AMERICAN ACADEMY OF PEDIATRICS TECHNICAL REPORT Reduction of the Influenza Burden in Children

Epidemiologic studies have shown that children of all ages with certain chronic conditions, such as asthma, and otherwise healthy children younger than 24 months (6 through 23 months) are hospitalized for influenza and its complications at high rates similar to those experienced by the elderly. Annual influenza immunization is already recommended for all children 6 months and older with high-risk conditions. By contrast, influenza immunization has not been recommended for healthy young children. To protect children against the complications of influenza, increased efforts are needed to identify and recall high-risk children. In addition, immunization of children between 6 through 23 months of age and their close contacts is now encouraged to the extent feasible. Children younger than 6 months may be protected by immunization of their household contacts and out-of-home caregivers. The ultimate goal is universal immunization of children 6 to 24 months of age. Issues that need to be addressed before institution of routine immunization of healthy young children include education of physicians and parents about the morbidity caused by influenza, adequate vaccine supply, and appropriate reimbursement of practitioners for influenza immunization. This report contains a summary of the influenza virus, protective immunity, disease burden in children, diagnosis, vaccines, and antiviral agents. Pediatrics 2002;110(6). URL: http://www.pediatrics.org/ cgi/content/full/110/6/e80; influenza, vaccine, treatment, diagnosis, antiviral. ABBREVIATIONS. HA, hemagglutinin; NA, neuraminidase; IgA, immunoglobulin A; HAI, hemagglutinin-inhibiting; AOM, acute otitis media; CDC, Centers for Disease Control and Prevention; PCR, polymerase chain reaction; TIV, trivalent inactivated influenza vaccine; T-CAIV, trivalent live-attenuated, cold-adapted influenza vaccine; FDA, Food and Drug Administration; GBS, Guillain-Barré syndrome; CI, confidence interval; HIV, human immunodeficiency virus; MMR, measles-mumps-rubella; NIH, National Institutes of Health; TCID, tissue culture infectivity dose.