Giuseppe
Emeritus
2009 Influenza A(H1N1) Monovalent Vaccines for Children (JAMA, editorial, excerpts, edited)
2009 Influenza A(H1N1) Monovalent Vaccines for Children
Anthony E. Fiore, MD, MPH; Kathleen M. Neuzil, MD, MPH
JAMA. 2010;303(1):73-74.
Published online December 21, 2009 (doi:10.1001/jama.2009.1929).
The 2009 influenza A(H1N1) virus was first identified 8 months ago,1 but the virus has already had a substantial effect on human health. Influenza activity in the United States has remained higher than normal since May, and measures of severe illness such as hospitalizations and deaths during the summer and fall have been equal to or higher than rates usually observed in a typical winter influenza season in all age groups except older adults.2 Even though influenza activity has decreased in recent weeks in some states, there remains the possibility of continued activity through the traditional winter influenza season and the prospect of normal winter circulation of seasonal influenza viruses.
The 2009 influenza A(H1N1) pandemic highlights the role of children in influenza epidemiology. Serological studies suggested that children had no measurable immunity against H1N1 prior to the outbreak.3 In addition, children have been a primary source of illness in community outbreaks of pandemic influenza, as indicated by the association between outbreaks in schools or summer camps and influenza activity in the community.4 Children also have developed severe influenza A(H1N1)?related complications more frequently than is usually seen for seasonal influenza and reports of pediatric deaths and hospitalizations continue to increase.2 As of December 5, 2009, 224 laboratory-confirmed deaths among children had been reported to the Centers for Disease Control and Prevention, far surpassing any recent influenza season,2 and the actual number of pediatric deaths due to the influenza A(H1N1) virus pandemic is likely to be considerably higher.5 Children have been among the primary groups targeted for the limited amount of vaccine available in most areas.6
A logistical challenge for immunization programs and clinicians who provide vaccinations is the need for 2 doses in young children.6 For seasonal influenza vaccine, 2 doses are recommended for all children younger than 9 years who are being vaccinated for the first time, based on immunogenicity and vaccine effectiveness studies that indicate better protection with a 2-dose schedule for young children.7 For the 2009 influenza A(H1N1) monovalent vaccines, the current recommendation is based on these seasonal vaccine studies even though the age group recommended for 2 doses is children younger than 10 years.6, 8
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<cite cite="http://jama.ama-assn.org/cgi/content/full/303/1/73?etoc">JAMA -- 2009 Influenza A(H1N1) Monovalent Vaccines for Children, January 6, 2010, Fiore and Neuzil 303 (1): 73</cite>Anthony E. Fiore, MD, MPH; Kathleen M. Neuzil, MD, MPH
JAMA. 2010;303(1):73-74.
Published online December 21, 2009 (doi:10.1001/jama.2009.1929).
The 2009 influenza A(H1N1) virus was first identified 8 months ago,1 but the virus has already had a substantial effect on human health. Influenza activity in the United States has remained higher than normal since May, and measures of severe illness such as hospitalizations and deaths during the summer and fall have been equal to or higher than rates usually observed in a typical winter influenza season in all age groups except older adults.2 Even though influenza activity has decreased in recent weeks in some states, there remains the possibility of continued activity through the traditional winter influenza season and the prospect of normal winter circulation of seasonal influenza viruses.
The 2009 influenza A(H1N1) pandemic highlights the role of children in influenza epidemiology. Serological studies suggested that children had no measurable immunity against H1N1 prior to the outbreak.3 In addition, children have been a primary source of illness in community outbreaks of pandemic influenza, as indicated by the association between outbreaks in schools or summer camps and influenza activity in the community.4 Children also have developed severe influenza A(H1N1)?related complications more frequently than is usually seen for seasonal influenza and reports of pediatric deaths and hospitalizations continue to increase.2 As of December 5, 2009, 224 laboratory-confirmed deaths among children had been reported to the Centers for Disease Control and Prevention, far surpassing any recent influenza season,2 and the actual number of pediatric deaths due to the influenza A(H1N1) virus pandemic is likely to be considerably higher.5 Children have been among the primary groups targeted for the limited amount of vaccine available in most areas.6
A logistical challenge for immunization programs and clinicians who provide vaccinations is the need for 2 doses in young children.6 For seasonal influenza vaccine, 2 doses are recommended for all children younger than 9 years who are being vaccinated for the first time, based on immunogenicity and vaccine effectiveness studies that indicate better protection with a 2-dose schedule for young children.7 For the 2009 influenza A(H1N1) monovalent vaccines, the current recommendation is based on these seasonal vaccine studies even though the age group recommended for 2 doses is children younger than 10 years.6, 8
(...)
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