Flu shots: A logistical suggestion

It's plenty difficult to jam influenza vaccinations into the short time slot available each season, especially for vaccine-naive children who need two shots a month apart. A potential strategy for dealing with this problem comes from Emmanuel B. Walter, MD, director of the Vaccine and Infectious Diseases Epidemiology Unit at Duke University Medical Center: Give one dose of the flu vaccine in the spring!

Even though the spring shot may not cover the same antigens as the following season's mix, it may still have a priming effect.

"In years when there's an early influenza epidemic and not enough time to give two doses of vaccine in the fall,"Dr. Walter said, "a spring-fall strategy has the potential advantage of covering a greater proportion of young children earlier in the season."

When the two groups were compared after their first dose of the fall vaccine, the proportion of children who had a protective antibody level to all three antigens was greater in the spring-fall group. After the fall-fall children were given their second shot, titers to the H1N1 antigen were comparable for both groups, whereas titers for the H3N2 and B antigens-which differed from the 2003-2004 formulation-were less robust in the spring-fall group.

"No matter when the first dose of TIV is given, two doses of TIV are always preferable to a single dose," Dr. Walter concluded.

The study was presented at the Annual Meeting of the Infectious Diseases Society of America this past October in San Francisco. If you have enough vaccine left over come spring, you might want to give this strategy a try.

Ms. Asch-Goodkin is a contributing editor for Contemporary Pediatrics. She has nothing to disclose in regard to affiliations with, or financial interests in, any organization that may have an interest in any part of this article.