Flu Vaccines Necessary in Kids?

To me, the best part of being a journalist is that sometimes my preconceived notions get thrown to the wind in the process of researching an article. After interviewing about two dozen experts for a feature I'm writing on vaccines, I've come to question the wisdom of the new government recommendation that all children be vaccinated against the flu. Let me state this in bold face: I am very much pro-vaccines. My three children were all vaccinated on the recommended schedule and got their chicken pox boosters at their last checkups. But I opted not to give them the flu vaccine.

That's because whereas I once viewed all vaccines as 100 percent risk free and completely necessary, I now see them as akin to very safe medicines. They have saved countless lives, but they're not without their risks. This more complex message often gets lost in the push to get kids vaccinated, because public health officials are justifiably fearful that any talk of risks will turn parents off to vaccinations.

Unfortunately, journalists often deliver an oversimplified message, too. While sounding the call for all kids to get the flu vaccine, Carey Goldberg of the Boston Globe outlined the vaccine's risks and benefits.

"In perhaps one in a million cases, a vaccine can prompt a life-threatening allergic reaction, he said. Similarly, in perhaps one in a million cases or less, flu vaccines have appeared to be linked to a paralyzing neurological disease called Guillain-Barre syndrome. But the odds of dying from the flu are far greater—as those 83 pediatric deaths last year demonstrate."

The trouble with this argument is that the risks of a child dying from the flu aren't all that great when you consider the estimated number of children in the United States is 73 million to 80 million. In other words, a child's individual risk of dying is about 1 in a million. Compare that to the risk of suffering anaphylactic shock from an allergy to the vaccine or total paralysis from GBS, and suddenly the benefits don't seem to add up to much. What's more, several of the children who died from the flu last year had been vaccinated against it. Parents may also want to opt out if their child has an egg allergy since the vaccine contains traces of eggs.

On the other hand, the Centers for Disease Control and Prevention says that children are at increased risk of developing severe complications from the flu, the kind that require hospitalization. They're also the ones most likely to transmit infections to family members, resulting in lost school days and work time. What's more, the vaccine is 75 percent effective at preventing the flu—though I'm assuming that's when scientists correctly predict which strains will hit the United States, which they weren't able to do last year.

Parents need this sort of basic information when it comes to determining whether to get their kids vaccinated against the flu. They don't, though, need states to take the position of New Jersey, which is now mandating that all preschoolers get flu shots before entering nursery school and daycare centers. And they don't need the sort of black-and-white messages being transmitted by public health experts and antivaccine activists alike. A good doctor should be able to explain the flu vaccine's pros and cons, but many still have a hard time boiling down all those health statistics as my colleague Avery Comarow recently reported here.