Vaccination of Children

It is important that children at particular risk of severe complications from influenza are vaccinated. The Australian Technical Advsory Group on Vaccination (ATAGI) has made a number of recommendations with regard to childhood influenza vaccinations, which are summarized below. 

Children from 6 months to 5 years MUST NOT recieve Fluvax (CSL).

Fluvax has not been registered for use in this age group since late 2010 because of an unexpected increase in reports of fevers and febrile convulsions. In children aged >5 to <10 years, an alternative brand is preferred. Fluvax (CSL) may be used if no alternative is available and parents are informed of the potential increased risk of fever. 

 What do I need to know about febrile reactions to paediatric influenza vaccination?

In 2010, the observations regarding febrile reactions in children vaccinated with Fluvax® were unique and have not been seen previously with this or other influenza vaccines despite widespread use in millions of children worldwide.

Following extensive investigations, a cause for these adverse events had not been found, and consequently Fluvax® is no longer registered for use in young children. Other vaccines found to be safe in 2010 have been approved by the Therapeutic Goods Administration (TGA), and are available.

The Influenza Specialist Group (ISG) understands that some people may have concerns regarding the safety of influenza vaccine in infants. However, following consideration of all available information by Australian vaccination experts and the TGA, the Australian Technical Advisory Group on Immunisation (ATAGI) continues to recommend influenza vaccination in children and adults, apart from the use of Fluvax® in children under 5 years of age. It is however important to first consult a health professional when seeking an influenza vaccination.

For more information, read the Australian Government’s Chief Medical Officer’s statement here.

Alternatively, you can access the full ATAGI statement which includes the rationale for these recommendations at www.immunise.health.gov.au

Which children should be vaccinated against influenza?
  • Current Australian immunisation guidelines recommend annual vaccination for anyone who wishes to protect themselves against influenza. In particular, the recommendations state that Australians over the age of six months who are at risk of severe complications from influenza should be vaccinated annually.
  • It is important that children at particular risk of severe complications from influenza are vaccinated, including those with: 
                 - Heart conditions
                 - Asthma and other lung conditions
                 - Diabetes (type 1 and type 2)
                 - Kidney problems 
                 - Impaired immunity
  • Pregnant women should also get vaccinated against influenza, including those in the first trimester at the time of vaccination and there is evidence that this may provide some protection for the new-born infant.
  • People who care for or are in close contact with at-risk individuals, are also advised to protect themselves against influenza to avoid passing on the disease.
  • Many other parents of healthy children aged ≥6 months may also wish to get their children vaccinated - this is within National Health and Medical Research Council (NHMRC) guidelines.
What is the dosing and schedule for childhood influenza vaccination?
  • Children under nine years of age who have not been vaccinated previously are recommended to receive two doses at least one month apart, for the first year they get vaccinated (refer to Table 1). In subsequent years, they only require one dose.
  • Some influenza vaccines available in Australia are packed in syringes for the paediatric dose (i.e. 0.25 mL pre-filled syringe ready for use)

 * Based on population data that 105.8 per 100,000 Australians aged ≤five years are hospitalised due to influenza and the current population figure for that group is 1,371,051 (ABS accessed 5 March 2009)


  Table 1: Recommended doses of influenza vaccine

Doses2

 

NHMRC. The Australian Immunisation Handbook 10th Edition 2015. 

Available here

How effective is influenza vaccination in the six month - five year age group?
  • No vaccine is 100% effective.  However, clinical trials have shown that influenza vaccination is very effective in protecting against the severe consequences of infection, including among children.
  • A two-year randomised study of children aged 6-24 months determined that >89% of children seroconverted to all three vaccine strains during both years, and in another study inactivated influenza vaccine was shown to be 77-91% effective against influenza respiratory illness.
  • Mathematical modelling has shown that vaccinating children under five years could decrease the incidence of influenza in the total population by 22-38%.
What can parents do if their child falls ill with influenza?
  • Influenza is highly contagious and can be spread for up to a day before symptoms appear and for five days afterwards - potentially even longer among young children. Ways to avoid spreading influenza include:

             - Wash hands regularly 
             - Cover nose and mouth when coughing or sneezing
             - Avoid physical contact with others 
             - Avoid mixing with other people, particularly those in a high-risk category, while contagious 
             - Don't return children to child care early, as they could still be contagious 

  • Antiviral medications (including paediatric formulations) that can limit the progression of influenza if they are taken early after onset of symptoms (within the first two days of the illness) are available on prescription.

 

Last updated:  Wednesday 12th August 2015