Pediatric Influenza Management ForumCo-chairs
Gary Marshall, MD
Chief, Division of Pediatric Infectious Illnesses College of Louisville College of Drugs Norton Youngsters’s HospitalLouisville, Kentucky
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Donald Middleton, MD
Vice President of Household MedicineUniversity of Pittsburgh College of MedicineUPMC St. MargaretPittsburgh, Pennsylvania
Advisors
Shelle AllenPresidentFamilies Preventing FluArlington, Virginia
Ruth Carrico, PhD, DNP,APRN, FNP-C, CIC, FSHEA, FNAP, FAANExecutive Director of the Infectious DiseasesInstitute for Norton HealthcareProfessor and Household Nurse Practitioner,free of charge college, with the College of Louisville College of Drugs, Division of Infectious DiseasesLouisville, Kentucky
Claire Hannan, MPHExecutive DirectorAssociation of Immunization ManagersRockville, Maryland
Serese MarottaDirector, Advocacy & EducationVaccinate Your FamilyWashington, DC
Carole Moloney, APRN, MSN, CPNPAssistant Professor of PediatricsDepartment of PediatricsDivision of Pediatric Infectious DiseasesBoston Medical CenterBoston, Massachusetts
Flor Munoz, MD, MScAssociate Professor of PediatricsMolecular Virology and MicrobiologyBaylor Faculty of MedicineMedical DirectorTransplant Infectious DiseasesTexas Youngsters’s HospitalHouston, Texas
Stephen Pelton, MDProfessor of PediatricsBoston College College of MedicineSenior Attending PhysicianPediatric Infectious DiseasesBoston Medical CenterBoston, Massachusetts
Litjen (L.J) Tan, MS, PhDChief Coverage and Partnerships OfficerImmunize.org (previously, Immunization Motion Coalition)Co-Chair, Nationwide Grownup and Influenza Immunization SummitSaint Paul, Minnesota
Todd Wolynn, MD, MMM, IBCLCPresident and CEOKids Plus PediatricsPittsburgh, Pennsylvania
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The Pediatric Influenza Management Discussion board convened on December 15, 2022, the place an esteemed group of pediatricians, nurse practitioners, and members of advocacy teams got here collectively to debate influenza immunization in pediatric medical observe, obstacles to immunization, and methods to beat these obstacles to extend immunization charges. Dr. Gary Marshall and Dr. Donald Middleton co-chaired the assembly.5
The burden of flu continues to be excessive, with pediatric hospitalizations peaking early within the 2022-2023 season4,6
Hospitalizations peaked early within the 2022-2023 season in comparison with earlier seasons.4,6 This early peak brings into dialogue the timing of the influenza vaccination. One advisor mentioned vaccinating kids earlier within the season, earlier than the virus is circulating. “Sadly, individuals wait till October or later [for flu vaccination], after which it’s too late, as we noticed this yr.5”
In response to the CDC, as of March 31, 2023, of the 1,263 kids hospitalized with influenza for whom data was obtainable, 65.8% had not less than one reported underlying medical situation; essentially the most generally reported was bronchial asthma, adopted by neurologic illness, and weight problems.4
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40% to 60% of kids who died from flu didn’t have any underlying medical situations, and the vast majority of them weren’t vaccinated6,7
As of March 31, 2023, there have been a complete of 138 influenza-associated pediatric deaths throughout the 2022-2023 flu season, whereas, prior to now, the vary of pediatric deaths had been 1 (2020-2021) to 199 (2019-2020) in your complete flu season.4 40% to 60% of the kids who died on account of flu between 2019 and 2023 didn’t have any underlying situations.7 The advisory panel thought of these information essential to convey to folks, particularly that even wholesome kids can succumb to flu.5
Of the 106 kids who died as of February 10, 2023, 103 had been eligible for vaccination, and of the 81 kids whose vaccination standing had been obtainable, 90% weren’t absolutely vaccinated in opposition to flu. In previous seasons, about 80% of kids who died from flu haven’t been absolutely vaccinated.7
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Regardless of the excessive burden of flu, the charges of flu vaccination haven’t reached the Wholesome Individuals 2020 and 2030 objective of 70percent1-4
Regardless of the excessive burden of flu, the charges of flu vaccination haven’t reached the Wholesome Individuals 2020 objective of 70% for annual influenza vaccination for youngsters 6 months by way of 17 years of age.1-4 In response to the CDC, as of February 11, 2023, the general vaccination price for youngsters 6 months and above is 53%, these 6 months to 4 years is 62.4%, these 5 to 12 years is 53.8%, and people 13 to 17 is 44.4% that are a lot decrease than the goal for Wholesome Individuals 2020 and 2030.1-3
Insurance coverage claims knowledge exhibits that because the starting of the COVID-19 pandemic, pediatric flu vaccination claims have declined by 43.4% by way of December 20229
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As per preliminary interim estimates from the New Vaccine Surveillance Community (NVSN), throughout the 2022-2023 season, as of January 25, 2023, flu vaccination resulted in a 68% effectiveness in opposition to flu-related pediatric hospitalizations and a 42% effectiveness in opposition to flu-related pediatric emergency division (ED) visits9
By way of January 25, 2023, influenza vaccination considerably lowered laboratory-confirmed medically attended influenza within the 2022-2023 season1068% (95% CI, 46, 81) discount in pediatric hospitalizations visits42% (95% CI, 25, 56) discount in pediatric ED visits
There was notable safety in opposition to each A/H3N2 and A/H1N1 related illnesses10
Although the flu vaccine doesn’t all the time stop influenza an infection, it considerably reduces dangers of extreme illness and issues.10 This was a message that was essential to convey to folks, as mentioned within the Pediatric Influenza Management Forum5
Insights from the Pediatric Influenza Management Forum5
As mentioned within the Pediatric Influenza Management Discussion board assembly on December 15, 2022, under are a few of the many obstacles to flu vaccination in kids.
Limitations to flu vaccination5
Mother and father typically lack consciousness of the seriousness of influenza and its issues. Misconceptions about its impression affect their choice to not immunize their childrenTiming of the flu vaccine and again to highschool go to might not align and vaccination could also be missed, particularly as it isn’t required for schoolMany mother and father delay flu vaccination on account of misconceptions on timing and threat of waning immunity
Misinformation and myths associated to the efficacy and security of the flu vaccination has been compounded by the COVID-19 pandemic, growing vaccine hesitancy, resulting in low flu vaccination ratesA frequent false impression is that the flu vaccine could also be secure however doesn’t work. Nevertheless, flu vaccines stop severe illness which may result in hospitalization and death10Unfounded myths concerning the COVID-19 vaccines have triggered considerations relating to the security and efficacy of different vaccines, together with the flu vaccine, resulting in a rise in anti-science and anti-vaccine sentiments
Social media performs an influential function in shaping client perceptions and may be dominated by misinformation with anti-vaccine campaigns, resulting in vaccine hesitancy
Staffing constraints have lowered alternatives to obtain a flu vaccination at some clinics. Each mother and father and suppliers can unintentionally deprioritize flu vaccinationAdvisors shared that, throughout a clinic go to, typically a number of vaccines are due and oldsters select solely those which had been required for varsity, deprioritizing flu vaccinationIn addition, employees shortages could also be a think about mother and father’ choice, typically requiring rescheduling and planning for clinic/pharmacy visits
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Methods to extend pediatric flu immunization rates5
HCPs want to interact with sufferers to construct belief and encourage vaccination
In response to the CDC, a powerful supplier advice is a important think about figuring out whether or not a baby will get a flu vaccination11
Sufferers should be educated by their HCPs relating to the dangers of flu and the necessity for flu vaccination
The affect of face-to-face communication with a supplier can’t be underestimated
It is very important educate mother and father that flu vaccination is really helpful even for wholesome kids with no underlying illnesses. Flu doesn’t discriminateParents ought to be reminded early within the flu season, and even earlier than, to get their kids immunized in opposition to fluEmphasize that flu is preventable, and make clear that the objective of vaccination is to extend safety in order that extreme sickness may be avoidedEmphasize that flu is a household sickness, affecting college and work attendance
Private accounts/anecdotes throughout affected person visits ought to be utilized to convey the significance of flu vaccination and strongly suggest flu vaccination. “Storytelling works”
Analogies might assist to elucidate the significance of flu vaccinationSeatbelt analogy: A seat belt is just not 100% efficient however offers the very best probabilities of survival in case of an accidentCar mechanic analogy: When a automotive breaks down, a mechanic or specialist is consulted. Equally, pediatricians ought to be consulted when it considerations flu vaccination
HCPs can make the most of social media to convey the significance of flu vaccination and bust myths
HCPs ought to methodically handle confusion surrounding the COVID-19 vaccine and misinformation relating to the flu vaccine, particularly its efficacy and safetyExplain that there are similarities but additionally variations between COVID and flu vaccinesStress that the flu vaccine has a demonstrated security file over a variety of years12
Individuals ought to be educated that, even when the flu vaccine is just not 100% efficient, it’s the most suitable choice we now have to guard kids from extreme flu
Emphasize the chance of illness versus the chance of vaccination
Advocacy for optimistic vaccine insurance policies is required to extend flu vaccination ratesThe flu vaccine is underutilized as a result of it’s a seasonal vaccine and unintentionally deprioritized by parentsEfforts ought to be made on the Federal, State, and regional ranges to help optimistic vaccination insurance policies to extend flu vaccination charges
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Lack of know-how relating to the dangers of flu and the quite a few misconceptions relating to the flu vaccine, particularly on social media throughout the COVID period, makes it crucial that healthcare suppliers construct belief and talk successfully with mother and father, encouraging pediatric flu vaccination and stopping antagonistic outcomes
References
Wholesome Individuals 2020. 2020 matters & targets: immunization and infectious illnesses. Accessed March 21, 2023. https://wayback.archive-it.org/5774/20220414033335/https://www.healthypeople.gov/2020/topics-objectives/subject/immunization-and-infectious-diseases/targets
CDC. Accessed April 3, 2023. https://www.cdc.gov/flu/fluvaxview/dashboard/vaccination-coverage-race.html
Wholesome Individuals 2030. Accessed March 14, 2023. https://well being.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-proportion-people-who-get-flu-vaccine-every-year-iid-09/knowledge
CDC. Accessed April 3, 2023. https://www.cdc.gov/flu/weekly/index.htm#print
Knowledge on file. Assembly takeaways. Seqirus USA Inc. Summit, NJ
CDC. Accessed March 2, 2023. https://gis.cdc.gov/grasp/fluview/FluHospRates.html
CDC. Accessed March 14, 2023. https://www.cdc.gov/flu/spotlights/2022-2023/pediatric-flu-deaths.htm#print
CDC. Accessed March 1, 2023. https://gis.cdc.gov/grasp/fluview/pedfludeath.html
Knowledge on file. IQVIA Medical Claims. Seqirus USA Inc. Summit, NJ
CDC. Accessed March 1, 2023. https://www.cdc.gov/vaccines/acip/conferences/downloads/slides-2023-02/slides-02-22/influenza-03-Olson-Lewis-Tenforde-508.pdf
CDC. Accessed March 14, 2023. https://www.cdc.gov/flu/pdf/professionals/vaccination/Make-a-Sturdy-Flu-Vaccine-Rec_6-mos-17-2022.pdf
CDC. Accessed March 14, 2023. https://www.cdc.gov/flu/stop/vaccinesafety.htm