Influenza vaccine in children with asthma: Why no progress?

Abstract

In an average year, 20% to 30% of chil- dren will be infected with influenza; this attack rate may be substantially higher during epidemic years and among certain populations, such as children in day care. Although most regard influenza as a self-limited ill- ness in children, it may cause substan- tial morbidity in children with and fluenza-associated excess hospitaliza- tion rates of 3 per 1000 high-risk chil- dren younger than 4 years. 2 For the vast majority of these children, the high-risk condition was asthma. Simi- larly, we conducted a study of children with asthma enrolled in Tennessee Medicaid and demonstrated excess hospitalization rates of 5.6 per 1000 children with asthma aged 1 to 3 years. 3 The hospitalization rates in both of these studies are comparable to rates in adult high-risk populations for whom influenza vaccine is recom- mended. In addition, in the Tennessee Medicaid study, an estimated 10% to 20% of children with asthma younger than 15 years had an additional outpa- tient visit during an average influenza season, and approximately 14% of such children received an additional antibiotic prescription. 3