Tuesday, January 31, 2006

U.S. infectious disease experts last week dismissed suggestions that there is insufficient evidence for recommending routine flu shots for healthy children between 6 and 23 months of age.

A review published by the Cochrane Collaboration, an international organization that evaluates medical research, looked at 51 studies worldwide involving more than 250,000 children under age 16. The review uncovered few studies of children under age 2, and found that in studies of vaccines using killed virus -- the only kind approved for use in children under 5 -- shots were no more effective than placebo.

The report didn't carry much weight with U.S. health experts.

John Bradley, director of infectious disease at Children's Hospital in San Diego and a member of the American Academy of Pediatrics committee on infectious diseases, termed the Cochrane review exhaustive and meticulous -- but unpersuasive.

Missing Data In gathering published research dating back to 1976, Bradley said, the reviewers failed to account for variation in the quality of vaccines and research methods. The review, he said, also fails to account for the fact that much of the efficacy data on vaccines is gathered by drug companies that may choose for business reasons not to publish their findings.

"The data that [the researchers] have collected doesn't prove that vaccination doesn't work," Bradley said.

U.S. flu experts agree more research is needed but say there is no reason to question the vaccine's safety for toddlers. Ray Strikas, a flu specialist at the Centers for Disease Control and Prevention (CDC), said the agency's decision to add toddlers to the priority groups for flu vaccine in 2004 was based on U.S. studies showing high rates of serious flu complications in children under 2.

"It was driven by fairly high rates of hospitalization and illness in these kids, with the knowledge that there are not a lot of data about . . . vaccine effectiveness in this population," Strikas said. "We felt there was enough data to say that the vaccine does work -- kids do make [flu] antibodies -- and that it was a reasonable thing to recommend because it's a safe vaccine and all the data suggest it should be effective."

Get the Shot The CDC and the American Academy of Pediatrics continue to recommend annual flu shots for children under 2. They're considering extending the recommendation to include all children up to age 6.

-- Gregory Mott