Seasonal Flu Vaccine For Asthma Patients-Potential Added Benefit but Caution Required

Children with asthma who had received influenza vaccination had fewer asthma exacerbations, according to a recent study conducted in the pediatric clinics of Brooke Army Medical Center, Fort Sam Houston and Wilford Hall Medical Center, Lackland Air Force Base in Texas.¹

Researchers analyzed data from 80 children aged 3 to 18 years in military families. All enrolled children had an asthma diagnosis. Asthma exacerbation defined by oral corticosteroid prescription, hospital visits, and unscheduled clinic or emergency department (ED) visits for asthma symptoms was matched with influenza vaccination and selected demographic variables to identify associations. Administration of the influenza vaccine was associated with a significant decrease in oral corticosteroid use during in the past 12 months in both univariate and multivariate analyses. Demographic variables did not alter the results. The association was less apparent with ED or unscheduled clinic visits in the past 12 months.

The authors suggest that annual influenza vaccination of children with asthma in military families may provide a protective effect against indicators of asthma exacerbations.

The CDC’s current guidelines warn against using the live, attenuated influenza vaccine in young children with asthma. The live, attenuated influenza vaccine is licensed for use among nonpregnant persons aged 2 to 49 years; however, safety has not been established in persons with underlying medical conditions that confer a higher risk for influenza complications. The inactivated influenza vaccine is licensed for use among persons aged 6 months and older, including those who are healthy and those with chronic medical conditions, such as asthma.²

Children aged 2 to 4 years with asthma or a recent wheezing episode should not be given the live, attenuated influenza vaccine. To ensure that these children are not given the live vaccine or to identify those who may be at risk for wheezing after receiving the live vaccine, clinicians can screen for reactive airways disease, consult the medical record (when available), and ask parents or caregivers: “In the past 12 months, has a healthcare provider ever told you that your child had wheezing or asthma?” If the answer is “yes,” these children should not receive the live vaccine.

 

References:

REFERENCES:

1.

Ong BA, Forester J, Fallot A. Does influenza vaccination improve pediatric asthma outcomes?

J Asthma.

2009;46:477-480. Abstract available at:

http://www.ncbi.nlm.nih.gov/pubmed/19544168

.

2.

Centers for Disease Control and Prevention. Seasonal Influenza (Flu). 2009-10 Influenza Prevention & Control Recommendations. Influenza Vaccine Composition & Major Differences.

http://www.cdc.gov/flu/professionals/acip/composition0910.htm

. Accessed October 1, 2009.