Public health officials have been trying to drum up support for flu vaccination for all kids ages six months and older for several years now. Vaccination rates have crept up, but half of all kids still don't get a yearly flu shot. A new study suggests that schools may be the best place to immunize kids, especially schools in lower-socioeconomic areas where annual flu vaccine rates are low.
Getting kids immunized is no small matter. About 24,000 people, adults and children, die each year from the flu. Moreover, studies in recent years have pointed to preschool and grade-school aged children as robust carriers of the virus that then spreads throughout all age groups. If those kids are immunized, the thinking goes, then flu rates would be lower throughout communities.
"Children are very capable of spreading the flu," Dr. Pia Pannaraj, an assistant professor of pediatrics at the University of Southern California and Children's Hospital Los Angeles, told Take Part. "They spread the virus very easily to each other. They go home and bring the flu virus to grandma and grandpa and baby brother or baby sister who could become severely ill with this virus."
In data presented last week, Pannaraj makes a strong case for vaccinating kids in schools. The study was comprised of almost 4,500 kids in grades kindergarten through six at eight schools in Los Angeles County during the 2010-2011 flu season. In four of the schools, information and permission slips for a school-based, free flu vaccine program were sent home to parents. The other four schools were used as a comparison group. In schools with the vaccine program, parents could choose which type of vaccine their child received -- shot or nasal spray. The parents did not have to be present when the child received the vaccine.
To accurately assess flu rates, the researchers ran lab tests on any student who came down with a respiratory symptom, such as a cough, sneezing or sore throat.
Pannaraj found that vaccinated kids were three times less likely to get the flu and missed half the number of school days compared to unvaccinated children.
Reducing absenteeism means fewer missed days of work for parents and more money for schools. Public schools receive funding based on daily attendance of students, says Pannaraj. And flu often translates to several days of missed school.
"It's in the schools' best interests to protect their children against influenza," she says. "Many people think the flu is similar to the common cold. Those children who had the flu missed double the number of days compared to children who had respiratory viruses that cause the common cold."
The study -- presented at the annual ID Week, a joint meeting of the Infectious Diseases Society of America and other organizations focused on infectious disease -- also showed that vaccinating kids at school can offer protection for a larger community. In one school, where 47% of the kids were vaccinated, flu rates were down overall. That means "herd immunity" can be achieved at schools without everyone getting immunized.
About half of all U.S. kids, ages six months to 18, now receive an annual flu vaccine. However in lower-socioeconomic neighborhoods, such as the region in Pannaraj's study, flu vaccine rates are often as low as two percent to five percent. It's difficult for working parents to get their children vaccinated, she notes.
"The school-based vaccination offers a solution to that," she says. "We can basically line these children up to vaccinate them so they are protected against influenza."
It may take some convincing to get more parents to consent to school-based vaccination, however. Vaccination rates in the four schools that offered the program ranged from 27.8 percent to 47 percent. Few parents expressed a fear that the vaccines would cause autism -- a theory that has been debunked. However, some said they worried that the vaccine would cause the flu. Vaccines, however, do not cause the flu.
Schools that reached out to parents, providing information and support for the program, had the highest vaccination rates, says Pannaraj. Decades ago, schools were key places for child vaccination, such as the polio vaccine programs of the 1960s, notes Dr. David Kimberlin, an expert in pediatric infectious diseases at the University of Alabama at Birmingham.
"It's worked before," he says. "These studies show why we need it."
Flu is not just an inconvenience, adds Dr. Karen K. Wong, an epidemic intelligence service officer with the Centers for Disease Control and Prevention. Wong presented data at IDWeek showing that almost half of the children who died from the flu over the past decade had been previously healthy. Children with underlying health problems, such as asthma or diabetes, are at higher risk for complications from flu. But healthy children can become critically ill, too.
"It shows that really any child can be at risk, not just those with medical conditions," Wong says. "Prevention is really the best defense."
Question: Would you allow your child to receive the flu vaccine at school? Tell us your thoughts in the comments.
Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.
- Public Health