How to better inform the decision making about universal influenza vaccination in children

Abstract

The disease burden of seasonal influenza in young children is substantial. And yet only the USA, Canada, Finland and one state in Australia currently have a routine influenza vaccine policy in place for young children. Few countries seem keen to follow their lead. This paper reviews the evidence required to inform a policy of universal paediatric vaccination; key features include protective effect, economic impacts and the safety of influenza vaccination in this age group. We found that i. there is insufficient data on the protective effect of vaccinating infants aged 6–23 months, ii. there are very few economic evaluations and most of the current published economic evaluations involve modelling and were performed using data from a variety of sources which are not setting specific, and iii. safety data have not been specifically addressed by an in-depth separate systematic review. To better inform relevant policy making, we suggest that interdisciplinary research, (combining epidemiology and health economics at least), is required to fully examine the protective effect, economic impacts and safety of influenza vaccination in children aged 6–59 months. We also suggest that the safety data on influenza vaccination in this age group should be assessed specifically by an in-depth separate systematic review, using published and grey literature.