Influenza Vaccine in the Red Zone Defense: A Game-Day Player

Abstract

Ultimate victory over influenza will rank among the great achievements of humankind because the defeats have been so bitter. The defense is growing stronger, and losses are less extreme. Incomplete successes against a lethal foe are great successes that fuel the determination for a shared and total victory. Studies reported in this issue of The Journal of Infectious Diseases invite consideration of the strengths and limitations of influenza vaccination, an especially important defense against life-threatening influenza disease and its transmission. Influenza vaccination has not yet fulfilled the hope of complete protection against disease. Influenza vaccine effectiveness against all forms of influenza disease is variable. However, the prevention of influenza morbidity in all forms is less grave a need than prevention of mortality, and influenza vaccine performance is generally better in this regard. Consequently, persons at high risk for severe influenza disease benefit most from influenza vaccination, a conclusion that underpins the strongest recommendations for vaccination of this population [1]. Children who are older than 6 months, thus eligible for influenza vaccination, suffer high attack rates of influenza, though lower hospitalization rates than children younger than 6 months [2]. Children play an important role in the epidemic spread of influenza virus [3– 6]. Childhood influenza deaths are devastating losses, and their ongoing prevention by vaccination would be a tremendous achievement; nowhere is the struggle with influenza more hard fought than in the red zone of our pediatric intensive care units (PICUs).