tetano
Editor, Senior Moderator
Hum Vaccin Immunother. 2012 Jan 1;8(1). [Epub ahead of print]
Influenza vaccination coverage rate in children: Reasons for a failure and how to go forward.
Olivier CW.
Source
Department of Pediatrics; University Denis Diderot Paris VII; Paris, France.
Abstract
Based on an increasingly extensive literature expressing the large interest in the field, this paper gives an overview of different aspects of influenza prevention in children. It relies on paradoxes. First, the heaviest part of the burden is well demonstrated in the youngest infants by sound and numerous epidemiological data elsewhere; on the contrary, with children increasing age, the prevention by influenza vaccines is more efficacious-without notable side effects. Second, the available TIV vaccines are 60 years old and the requests of registration and regulation of vaccines have evolved (in a good sense); there is a specific need in children: it is time to re-discuss the pragmatic utilization of influenza vaccines (full dose in the youngest? more suppleness about the interval between the two required doses in vaccine-na?ve children?) and to change from a compassionate use to a targeted research and adapted vaccines considering the limits of TIV in the youngest children. Third, influenza virus transmission is the highest in children in semi-close communities (day-care centers, schools), diffusing to households and more largely to the population; a restricted policy on high risk groups (roughly 10% in a pediatric population, all medical conditions including asthma, for whom influenza vaccine coverage is a 15-75% range) is far below the estimated threshold of 45% coverage rate to limit the virus circulation by an indirect impact during seasonal epidemics. Fourth, public health decisions in the vaccination field are usually taken from top to bottom; the pandemic A/H1N1 has toughly demonstrated that "forgetting" about the perception and expectations of the public and the parents nearly created conflicts and at least a strong resistance impeding the quality of a program worked on for a long time ahead. Fifth, and not the least, HCPs are pivotal in influenza vaccination mostly trusted by the parents; too often, they are not backed by a national and clear support and they need to reinforce their knowledge on the disease and the vaccines.
PMID:
22252000
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22252000
Influenza vaccination coverage rate in children: Reasons for a failure and how to go forward.
Olivier CW.
Source
Department of Pediatrics; University Denis Diderot Paris VII; Paris, France.
Abstract
Based on an increasingly extensive literature expressing the large interest in the field, this paper gives an overview of different aspects of influenza prevention in children. It relies on paradoxes. First, the heaviest part of the burden is well demonstrated in the youngest infants by sound and numerous epidemiological data elsewhere; on the contrary, with children increasing age, the prevention by influenza vaccines is more efficacious-without notable side effects. Second, the available TIV vaccines are 60 years old and the requests of registration and regulation of vaccines have evolved (in a good sense); there is a specific need in children: it is time to re-discuss the pragmatic utilization of influenza vaccines (full dose in the youngest? more suppleness about the interval between the two required doses in vaccine-na?ve children?) and to change from a compassionate use to a targeted research and adapted vaccines considering the limits of TIV in the youngest children. Third, influenza virus transmission is the highest in children in semi-close communities (day-care centers, schools), diffusing to households and more largely to the population; a restricted policy on high risk groups (roughly 10% in a pediatric population, all medical conditions including asthma, for whom influenza vaccine coverage is a 15-75% range) is far below the estimated threshold of 45% coverage rate to limit the virus circulation by an indirect impact during seasonal epidemics. Fourth, public health decisions in the vaccination field are usually taken from top to bottom; the pandemic A/H1N1 has toughly demonstrated that "forgetting" about the perception and expectations of the public and the parents nearly created conflicts and at least a strong resistance impeding the quality of a program worked on for a long time ahead. Fifth, and not the least, HCPs are pivotal in influenza vaccination mostly trusted by the parents; too often, they are not backed by a national and clear support and they need to reinforce their knowledge on the disease and the vaccines.
PMID:
22252000
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22252000