July 14, 2006

Flu study spurs new age guidelines for children

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Katherine Poehling, M.D.

Flu study spurs new age guidelines for children

Pediatric flu vaccine practices nationwide have changed as a result of a newly released study by Vanderbilt researchers that appeared in the New England Journal of Medicine.

Katherine Poehling, M.D., assistant professor of Pediatrics, was lead author of the CDC-sponsored, multicenter study, which — based on an advance look at the findings — led the U.S. Advisory Committee on Immunization Practices (ACIP) to expand its recommendations for giving flu shots to children to include giving flu shots to all children ages 6 months to 5 years.

Previously the ACIP had recommended vaccinating children 6-to-23 months old.

The four-year, multi-center study of children seen in pediatrician's offices and children's hospitals, including the Monroe Carell Jr. Children's Hospital at Vanderbilt, proved the flu has a tremendous impact on all children up to 5 years old.

“People in hospitals have long suspected that influenza brought in a lot of young children, but what we didn't realize is the number of outpatient visits the virus creates,” said Poehling.

“We went to pediatrician's offices and tested children 6 months to 5 years and found that in a moderate flu season, one in six children seen actually had the flu. It was one in 16 during a mild flu season.”

The flu was confirmed by nasal swab in 160 of the more than 2,797 children who had respiratory symptoms in the inpatient setting. In pediatrician’s offices and emergency departments, 1,742 children were tested with 16 percent testing positive during the flu season. While younger children accounted for most of the hospitalizations — 80 percent were under 2 years old — the most surprising finding was that outpatient visits associated with the flu were up to 250 times more common than hospitalizations.

“And despite the common occurrence, few children were specifically diagnosed as having influenza,” Poehling said.

“That means as a community and a nation, we were not fully recognizing the burden of this potentially preventable virus.”

Co-authors of the study included Vanderbilt's Kathryn Edwards, M.D., and Marie Griffin, M.D.