Flu vaccineVaccinating against flu poses a particular problem. The flu virus is able to mutate rapidly, such that every year different types of flu are likely to predominate. A one-off vaccination can only protect against specific strains, and so is unable to offer long-term protection. Every February, the World Health Organisation (WHO) predicts which strains of flu are most likely to be causing problems during the following winter. Most, but not all, governments follow the WHO’s advice when formulating their flu vaccines. Each year, a vaccine is made using the whole, or parts, of three killed flu viruses. Live flu vaccines are also made, in the form of a nasal spray. As the vaccine is only designed to help protect against one season’s flu, yearly vaccinations are required to maintain protection. Natural protection to flu, after an attack, also declines rapidly as the virus mutates. Unlike adults, younger children need two separate injections given 4-6 weeks apart if receiving the jab for the first time.
New UK PolicyIn the UK the flu jab was recommended only for children over 6 months who suffer from certain conditions such as severe asthma, bronchiectasis, cystic fibrosis, congenital heart disease and those receiving drugs that suppress the immune system - such as for cancer.
The UK government has announced that all children in England and Wales aged between 2 and 17 years of age are to be offered yearly flu jabs. This has been described as “cost-effective" as a result of complex mathematical models that predict the vaccine will reduce the burden of influenza on GPs' work and will reduce the number of deaths and hospital admissions from flu. However no one is pretending that it is the vaccinated children who are going to benefit. Children, especially healthy children, very rarely die from influenza; in fact in many years there are no deaths at all from flu in children under 15 years of age.
Vaccine effectivenessFlu vaccines probably do not work in children under two years of age. In children over two years the flu jab containing killed flu virus (the one that has been used up until now in the UK) prevents flu caused by the strains in the vaccine in 6 out of 10 children. The new live vaccine given as a nasal spray is more effective and protects up to 8 out of 10 against the flu strains present in the vaccine, but only protects around 3 out of 10 children against flu-like illness caused by other types of viruses.
Vaccine safetyAs the flu vaccine has to be reformulated every year it is difficult to predict adverse reactions as accurately as with other vaccines. For example one brand of the swine flu vaccine (the main one used in the UK) used in the 2009/2010 swine flu pandemic was later found to have caused narcolepsy (an extremely rare disorder causing unusual sleepiness) in some children who had received the vaccine.
Known side-effectsThe inactivated (killed) vaccine commonly causes local pain, tenderness, redness and swelling at the injection site in around a quarter of recipients. Fever, malaise, muscle ache and headache may also, less commonly, occur, as can vomiting and diarrhoea. The risk of allergic reactions such as urticaria (hives) increases with each dose of vaccine received. Febrile convulsions (fits as a result of a fever) also occasionally occur and appear to be more common with some makes of vaccine than others.
The live vaccine commonly causes mild symptoms of flu such as headache, fever, stuffy and runny nose, vomiting and muscle ache. The live vaccine also causes an increase in wheezing and asthma in some children under three years of age, and so there is some concern that it might not be safe to give to children with asthma or a history of wheezing. The risk of wheezing after receiving the vaccine appears to be greater the younger the child and may be confined to children under 4 years of age. However children with mild to moderate asthma or wheezing do not appear to suffer greater wheezing after the live vaccine compared to the inactivated vaccine. However one expert reviewer has nevertheless concluded that the vaccine should not be given to any children with asthma.
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