WASHINGTON — Expanding the traditional window for influenza vaccination would expand the number of vaccination opportunities by increasing the number of pediatric office visits, based on data for 77.6 million children from a national survey during the 2004-2005 flu season.
By expanding the vaccination window either 6 months earlier or 6 months later, the overall number of children between 0-18 years with at least one provider visit jumped from 11.1 million to 23.4 million (July through December) or to 18.2 (October through March), Dr. Richard G. Judelsohn reported in a poster at the jointly held annual Interscience Conference on Antimicrobial Agents and Chemotherapy and the annual meeting of the Infectious Diseases Society of America. MedImmune LLC, which makes Flumist nasal influenza vaccine, sponsored the study. Dr. Judelsohn's coauthors are employed by MedImmune.
In 2008, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices expanded its recommendation that all children aged 6 months to 18 years receive the seasonal flu vaccine each year. But many children do not visit a health care provider during the traditional flu vaccine window (Oct. 1-Dec. 31). The need for additional office visits for the vaccine could be a barrier to increasing flu vaccination.
The researchers used data from the Medical Expenditure Panel Survey, a federally funded survey of families, medical providers, and employers nationwide. Data from the 2004-2005 flu season was used to assess the number of children with existing medical provider office visits during specific monthly intervals. In particular, they identified the number of children with one or more provider visit for various intervals by adding 1, 2, or 3 months before or after the Oct. 1-Dec. 31 period.
They also looked at the data for five distinct age groups: less than 12 months, 12-23 months, 2-4 years, 5-8 years, and 9-18 years. Well visits were summarized separately from other provider visits because these may represent the greatest yield vaccination opportunity.
“With expansion of the traditional vaccination window, the largest percentage increase in the number of children with a provider visit is seen in children 5-18 years of age,” wrote Dr. Judelsohn, a professor of pediatrics at the University at Buffalo (N.Y.), and his colleagues. The percentage jumped from 27% between October and December to 46%-48% having a visit during either 6-month window.
“Overall, the proportion of children with existing visits decreases with increasing age,” they wrote. In all, 59% of children younger than 23 months had a visit between October and December, compared with 27% of children aged 5-18 years. Among children with a visit, the proportion with well child visits also decreases with increasing age.
“The early months of July, August, and September appear to be important for reaching school-aged children during well visits, with the biggest increase seen including August,” they noted.
Estimated Number of Children With at Least One Provider Visit (in millions) ELSEVIER GLOBAL MEDICAL NEWS