The Advisory Committee on Immunization Practices (ACIP), a federal panel of 15 experts from immunization-related fields, voted Feb. 27 to expand annual flu shots for all children ages 6 months to 18 years by the year 2010.

Previously, the flu shots were recommended for children ages 6 months to 5 years. Including children up to 18 years old in the recommendation range suggests about 30 million more children be vaccinated.

Dr. Kathleen Buetow, pediatrician at Carle Clinic and head of pediatrics for the College of Medicine at the University, said about 30 percent of school-age children get the flu, but this allows them to spread the disease to the elderly, the group that has the highest mortality rate from influenza.

“Some of the advantage of the vaccination is to the individual, and some is to protect the community,” Buetow said.

Dr. David Lawrance, staff physician at McKinley agrees with Buetow.

“The child who was immunized before probably protected themself and two or three other people. Multiply that by hundreds of thousands or millions of children and the community protective effect could be very strong,” Lawrance said.

Vaccinations have to be remade every year to accommodate anticipated strains, and some years the vaccinations do not protect individuals from all strains.

Last year, vaccinations were 75 percent effective for children, Buetow said.

“The thinking is changing on how to protect vulnerable populations, and the best way is to vaccinate everyone,” Lawrance said.

Carle Clinic, as well as many other hospitals and clinics, have already ordered flu shots for next year’s flu season.

The recommendation applies to the 2008-2009 year, but will not be actively implemented until 2009-2010 flu season. Buetow said only 20 percent of the highest risk group, the elderly, are vaccinated.

“I don’t know how seriously the population is going to take this recommendation,” Buetow said.

“If 80 percent ignore the vaccine, what’s going to happen to a lower risk group who is told to get vaccine? It’s going to be an issue.”

Although the majority of the high-risk population does not follow the recommendation, Lawrance believes the committee’s action will pay off.

“More people will follow the recommendation if the ACIP recommends it than if they don’t,” he said. “The ACIP has representatives from all the important medical organizations.”

Buetow said the recommendation could cause other problems, such as controlling the flow of people at doctors’ offices.

“Essentially in our community there are two main large clinics,” she said. “If you think of small doctors’ offices in small towns, that’s going to be a problem. They can only see a certain amount of people per day.”

Buetow proposed school-based clinics as a solution, but admitted even that was problematic.

“We could go to a school and immunize everyone in school, but that would require parental consent and sometimes that is not easy,” she said.

Another issue is the source of financial support for all the vaccinations, Buetow said.

“At Carle, when we order this vaccine we are obligated to pay for it,” Buetow said. “But if you think you have a 1,000 patients, how much money do you consider for supplying vaccines?”

Although Carle is obligated to pay $25 per dose, Lawrance said an ACIP recommendation may broaden payment coverage by insurance companies and the government.

“This is going to be a trial and error season to see how much people want and how many people will get the vaccination,” Buetow said.

Age spread of flu deaths

There are an estimated 36,000 deaths attributed to the flu annually. Of those, about 75 percent occur among people aged 70 and older, but only 25 to 50 deaths occur in children ages 5 to 18.

Source: Centers for Disease Control Web site