Did your preschooler get a flu shot this season? Almost 40 percent of parents of young children say yes, according to a new poll. That's pretty darned good, considering that the federal government officially started recommending yearly flu shots for children ages 6 months through 2 years starting in 2004, and only added children through age 5 for the 2006-07 flu season. I must confess that I'm not among that noble number, having not quite managed to make the trek to the pediatrician's office with my own 4-year-old in the fall.
The real number's probably not quite as good; we all tend to fib when asked whether we're following health advice. The Centers for Disease Control and Prevention estimates that 20 percent of eligible children were fully vaccinated for the 2005-06 flu season. (And this week the CDC reported that adults are dismal at keeping up with their own vaccinations, with only 2 percent getting the recommended shots for pertussis and shingles.)
So parents deserve an "attaboy!" for that 36 percent, reported this week by C.S. Mott Children's Hospital in Ann Arbor, Mich. There are two thoughts behind the expansion of flu immunizations for children. One is that young children are more likely to get seriously ill from the flu and wind up in the hospital than are older kids. Another is that small children are supergood at spreading germs. Keep the flu virus out of the kid, the theory goes, and everyone else in the family is less likely to get sick. The idea is gaining traction; this fall, New Jersey will become the first state in the nation to make flu shots required for children attending daycare or preschool. No doubt more states will follow. Children who haven't had the shot before need two doses; children ages 2 and older now can also use FluMist, a vaccine nose spray.
But the idea's not a slam-dunk. There's evidence that flu shots aren't as effective at building immunity in small children as they are in healthy teens and adults. And some parents worry that thimerosal, a mercury-based preservative used in some flu shots, could cause autism, despite mounting evidence that it's not a risk factor. Moreover, there are more deaths from flu among older children than among tots. Last flu season, 68 children died of flu nationwide, according to the CDC. Of those, 39, or more than half, were school-age children, ages 5 to 17. Most had not gotten flu shots.
Because of that scary fact, in February, the CDC's Advisory Committee on Immunization Practices is expected to recommend that all school-age children start getting annual flu immunizations, too, starting either this fall or in 2009. A 2006 study with 15,000 schoolchildren found that in those who used FluMist, 17 percent of the households had a child with a flulike illness, compared with 26 percent in households where children weren't immunized. Eight percent of the FluMist households had a sick adult, compared with 13 percent in the controls. Research has shown that the vaccine is cost-effective because adults miss less work.
Barbara Loe Fisher, cofounder and president of the National Vaccine Information Center, a vaccine safety advocacy group, wonders if children might be better off in the long run if they built up their immunity to seasonal flu strains the old-fashioned way, by getting sick. It's true that for healthy children, flu poses less of a risk of death or disability than do the really nasty diseases like polio and smallpox that made vaccines the marvels of public health that they are. Flu shots for children, like any new public-health policy, are an experiment. It's one that comes with obvious benefits and probably not too many risks. But as with all such experiments, we won't know the final tally until many years from now, perhaps when some of the first flu-shot babies are parents themselves.