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Some young children may need only one flu shot this year

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Children aged 6 months to 8 years usually require two doses of influenza vaccine, but if they were vaccinated last season they only require one dose this upcoming season — because the composition of the 2011-2012 vaccine is unchanged from the 2010-2011 season.

That has happened only four times in 25 years, according to a policy statement from the American Academy of Pediatrics on recommendations for prevention and control of influenza in children, 2011-2012, published in the October issue of Pediatrics.

One of the components of the vaccine is an H1N1 antigen derived from the 2009 pandemic influenza A virus, which disproportionately affected children in 2009 and 2010.

All children over 6 months of age should be immunized, the document recommends. Those up to 8 years of age should be given two doses unless previously immunized (as mentioned), while children aged 9 and up need only one dose.

A new feature of the upcoming season will be the availability of an intradermal version of the trivalent influenza vaccine (TIV) for use in people 18 to 64 years old, along with the familiar intramuscular version as well as the intranasally administered live-attenuated influenza vaccine (LAIV).

Intradermal administration “involves a microinjection with a needle 90% shorter than needles used for intramuscular administration,” the statement notes. Apart from that, adverse effects do not seem to be any less than with intramuscular injection, and there is no preference for either formulation.

Another new recommendation for the 2011-2012 season is that extensive allergy testing in children with presumed egg allergy is not usually necessary, because both the TIV and the LAIV are well tolerated by most such individuals. However, “Clinicians should consult with an allergist for children with a history of severe reaction,” the report advises.

While the focus is on protecting all children, the statement recommends special efforts to vaccinate those with conditions that increase the risk of complications, as well as contacts of such children, and women who are pregnant or breastfeeding during the flu season.

It also urges healthcare providers to “act as role models by receiving influenza immunization annually and recommending annual immunizations to both their colleagues and patients.”

Recommendations for Prevention and Control of Influenza in Children, 2011–2012
Pediatrics 2011;128.