Flu jabs for under-fives the right medicine

PUBLISHED : Tuesday, 17 June, 2008, 12:00am
UPDATED : Tuesday, 17 June, 2008, 12:00am

Flu outbreaks in schools led some to shut early before Easter. The government's public health strategy for the next flu season therefore means more to parents than it usually would. At the height of the recent scare, health authorities did not rule out the radical - and costly - option of providing free flu vaccinations for all children under 12. That raised questions about its cost-effectiveness and the health benefit to the community, issues upon which the medical community as a whole remains divided.

The government offers free flu vaccinations to children aged six months to 23 months whose families are on welfare. In future it will subsidise vaccinations for all children under five - a total of 320,000 - a programme which may involve private doctors administering the shots. The age distribution of those infected in the most recent flu season supports this approach. Contrary to appearances, infection rates were lowest among school-age children. The rate for six- to 11-year-olds was 33.8 per 10,000, compared with 137 per 10,000 among two- to five-year-olds and 170 per 10,000 aged under two.

The argument for vaccinating children is that it is a better way of stopping the virus spreading than closing schools after flu has begun spreading. Advocates of this approach include an advisory panel to the US Centres for Disease Control and Prevention. A local expert panel has found that while common flu strains have not mutated in significant ways, they have undergone genetic changes big enough to lower the natural immunity to flu which young children and elderly people enjoy.

Flu vaccines are effective but have to be given every year to keep up with changes in the virus. Subsidies must be paid out every year too and the bill can easily increase. For that reason, the government has, until now, offered free flu shots only to needy children and old people. Given the pattern of infection last season, there is no reason to suppose the government is taking a risk with public health by not offering free vaccination to all under-12s. But it would be sensible to advise parents of older children to consider paying for flu shots and to encourage doctors to provide them at an attractive price.