Flu shots are de rigueur for children with neurologic and neuromuscular diseases given their high risk of influenza-related respiratory failure.
“Children with pulmonary disease, cardiac disease, or NNMD [neurologic and neuromuscular disease] had approximately a 10% probability of respiratory failure” during a hospitalization for influenza, Dr. Ron Keren and his colleagues reported. “Having two of the three chronic conditions increased the probability another three- to fourfold” (JAMA 2005;294:2188–94).
Dr. Keren, of the Children's Hospital of Philadelphia, and his associates examined rates of respiratory failure in 745 children and adolescents (aged 21 years and younger) in 2000–2004. Eighty-nine (12%) had an NNMD, most commonly cerebral palsy (40%), seizure disorders (42%), and hydrocephalus/cerebrospinal fluid shunt (30%).
During the study period, 32 children developed respiratory failure; 14 of those had an NNMD, a sixfold increased risk, compared with those with no chronic health problem.
This risk was higher than that associated with pulmonary disease (OR 5.0) or cardiac disease (OR 4.0), both of which are accepted indications for an annual childhood influenza vaccine.