Child/Adolescent Health

Study supports recommendation to expand use of influenza vaccine to children older than 2 years of age

Influenza causes significant complications, more hospitalizations, and increases care costs among children older than 2 years of age, according to a new study. These findings provide support for the 2006 recommendations by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices to expand the group of people who should get annual flu shots to include children ages 24 to 59 months.

The researchers estimate that the new guideline would target 80 percent of children hospitalized for influenza. They retrospectively studied 325 children, who were hospitalized with laboratory-confirmed influenza at 1 medical center during 3 influenza seasons. Of this group, 28 percent were under 6 months of age, 33 percent were between 6 and 23 months of age, and 39 percent were over 2 years of age.

Overall, 49 children (15 percent) were treated in the intensive care unit (ICU) and 27 required mechanical ventilation. Half of these children were older than 2 years of age. The total hospital cost for the whole group was $2 million, with 55 percent accounted for by children older than 2 years of age. When comparing the three age groups (less than 6 months, 6 to 23 months, and 2 years and older), there were significant differences in the proportion of children who developed pneumonia (5.4 vs. 19.4 vs. 20.3 percent), were admitted to the ICU (10 vs. 13 vs. 20.3 percent), and required mechanical ventilation (3.3 vs. 8.3 vs. 11.7 percent), respectively (select for Figure).

Overall, children 2 years or older stayed in the hospital significantly longer and had higher total hospital costs (median cost $3,127 vs. $2,534) than those younger than 6 months old, and similar stays and costs to those 6 months to 23 months of age. The study was supported in part by the Agency for Healthcare Research and Quality (HS11826).

See "Epidemiology, complications, and cost of hospitalization in children with laboratory-confirmed influenza infection," by Krow Ampofo, M.B., B.S., Per H. Gesteland, M.D., M.S., Jeffery Bender, M.D., and others, in the December 2006 Pediatrics 118(6), pp. 2409-2417.

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