Influenza effects and prevention in children

The American Academy of Pediatrics (AAP) has released a report on the effects of influenza in children, along with guidelines for infection prevention.

Influenza rates have been lower in recent years, which the AAP has attributed to mitigation efforts against SARS-CoV-2. However, influenza still has a significant effect on the pediatric population, with the greatest hospitalization rates seen among children aged 0 to 4 years.

Annually, about 9% of children in the United States are afflicted with symptomatic influenza virus infection. Children aged under 5 years are at the greatest risk of hospitalization, and deaths occur in children with and without underlying conditions. In a cross-sectional study, 20% of children hospitalized from influenza were admitted to intensive care unit, 17% had pneumonia, and 5% required medical ventilation.

Of infants hospitalized, 8% to 11% experience neurological complications. These include encephalopathy, febrile seizures, and nonfebrile seizures. Children with pre-existing neurological condition or those who had not received a seasonal influenza vaccine are at a greater risk of neurological complication, showcasing the need for timely vaccination.

The highest risk of complications from influenza was seen in children aged less than 5 years, along with certain populations with social or community characteristics. Researchers saw an increased need to remove barriers for access of influenza vaccination among these higher risk groups.

Vaccination has been proven to be most effective in children aged under 5 years. The Centers for Disease Control and Prevention has estimated that 16% of hospitalizations among children aged 5 to 17 years, and 28% of hospitalizations among children aged 6 months to 4 years, were prevented by the influenza vaccine in the most recent influenza season.

Up to 80% of recorded pediatric deaths from influenza were in unvaccinated children aged 6 months and older. Vaccine effectiveness against mortality in pediatric patients was 65% in a case-cohort analysis, and 51% in children with underlying conditions.

The AAP outlined available vaccinations for the 2022 to 2023 influenza season but stressed that vaccination should not be delayed in waiting for a specific brand. The vaccines listed in their policy statement all contained the same influenza strain and were recommended by the US Food and Drug Administration and the World Health Organization.

Based on the AAP’s guidelines, the influenza vaccine can be administered concomitantly alongside other vaccines in adults, including the currently available vaccines for COVID-19. A study is currently taking place to analyze the safety of concomitant vaccine administration in pediatric patients aged 12 years and older.

Influenza vaccination has been proven safe in children with and without underlying conditions when administered through IIVs. As influenza can circulate as early as October, the AAP encouraged timely influenza vaccination.

Reference

Recommendations for prevention and control of influenza in children, 2022–2023. Pediatrics. 2022. doi:10.1542/peds.2022-059275