Shots for Kids May Be Best Flu Defense

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STEVE INSKEEP, host:

This is MORNING EDITION from NPR News. I'm Steve Inskeep in New Orleans.

RENEE MONTAGNE, host:

And I'm Renee Montagne in Washington.

In this morning's personal health segment, children and how they spread disease among themselves and adults. In a moment, one school's innovative approach to hygiene.

First, we'll look at the idea that the best way to prevent the flu in all Americans is to vaccinate children, the biggest spreaders of the flu. Right now only kids from two to 23 months old are supposed to get flu shots. NPR's Richard Knox has this report.

RICHARD KNOX reporting:

Dr. Kenneth Mandl stands in the emergency room at Children's Hospital in Boston, one of the busiest in New England. He says the place is about to get even busier.

Dr. KENNETH MANDL (Children's Hospital): We expect flu season to start around October sometime, and the patients to start coming in here in droves.

KNOX: Mandl and his colleague John Brownstein have discovered something interesting about that annual onslaught: It starts with preschoolers.

Dr. MANDL: The pattern that we're seeing is that three- and four-year-olds lead off the flu epidemic every year. They present to emergency departments and to primary care settings first in a way that signals the general burden of illness from influenza three weeks in advance. So by following these young children, we get a peek into the future.

KNOX: Mandl says these little kids are not just the canaries in the coal mine signaling the new flu season.

Dr. MANDL: I believe that three- and four-year-olds are actually driving the epidemic. It's not just the fact that they're coming in early that leads us to believe that they are starting off the epidemic, but this tight correlation with a later burden of illness from influenza.

KNOX: That has important practical implications. It suggests that if enough young children were vaccinated, fewer people at high risk in a community, especially seniors, would get the flu. There's lots of evidence that it works. For decades, Japan vaccinated virtually all schoolchildren against flu. That drastically cut flu deaths among the elderly. When Japan stopped vaccinating kids, flu deaths among older people went up. And for the past several years, Baylor University researchers have been vaccinating school kids in the central Texas cities of Temple and Belton, but not neighboring communities. Dr. Paul Glezen leads the experiment.

Dr. PAUL GLEZEN (Baylor University): There was a significant decrease in acute respiratory illness in people 35 years of age and older in Temple and Belton as compared to the other communities.

KNOX: That kind of evidence is sparking a debate among public health experts. More and more are saying we should give flu shots to young children, those whose parents say it's OK, as the best way to reduce the deaths and hospitalizations among elders and high-risk people. There are other reasons to do that. Dr. Ray Strikas of the Centers for Disease Control and Prevention says it's very hard to persuade seniors to get flu shots.

Dr. RAY STRIKAS (Centers for Disease Control and Prevention): There's been a plateau over the last five or so years and your older adults, 65 and older, sort of leveled off at about 65 percent, 66 percent of people vaccinated.

KNOX: Finally, experts say flu vaccine is just not very effective among the oldest and highest-risk seniors. This month the CDC and others will sponsor a conference on universal vaccination of children and perhaps healthy young adults as well. It would be several years before that could be implemented.

(Soundbite of voices)

KNOX: Meanwhile, Dr. Ken Mandl of Children's Hospital in Boston says parents don't have to wait.

Dr. MANDL: Well, I'll tell you, I get my own three- and five-year-old vaccinated every year since they were young. The side effects from the flu vaccine are very low. The adverse consequences of influenza are high enough that the benefit is there.

KNOX: Later this month, after high-risk people have had their chance to get flu shots first, parents are free to follow Mandl's example.

Richard Knox, NPR News, Boston.

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