two squirts actually, one up each nostril).
  • If you or your child is in a risk group, this does not replace the need for annual vaccination, it is an additional layer of protection.  You (or your child) still need to be vaccinated as normal.
  • Finally, immunity is not immediate; you need to give the system a good 2 weeks for immunity to develop.
 There are a few children who should not have it: those under 2 years, those with egg allergy, children who are severely immune suppressed and other children who live in their house, and children with asthma who are wheezy at the time of vaccination.
Although this is a new vaccine to the UK, the Americans have been using it for some time.  For people who are worried about it I would just say this, if you are not convinced of the need for your child to be protected; if you are not convinced by the part that this will play in reducing the spread of flu, and I respect (but disagree with both of these); it can’t be worse than catching the flu anyway – because that is all it is, but in a form that is much, much, much less likely to cause disease.

The advice from the JCVI is here; the guidance that healthcare professionals use (the 'Green Book') is here, always check before use as  it changes quite regularly; and the letter from the Department of Health is here.

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