This meant that full vaccination is necessary to optimally protect children of this age group from Influenza (Shueler et al.).
The results are consistent with those of other evaluative studies on children through randomized, controlled trials for efficacy and observational studies for effectiveness (Shueler et al., 2007). Vaccine effectiveness depends on the characteristics of the study population, specificity of the outcome, and the Influenza season. It was dissimilar to the findings of Ritzwoller and his team in that Shueler and team's subjects had more exposure to Influenza. The more specific outcome of laboratory-confirmed Influenza made the detection possible. And Shueler and his team's findings were similar to Ritzwoller and his team's in that the findings of both teams offered assurance that vaccination of young children would be beneficial, even in a year with sub-optimal match (Shueler et al.).
Vaccination Efficacy not Found
A case -- cohort study aimed at measuring vaccination among children aged 6-59 months during 2 Influenza seasons (Szilagyi et al., 2008). Participating patients were 165 and 80 inpatient/emergency department and 74 and 95 outpatient Influenza cases. Another group of 4,500 inpatient/ED and more than 600 outpatient sub-cohorts, respectively, were also evaluated. The team compared vaccination status of laboratory-confirmed Influenza cases with random sales in 3 counties during the 2 seasons. Results showed that vaccine effectiveness could not be determined for any season, age or setting after adjusting for county, sex, insurance, chronic conditions and timing of vaccination. The case-cohort research design might be inefficient and insufficiently account for important factors, like the inclination to obtain care. The team concluded that further studies should be conducted using other designs to evaluate the yearly impact of Influenza vaccination programs for children (Szilagyi et al.).
Live Attenuated Influenza Vaccine or LAIV
This is the approved vaccine in the United States for persons aged 2-49 (Ambrose et al., 2008). It is administered as an intranasal spray. It has provided high levels of efficacy in both match and mismatched strains in this age group. Comparative studies between LAIV and inactivated Influenza vaccine in children showed that patients with LAIV had up to 53% fewer cases of illness than with the other vaccine. The most common adverse reactions are runny nose or nasal congestion in the said age group and less than 100 degrees Fahrenheit fever in children. Formulations of LAIV are under experiment (Ambrose et al.).
Live attenuated Influenza viruses replicate primarily in the nose and throat area to induce the body's immune response (Ambrose et al., 2008). These viruses do not replicate too well in lower airways and lung where the temperature is warmer. During replication, viral proteins will be perceived by the immune system, which responds to natural infection by Influenza viruses. The vaccine is now currently approved for children 2 years old and older. Tests showed up to 93.4% efficacy against illness after the first year of vaccination. It reached 100% after the second year. LAIV also protects against antigenically mismatched strains as a single dose in children 1.5 to 18 years of age. As to dose, tests showed that a single dose had a 58% efficacy while two doses had 89%. Thus, the recommended dose is 2. The vaccine was also evaluated as safe in more than 18,000 tested children less than 5 years old except for nasal congestion or runny nose (Ambrose et al.).
There is concern about these viruses re-assorting with circulating seasonal Influenza viruses and evolve into easily transmissible types (Ambrose et al., 2008). Authorities addressed this concern by conducting clinical trials during months when the viruses are not likely to circulate. This can be done in an isolation facility between April and December. When a pandemic is imminent, the risks should be weighed against the benefits before the massive use of the vaccine. This will be the decision of public health authorities (Ambrose et al.).
Feasibility and Physicians' View of Influenza Vaccines
A national random study was conducted in February 2001 with 458 pediatricians and family physicians on the feasibility of routine Influenza vaccination of infants and toddlers (Humiston et al., 2004). It also determined the potential barriers to it and its current and projected use. The survey focused primarily on routine Influenza vaccination for children 12-35 months in injection or intranasal spray vaccine form (Humiston et al.).
Most of the respondent physicians agreed that vaccination was feasible at 80% and that it would significantly reduce visits for illness during the Influenza season at 69-80% (Humiston et al., 2004). They favored vaccination for children 12 through 35 months old in the form of an injection or intranasal vaccine. They did not favor administering to children less than 1-year of age. They also believed vaccination...
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