Vaccinate all school children against flu: experts

According to the minutes of a meeting of the Joint Committee on Vaccination and Immunisation last month, vaccinating children would be both “cost effective” and prevent serious illness in adults.

The minutes state: “Members considered that an extension of the annual influenza vaccination programme should include school-aged children.”

Dr George Kassianos, spokesman on immunisation for the Royal College of GPs, told GP magazine that the advisors support for expanding the immunisation programme was ‘extremely welcome’.

“It will be beneficial to children and will benefit other patients as well,” he said. “If we can reduce the infection rate among children we can reduce the morbidity and death rate in the community generally, and especially among the elderly.”

A study published last year found that immunising healthy children would prevent eight in ten flu infections and free up 790,000 GP appointments a year.

The minutes show the committee, which includes leading paediatricians, said the programme would be cost effective but there are not enough school nurses to implement it at present.

It was warned that such a programme would be received with ‘very mixed opinions by parents’ and that health professionals could also object.

The committee said it would produce recommendations, which are binding on the Department of Health, at its next meeting.

The new vaccine, made by AstraZeneca, was licensed in December and contains three strains of flu. It is made using hens’ eggs so cannot be given to children with a known severe allergy.

It is given in two doses four weeks apart and listed side effects include headache, loss of appetite, fever and muscle pain.

Children already receive 12 jabs against eight diseases by the time they start school.

All seasonal flu vaccines must be updated annually to match the three most common strains of the disease in circulation.

Pregnant women were added to the seasonal flu vaccination programme in 2010 after they were disproportionately affected by the H1N1 swine flu pandemic.

Elderly people over the age of 65, people with long-term conditions of any age and people in care homes and their carers and healthcare workers should be vaccinated annually against flu.

Jackie Fletcher, founder of Jabs campaign group, said: “I can understand targeting particularly vulnerable individuals but to vaccinate all four to 16-year-olds in close quarters at school is a perfect way to spread the disease according to the literature.”

Prof Ian Jones, Professor of Virology, University of Reading, said: “Vaccinating all school children, regardless of whether they are high risk or not, has been discussed before and was an option when pandemic flu appeared to be targeting the young.

“There is very strong evidence of benefits from vaccinating all children as not only does it protect the vaccinated child, but it also benefits society generally as children act as ‘superspreaders’.

“There are many safety tests that are gone through and this particular vaccine has been used extensively in the US. It’s also extremely unlikely that there could be any issue of ‘over-vaccinating’ as it is a nasal spray.”

Prof Adam Finn, Professor of Paediatrics, University of Bristol Medical School, said: “The catalyst for this interest is the arrival of a new nasal flu vaccine, which is very easy to give and is licensed for children from age two. There are, essentially no safety concerns about the nasal flu vaccine.

“The only country in Europe that is giving universal childhood vaccinations is Finland. There they are using the old injected vaccine but uptake is not great. Most of the data and experience comes from the USA. The Japanese took this approach for a long time but then gave up in the late 1980s / early 1990s.

“We are currently doing a series of studies in Bristol on acceptability, cost-benefit and the impact of such a proposal. My impression is that there is a need for more research before a decision is made.”

“Each year the World Health Organisation will still advise which mix of flu strains need to be protected against, so this will not do away with the need for regular updates.”

The panel is expected to make a statement to the Department of Health on the plans next month.

A Department of Health spokesman said: “The Joint Committee on Vaccination and Immunisation has said it is unable at this stage to recommend an extension of the flu vaccination programme as there are a number of issues that it believes need further consideration, for example the public response to such a programme.

“Extending the vaccination programme to healthy children would be a huge undertaking, increasing the number of people who get the vaccine, so it is important that we get this decision absolutely right.

“In the meantime, we continue to recommend that people in at risk groups, 65s and over and pregnant women do get vaccinated — they are the most at risk from suffering complications. The JCVI is clear that is the current priority.”