Physicians struggle with flu vaccination strategies for kids

Efforts are more frequently targeting children, but rates remain low and not all doctors are sold on the value for this group.

By Victoria Stagg Elliott, AMNews staff. Aug. 11, 2003.

This fall, Anders Nelson, MD, will host many flu vaccination clinics where a shot per minute will be the norm. But his clientele won't fit the stereotype of those usually targeted for flu shots: the elderly. Dr. Nelson is a pediatrician, and most of the patients rolling up their sleeves will be children.

"Every kid in my practice is a priority patient," said Dr. Nelson, from Clarks Summit, Pa. "If you try to pick out the kids who most need it, it takes a lot of effort. We go for as close to universal immunization as we can, and it turns out to be very efficient."

Dr. Nelson is one of a growing number of doctors who are increasingly seeing flu vaccine as important, not just for the elderly, but also for the young. Public health agencies and medical societies have long urged that children with medical conditions, such as asthma or diabetes, get the vaccine, but now some groups are considering expanding their recommendations to include healthier children.

"When you do risk-based recommendations, those tend to fail," said Jon Abramson, MD, past chair of American Academy of Pediatrics' Committee on Infectious Diseases. "You only get 10% to 20% of your high-risk patients vaccinated. It's always more effective to do an age-based recommendation."

Some groups and agencies already have weighed in on the issue. Last year, the Centers for Disease Control and Prevention started encouraging flu shots for those ages 6 months to 23 months, and the AAP stated in December 2002 that universal vaccination of all children was the goal for the future.