The Calgary Sun: Flu shot suspect in death
http://www.canoe.ca/CalgaryNews/cs.cs-01-06-0004.html
Tuesday, January 6, 2004
Flu shot suspect in death
By BILL KAUFMANN, CALGARY SUN
The grieving family of a 22-month-old Calgary girl who died mysteriously are
wondering if the tot suffered a fatal reaction to a flu vaccination. Relatives
say on Dec. 30, Emma Bealing came down with a high fever, then suffered multiple
seizures and died Sunday night at the Alberta Children's
Hospital after her parents consented to unhook their daughter from life support.
"She died in her dad's (Douglas's) arms," said Emma's aunt, Joanne Bealing,
yesterday.
Said Anthony Bealing, Emma's uncle: "No parent should have to decide how their
child dies."
The seizures "came out of the blue" said the uncle, adding Emma was placed on
life support last Tuesday. Her brain, he said, subsequently experienced severe
swelling consistent with the condition Acute Disseminated Encephalomyelitis (ADEM).
Along with bacterial or viral infections, ADEM can be caused by a severe
response to inoculation -- a reaction that can lie dormant for two to three
weeks.
Seizures are one symptom of an adverse reaction to inoculation, according to the
Canadian Medical Association. A family member said the girl had received a flu
vaccination about a month ago.
"(Vaccination as a cause) is only one theory we're looking at," said Anthony.
"We wish the doctors did know for sure but they don't." He said Calgary Health
Region officials told them an autopsy will be done to determine what led to the
tragedy. The CHR wouldn't comment on the case.
Douglas Bealing and his wife Maureen had overcome medical challenges to have
both Emma and her older brother, Harrison, 6, said the girl's aunt, Joanne.
"It's just extremely tragic -- this couldn't come to a more loving or
undeserving little family," she said. "Emma had a good personality even at 22
months and a good sense of humour." She said the death that's shocked and
devastated the family now has struck fear in her own household. "I have a
six-year-old and I'm going to be paranoid with every little fever she has," said
Joanne.
Late last month, Jayden Tucker, 2, of Airdrie died after what might have been
complications arising from the flu. Meanwhile, a three-year-old Nova Scotia girl
died on the weekend from what health officials believe was the flu, the
province's chief medical officer said yesterday. "It is rare for an
otherwise healthy child to get severely ill with influenza," Dr. Jeff Scott
said. So far this season, there have been three confirmed cases of the flu
causing or contributing to the death of a child in Canada -- two in Ontario and
one in British Columbia.
To date, three other cases are under investigation.
http://www.wral.com/health/2717143/detail.html
Devlin said a 22-month-old girl from Wake County died from the flu on Dec. 17
after being hospitalized on Dec. 15. She was the fifth child in the state to die
from the flu this flu season.
Because she was under 23 months, the girl was at high risk for flu
complications. She had received a flu shot October 17, but had not received a
second shot. Children receiving flu shots for the first time should receive
two vaccinations, 30 days apart, in order for the vaccination to be fully
effective. There are no studies that show how effective the vaccination is in a
previously unvaccinated child after just one dose. Two of the five children died
in the recovery period, one from an infection that can occur on the back end of
a flu sickness. Devlin said the elderly, despite the recent deaths of children,
remain the most likely group of people to die from the flu. This flu season,
more than five times the number of children have been immunized than were
immunized in past flu seasons.
Last year, 29,000 high-risk North Carolina children got their flu shots through
the state's immunization program. This year, more than 153,000 have been
immunized. Data is not available on the numbers immunized through private
providers. None of the new vaccine doses being delivered will be reserved for
flu booster shots for children under 9. Engel said those children should still
have partial protection from their first shot.
Thursday, December 18, 2003
By Matt Leingang
The Cincinnati Enquirer
The parents of an 11-month-old girl who had the flu and died this week say it is
not important to them whether health officials determine the exact cause of her
death. No autopsy on Olivia Harrison, who died at Cincinnati Children's Hospital
Medical Center, is being requested, her parents said Wednesday. She suffered
enough. "We're satisfied that doctors did everything they could to save her,"
said Olivia's mother, Joyce Harrison, 36, of Forest Park. Olivia's death is not
officially being blamed on flu. The Ohio Department of Health is waiting for
more information.
But Olivia's parents, speaking at a news conference at the hospital, said the
toddler tested positive for Type-A influenza when they brought her to the
emergency room Saturday evening. Over the next 24 hours, the virus quickly
caused her body's respiratory system to shut down, they said. "I want everyone
to know that Olivia was chosen for this," said her father Terence Harrison, 32.
"God called her home."
Joyce Harrison, a dialysis nurse who works in Blue Ash, said that her daughter -
who would have celebrated her 1-year birthday Dec. 26 - became ill Saturday
morning with a cough and fever. The symptoms did not appear severe enough
initially to warrant extra concern. By evening, though, the child became
lethargic and the family rushed to the hospital. Olivia had received
half a dose of the flu vaccine this fall, the dosage recommended by her
doctor, her parents said. Joyce and Terence Harrison said they are relying on
their religious faith to get them through this time. Said her mother: "I grieve.
I bawl. I cry. It's hard for all of us, but I have strength in God."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&
dopt=Abstract&list_uids=15056235
Pediatr Int. 2004 Apr;46(2):122-5. Related Articles,Links
Failure of inactivated influenza A vaccine to protect healthy children aged
6-24 months.
Maeda T, Shintani Y, Nakano K, Terashima K, Yamada Y.
Department of Pediatrics, Public Shisou General Hospital, Shisou, Japan.
Abstract Background: The efficacy of inactivated influenza vaccine in healthy
infants and children younger than 24 months has not been confirmed. The aim
of the present study was to determine the prophylactic effect of inactivated
influenza vaccine against influenza A in healthy children aged 6-24 months.
Methods: Healthy infants and young children (6-24 months old) were immunized
by subcutaneous injection of inactivated influenza vaccine before influenza
seasons. Age matched children were randomly assigned as the control. These
children were followed up from January to April in each year (2000, 2001 and
2002). The attack rates of influenza A infection was compared and
statistically assessed. Results: The attack rate of influenza A virus
infection in the vaccine group
and the control group were 14.8% (n = 27) vs 12.5% (n = 32) in 2000 (P =
0.526); 2.8% (n = 72) vs 7.2% (n = 69) in 2001 (P = 0.203); and 3.4% (n = 52)
vs 8.9% (n = 56) in 2002 (P = 0.205). The attack rates of influenza A between
the two groups were not significantly different. Conclusion: Inactivated
influenza vaccine did not reduce the attack rate of influenza A infection in
6-24 month old children.
PMID: 15056235 [PubMed - in process]
www.nationalautismassociation.org/library/A__Influenza%
20Vaccine%20Efficacy%20in%20Infants1.pdf
http://story.news.yahoo.com/news?
tmpl=story&cid=541&ncid=541&e=3&u=/ap/20040623/ap_on_he_me/flu_season_
cdc_1
100M Doses of Flu Shots to Be Available
Wed Jun 23, 4:45 PM ET
By DANIEL YEE, Associated Press Writer
ATLANTA - Determined to avoid a repeat of last year's flu-shot shortage, the
government said Wednesday that vaccine makers will have 100 million doses
ready for this winter. That figure does not include the estimated 4.5
million doses of flu shots the Centers for Disease Control and Prevention
(news - web sites) is planning to keep in reserve for children in its
first-ever stockpiling of the vaccine.
For the 2003-04 season, there were 86.9 million doses available, compared
with 95 million in 2002.
Last year, the nation's two producers of flu shots shipped their entire
supplies of the vaccine by December, thanks to an early start to the flu
season and fears that a dominant flu strain would cause more severe illness
than in recent years. Clinics around the country ran out of the injected
vaccine — which takes months to prepare — and officials urged healthy people
to opt for a nasal-spray version to save the traditional flu shot for
children and the elderly.
Memories of last season's flu shot shortages will compel people to get
vaccinated this year, and new flu shot recommendations — including having
children 6 months to 23 months old get the shot — also will prevent an
oversupply, said Gregory Wallace, of the CDC's immunization services
division.
All the vaccine must be used by the end of the season — which typically ends
around April — because the shots cannot be used for other seasons as the flu
strains vary each year. In another change, the CDC has directed states to
collect data on any children hospitalized with the flu and to report child
flu deaths. Because such data has not been consistently collected, health
officials do not know how many children typically die from the flu each year.
In the last flu season, the CDC found 152 children who died from the flu.
Their average age was 3, and about 70 percent of them had not received flu
shots. 30% did and died anyway?
Failure of Inactivated Influenza A Vaccine To Protect
Healthy Children Aged
6–24 Months
[Not yet available online.]
Pediatrics International (2004) 46 , 122–125
Taro Maeda, Yukihiro Shintani, Kanako Nakano, Kazuhiro Terashima And
Yoshiyasu Yamada
Department of Pediatrics, Public Shisou General Hospital, Shisou and
Department of Pediatrics, Rokko Island Hospital, Kobe, Japan
Abstract
Background: The efficacy of inactivated influenza vaccine in healthy
infants and children younger than 24 months has not been confirmed. The aim
of the present study was to determine the prophylactic effect of inactivated
influenza vaccine against influenza A in healthy children aged 6–24 months.
Methods: Healthy infants and young children (6–24 months old) were
immunized by subcutaneous injection of inactivated influenza vaccine before
influenza seasons. Age matched children were randomly assigned as the
control. These children were followed up from January to April in each year
(2000, 2001 and 2002). The attack rates of influenza A infection was compared
and statistically assessed.
Results: The attack rate of influenza A virus infection in the vaccine
group and the control group were 14.8% ( n = 27) vs 12.5% ( n = 32) in 2000 (
P = 0.526); 2.8% ( n = 72) vs 7.2% ( n = 69) in 2001 ( P = 0.203); and 3.4% (
n = 52) vs 8.9% ( n = 56) in 2002 ( P = 0.205). The attack rates of influenza
A between the two groups were not significantly different.
Conclusion: Inactivated influenza vaccine did not reduce the attack
rate of influenza A infection in 6–24 month old children. Different countries have selected a range of different programs for
influenza vaccine recommendations. In the United States, inactivated
influenza vaccine is recommended for any person aged greater than 6 months
old who is at increased risk for complications.
Children, not the elderly, 'should get flu vaccines'
By Steve Connor, Science Editor
22 November 2004
http://news.independent.co.uk/uk/health_medical/story.jsp?story=585396
Children, rather than the elderly, should be vaccinated against influenza to
protect the rest of the population against an epidemic, a study showing that
the virus spreads fastest in schools has concluded.
Present vaccination policy is to offer free flu jabs only to the over-65s,
but scientists have found that it would be better to target school-aged
children, because they are the ones who trigger an epidemic.
A pilot scheme to vaccinate thousands of children in Texas found that when
just a quarter of them were given the vaccine it led to a drop of up to 18
per cent in flu cases among unvaccinated adults.
Computer models suggest that vaccinating half the child population would
reduce the chances of an epidemic among adults by two-thirds. Vaccinating 90
per cent of children reduces the probability of an epidemic to just 4 per
cent.
Scientists involved in the study believe that vaccinating even a minority of
school-aged children against flu would lead to a significant decline in
outbreaks among the very old and the very young, who are at the greatest risk
of serious complications, such as pneumonia.
Paul Glezen, professor of virology and epidemiology at Baylor College of
Medicine in Houston, Texas, said there was little doubt that flu epidemics
were spread mainly by schoolchildren and that targeting them with a vaccine
was the best way to avoid a wider death toll. "There's a lot of evidence that
children have the highest infection rates and that the virus then spreads
from these children to their older and younger contacts," he said. "The
elderly and the very young are at the end of the transmission chain so
inoculating them won't have any effect on the rate of spread of an epidemic."
Even if only a proportion of children is vaccinated against flu, this could
lead to wider "herd immunity" within the population at large, said Pedro
Piedra, a member of the Baylor research team. "There have been studies
demonstrating that children contribute to the spread of flu in families and
communities. By reducing influenza in children, hopefully we can reduce the
spread of influenza in the community," Dr Piedra said.
"With the current policy [of vaccinating the elderly], you only try to
control mortality. If you want to control flu, our hypothesis is to focus on
children."
The Baylor researchers vaccinated 20,000 eligible children in the Texas towns
of Temple and Belton in 1998-99. The vaccine was delivered as a nasal spray
rather injection.
Cases of flu in adults over the age of 35 in the two towns fell by between 8
and 18 per cent compared with similar communities where there was no
significant childhood vaccination. Professor Glezen said this meant that
there were thousands of people who did not catch flu who otherwise would have
succumbed to the infection, and some would have developed more serious
respiratory illnesses.
John Watson, head of respiratory diseases at the British Government's Health
Protection Agency, said that any changes to Britain's vaccination policy
would have to be decided by the Department of Health. "This is an interesting
study that the Health Protection Agency will be keen to look at in more
detail. It is well recognised that children play an important role in the
transmission of the influenza virus in closed environments such as
households, schools and nurseries," he said.
Japan imposed widespread flu vaccination of schoolchildren but the policy was
abandoned in 1987 before epidemio- logists realised it had saved at least
10,000 elderly Japanese from respiratory diseases.
Professor Glezen said that in the US the number of people needing hospital
treatment as a result of flu had increased in recent years despite an
increase in the proportion of people over 65 who had been vaccinated.
"I don't think we can say we have an effective vaccination policy ... but it
doesn't mean that the vaccine is ineffective. We need to target
schoolchildren instead," he said.
http://www.mysanantonio.com/news/metro/stories/MYSA011905.kens.reaction.249d
0b5b.html
Mother claims son had adverse reaction to flu shot
Web Posted: 01/19/2005 05:00 PM CST
Wendy Rigby
Eyewitness News
A San Antonio woman believes a simple flu shot nearly killed her 5-year-old
son Maurice.
Maurice was a healthy kindergarten student when his mother took him for a flu
shot in October. Maurice has asthma and the doctor recommended the vaccine.
That night, according to his mother Michelle Mouille, "He began running a
high fever and two days later, lapsed into seizures." "He was drooling,
totally down his mouth and stiff as a board and couldn't move or talk," said
Mouille. " I just feel devastated." That's the last time Mouille heard her
son speak. He spent 40 days in intensive care at the hospital and several
weeks in rehabilitation.
Neurologists and a team of doctors say his brain swelling and injuries were
not caused by any obvious virus, and may have been a rare reaction to the flu
shot. The city's top health official says right now, there 's no hard
proof. "At best, it's coincidental, but because of the temporal sequence, we
have to say that at least there is that hypothetical possibility, or
theoretical possibility that it might be related," said Dr. Fernando Guerra,
Metro Health District Director.
Maurice is covered by Medicaid, which is paying for outpatient therapy. He's
walking and eating again, but there's no way to gauge how much brain function
he'll regain. If he was the victim of an adverse flu shot reaction, his case
would be one in a million. Maurice's mother feels compelled to share her
story. "Before they would get their child the flu shot to really think about
it because it might not help them like it's supposed to and it could really
damage them for life," said Mouille. Guerra says parents should not be
scared away from the vaccine, which he considers safe. "I would
certainly recommend to parents that they opt to protect their children," said
Guerra.
The Centers for Disease Control and Prevention is investigating Maurice's
case, but it will be months or even years before they determine if the flu
shot or a mysterious virus caused his brain damage.
http://www.forbes.com/lifestyle/health/feeds/hscout/2005/02/24/hscout524183.
html
Health
No Evidence Flu Vaccine Works For Toddlers
By Amanda Gardner
HealthDay Reporter By Amanda Gardner
HealthDay Reporter
THURSDAY, Feb. 24 (HealthDay News) -- There is no good science to back new
American and Canadian policies of vaccinating children under the age of 2
against the flu, a new report claims.
However, the researchers stress, this doesn't mean the vaccine is ineffective
in toddlers; it just means it needs to be studied further. "In children
below the age of 2, we could find no evidence that the vaccine works, but
that does not mean that the vaccine doesn't work," said Dr. Tom Jefferson,
lead author of the study, which appears in this week's issue of The Lancet.
"The data is insufficient to draw any conclusion," said Jefferson, who works
at Cochrane Vaccines Field, in Rome, Italy. "We need more research."
The researchers also did not find any convincing evidence that vaccines have
an effect on death rates, hospital admissions, serious complications and
transmission of the flu. Again, this doesn't mean that the vaccines are
ineffective, just that there's no research to prove they work. But before
making vaccination of very young children a public health policy, Jefferson
and his colleagues believe large-scale studies need to be conducted.
As the study authors pointed out, both the United States and Canada have
already started vaccinating children under the age of 2 against the flu.
Infants aged 6 months to 23 months were included in recommendations starting
in the 2004-05 flu season. Historically, vaccination efforts have targeted
people 65 and older. U.S. federal statistics released earlier this month
revealed that 57.3 percent of children aged 6 months to 23 months were
vaccinated from September through December 2004. At the time, Dr. Julie
Gerberding, director of the U.S. Centers for Disease Control and Prevention,
called those results "wonderful" -- especially since a 2002 survey showed
that only 7.7 percent of children in this age group were immunized.
The current review looked at the available data on the efficacy and
effectiveness of the flu vaccine on children 16 years old and younger.
Efficacy meant any reduction laboratory-confirmed cases of the flu (children
who actually got infected), while effectiveness referred to a reduction in
symptomatic cases, which is measured by reductions in mortality,
hospitalizations, school absenteeism, transmissions, and other indicators.
This analysis was part of a longer review, which should be released this
summer.
The authors identified 25 comparative studies that evaluated the efficacy
and/or effectiveness of flu vaccines in children aged 16 and younger. They
looked specifically at flu, flu-like illness, hospital admissions, school
absences, complications and secondary transmissions. Overall, vaccines with
live viruses had a 79 percent efficacy and 38 percent effectiveness in
children older than 2, compared with no immunization or a placebo.
Inactivated vaccines had an efficacy of only 65 percent and, in children
under 2, were similar in their effects to placebo. They had an effectiveness
of about 28 percent in children over 2.
Vaccines seemed to be effective in reducing long school absences, but
otherwise had little effect on hospital stays and other measures when
compared with a placebo or no intervention. This information was based on a
small number of studies, however. Information for hospitalizations was
similarly weak. "One small Italian study looked at length of hospitalizations
and found no difference, but the number of children was very small, so you'd
be wrong in concluding that it doesn't work," Jefferson said. "We just don't
know." The problem with ascertaining effectiveness, said Dr. Keith
Powell, a member of the American Academy of Pediatrics' infectious diseases
committee, is that kids may be hospitalized or miss school because of any
number of respiratory infections. "The average kid has eight respiratory
infections a year," he said. "Only one of those is going to be the flu."
"Unless we're doing something to diagnose and distinguish between the
two, you wouldn't know if you just looked at hospital rates by age for
respiratory illness," he added. While Jefferson called for more research,
Powell said he believes it is still a good idea to vaccinate kids aged 6 to
23 months.
(I hate when they experiment on children)
Doctors say flu shot may be linked to boy's mysterious illness
By The Associated Press
http://abclocal.go.com/ktrk/news/state/031005_APstate_mysterillness.html
(3/10/05 - SAN ANTONIO, TX) - A South Texas boy's mysterious and debilitating
illness has drawn attention from doctors across the country, some of whom
suspect that a flu shot may be to blame. Five-year-old Maurice Lamkin was
healthy and happy until Oct. 27, when he received the vaccination at a
clinic. That night he developed a fever, and a few days later he ended up in
an intensive care unit, his brain swelling as puzzled doctors reviewed his
case.
He fought for his life for 40 days and, after a stay at a rehabilitation
facility, returned home on New Year's Day. But he can't speak and has
returned to diapers, and all of his meals must be pureed to the texture of
baby food. While some doctors suspect the flu shot is to blame, others
say it's probably just a coincidence. Dr. Kenneth Mack, a pediatric
neurologist who consulted on Maurice's case, said an adverse reaction to the
flu shot can cause encephalitis, an inflammation of the brain.
"The body's immune system can get overactive and attack the brain," he said.
Maurice's pediatrician recommended he get a flu shot because he has asthma
and lives in a home with his infant sister. He had been vaccinated once
before without ill effects. His mother, Michelle Mouille, said she
regrets having him vaccinated. "He was just a healthy little boy. He was
running around -- he was so proud because he'd just learned to write his
first and last name," Mouille said. "He was living his life, singing,
dancing, wrestling with his brother -- it's so hard to understand."
Maurice's case has been reported to the Centers for Disease Control and
Prevention's National Vaccine Monitoring System. Dr. John Iskander, an
epidemiologist and pediatrician with the agency, said the cause of Maurice's
illness may remain a mystery. "It's very difficult to make a
determining decision whether the flu vaccine was to blame," he said.
Iskander said the CDC will monitor other reports of reactions to see if a
pattern emerges. But he reminded parents that the benefits of getting a flu
shot outweigh the small risk of a vaccine causing serious harm. Each year in
the United States, about 36,000 people die of the flu and 200,000 are
hospitalized.
(Copyright 2005 by The Associated Press. All Rights Reserved.)
Ultrasound device might remove needle from flu shot
BY ERIC HAND
St. Louis Post-Dispatch
http://www.kansas.com/mld/kansas/news/nation/11601332.htm
ST. LOUIS - (KRT) - There might be a way to get a flu shot without a shot.
St. Louis University researchers are getting flu vaccine under the skin of
volunteers without needles. The SonoPrep, an ultrasound device made by Sontra
Medical Inc., opens skin pores so that vaccine can seep through. Nothing ever
touches nervy muscles. "There's a machine and there's a sensation. But if
there's no needle, that takes away the biggest fear," said Dr. Robert Belshe,
director of the Center for Vaccine Development at St. Louis University. At
least 10 percent of the adult population has a severe fear of needles,
according to a 1995 study in the Journal of Family Practice. Belshe hopes the
new method will encourage the phobic to get in for their needleless flu
shots.
The method is not only pain-free but also uses less vaccine, according to
research Belshe published in November in the New England Journal of Medicine.
Belshe found that less than half of the normal muscular dose worked just as
well when injected into the skin only. Belshe said researchers have for
decades known about the skin's superior ability to create antibodies in
response to a vaccine. It makes sense, he said, since the skin needs plenty
of immune defenses to deal with cuts and scrapes.
"But there wasn't any reason to look at it until we had a vaccine shortage,"
he said. The trial used the tiny skin-pricking needles of tuberculosis
syringes and found that 40 percent of the normal dose was just as effective
for 18- to 60-year-olds, and nearly as effective for older people.
Franklin, Mass.-based Sontra contacted Belshe after reading the paper, hoping
to try it without any needles at all. In August, the company won FDA approval
for SonoPrep, which was originally used to deliver a skin-numbing drug.
Sontra also has tested it as a way to deliver insulin, and is currently
conducting a hepatitis vaccine trial in Worcester, Mass. The St. Louis flu
vaccine trial, which began in April, will test 60 volunteers between the ages
of 18 and 49.
Nurse Jan Tennant said that, so far, only a few people have complained of a
tingling sensation created by the hand-held device. Inside the SonoPrep is a
vibrating horn. The vibrations make thousands of microscopic bubbles in a
thin layer of soap water on the skin, said Shikha Barman, a Sontra
researcher.
The outermost layer of skin is made up of hardened dead cells held together
by fats, like bricks and mortar. The bubbles open pores and create pathways
by dissolving the fatty "mortar." The bubbles also disrupt the natural
electrical conductivity of skin, Barman said. The SonoPrep shuts off once it
detects the conductivity for a certain pore size. Other things, like water,
can change the permeability of skin. But the SonoPrep does it in seconds and
to the same level, regardless of your skin's oiliness, Barman said.
"If you could simply take a shower and slap on a vaccine patch, that product
would be out there," she said.
Nurses next place a doughnut-shaped patch on the skin, within which goes a
drop of vaccine. The vaccine seeps through the epidermis to dendritic cells,
immunilogic sentinels that eat the vaccine and "show" it to the immune system
in nearby capillaries, which produce antibodies. Nothing reaches nerve cells
in the deeper dermis. In a month, Belshe will see how many antibodies the
volunteers produced in response to the vaccine. He said it would likely be
two years before the method could be approved for routine use.
Barman said SonoPreps cost about $2,000.
Web address:
http://www.sciencedaily.com/releases/2009/05/
090519172045.htm
Children Who Get Flu Vaccine Have Three Times Risk Of Hospitalization For Flu,
Study Suggests
ScienceDaily (May 20, 2009) — The inactivated flu vaccine does not appear to be
effective in preventing influenza-related hospitalizations in children,
especially the ones with asthma. In fact, children who get the flu vaccine are
more at risk for hospitalization than their peers who do not get the vaccine,
according to new research that will be presented on May 19, at the 105th
International Conference of the American Thoracic Society in San Diego.
Flu vaccine (trivalent inactivated flu vaccine—TIV) has unknown effects on
asthmatics.
"The concerns that vaccination maybe associated with asthma exacerbations have
been disproved with multiple studies in the past, but the vaccine's
effectiveness has not been well-established," said Avni Joshi, M.D., of the Mayo
Clinic in Rochester, MN. "This study was aimed at evaluating the effectiveness
of the TIV in children overall, as well as the children with asthma, to prevent
influenza-related hospitalization."
The CDC's Advisory Committee on Immunization Practices (ACIP) and the American
Academy of Pediatrics (AAP) recommend annual influenza vaccination for all
children aged six months to 18 years. The National Asthma Education and
Prevention Program (3rd revision) also recommends annual flu vaccination of
asthmatic children older than six months.
In order to determine whether the vaccine was effective in reducing the number
of hospitalizations that all children, and especially the ones with asthma,
faced over eight consecutive flu seasons, the researchers conducted a cohort
study of 263 children who were evaluated at the Mayo Clinic in Minnesota from
six months to 18 years of age, each of whom had had laboratory-confirmed
influenza between 1996 to 2006. The investigators determined who had and had not
received the flu vaccine, their asthma status and who did and did not require
hospitalization. Records were reviewed for each subject with influenza-related
illness for flu vaccination preceding the illness and hospitalization during
that illness.
They found that children who had received the flu vaccine had three times the
risk of hospitalization, as compared to children who had not received the
vaccine. In asthmatic children, there was a significantly higher risk of
hospitalization in subjects who received the TIV, as compared to those who did
not (p= 0.006). But no other measured factors—such as insurance plans or
severity of asthma—appeared to affect risk of hospitalization.
"While these findings do raise questions about the efficacy of the vaccine, they
do not in fact implicate it as a cause of hospitalizations," said Dr. Joshi.
"More studies are needed to assess not only the immunogenicity, but also the
efficacy of different influenza vaccines in asthmatic subjects."
Adapted from materials provided by American Thoracic Society, via EurekAlert!, a
service of AAAS.
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