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zoom RSS 全ての子どもにインフルエンザワクチン接種を/米国

<<   作成日時 : 2008/02/28 21:50   >>

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画像 連邦政府の諮問機関が水曜日、6ヶ月から18才の全ての子どもが毎年インフルエンザワクチンを接種すべきであると発表した。
 毎年接種が推奨される子どもが3,000万人となる。
 子どもや親が小児科受診したり学校を休んだり、合併症に抗生物質を使用したりといったことによる損害を減らすことにある。さらに家族や地域社会への間接的な感染防止を上げている。来シーズンより始めるべきとした。今年は1億3200万供給できたので来年も十分供給可能と予測。CDCは先週22人の子どもが今期死亡したと報告した。
 CDCは長いこと高齢者と慢性疾患の人にワクチンを推奨してきた。2004年に、重症合併症予防のため、6ヶ月〜23ヶ月の乳幼児に接種を推奨。2006年に、対象を24〜59ヶ月にも広げた。6ヶ月〜9才の子どもには少なくとも1ヶ月開けて2回接種が必要。
 2005-2006、2006-2007の2シーズンでインフルエンザ合併症による入院の75%を防止できたとの最近の研究報告がされた。6ヶ月〜23ヶ月の子どもについての研究は今年度も継続される予定。今年度は前2年より厳しい結果のようである。
 ワクチンはインフルエンザの3つの株に対して防御するようにデザインされ、現在の流行から将来予測をして判断し株を決定している。通常は1〜2の株を毎年変更するが、WHOとFDAの委員会が2/22に次期のワクチンは3つ全ての株を変更すると異例の決定した。
 CDCは以下のすべての成人にワクチン接種を推奨している。50才以上の高齢者、慢性心肺疾患などの人、医療従事者、インフルエンザシーズン中に妊娠予定の女性。
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学校でのインフルエンザワクチン接種の費用対効果/米国医療事情
http://kurie.at.webry.info/200802/article_21.html
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Panel Advises Flu Shots for Children Up to Age 18
David Maxwell for The New York Times
http://www.nytimes.com/2008/02/28/health/28flu.html?ref=health
By LAWRENCE K. ALTMAN
Published: February 28, 2008

In 2006, Tommy Mericle received a flu shot at the Mahoning County District Board of Health in Ohio.

All children ages 6 months to 18 years in this country should receive an influenza shot every year, a federal advisory panel said on Wednesday.

The recommendation expands by about 30 million the number of children who should get annual flu shots. Current pediatric recommendations call for influenza vaccinations for children ages 6 months to about 5 years.

In expanding the new upper age limit to 18 years, the aim is to reduce both the time children and parents lose from visits to pediatricians and missing school and the need for antibiotics for complications, said Dr. Anne Schuchat, who directs the disease agency’s program on immunization and respiratory diseases.

An added expected benefit would be indirect ― to reduce the number of influenza cases among parents and other household members, and possibly spread to the general community.

The recommendation, which is voluntary, was made by the Advisory Committee on Immunization Practice, which advises the Centers for Disease Control and Prevention in Atlanta. The C.D.C. and its parent, the Department of Health and Human Services, generally follow the advice of the committee, which is composed of vaccine experts from academia and the private sector.

The committee voted unanimously that the expanded immunization should start as soon as possible, but no later than the 2009-10 flu season. The centers expect that the vaccine industry, which made 132 million doses available this year, will be able to produce a sufficient supply in future years.

Every state but one has reported widespread influenza this winter. In Florida, activity is regional. Last week, the centers reported that 22 children had died in this influenza season.

The C.D.C. has long urged older adults and those with chronic ailments to get influenza shots each season.

In 2004, following the advisory committee’s recommendation, the centers urged that all infants ages 6 months to 23 months receive flu shots to protect them from serious complications of the viral illness. Hospitalization rates among the infant group rivals those among elderly Americans.

In 2006, the centers expanded the recommendation to include children ages 24 months to 59 months to provide them direct protection against influenza infection.

For initial protection, children ages 6 months to 9 years require two doses of flu vaccine, at least one month apart, the committee said. Then they should receive annual shots.

In a new study reported at Wednesday’s meeting, Dr. David K. Shay, who led a team from the C.D.C. and eight state health departments, found that full immunization against flu provided about a 75 percent effectiveness rate in preventing hospitalizations from influenza complications in the 2005-6 and 2006-7 influenza seasons. (The 75 percent rate could range, according to a standard statistical measure known as confidence intervals, from 41 percent to 91 percent.)

The study, which involved children ages 6 months to 23 months who had laboratory confirmed cases of influenza, will continue through this flu season. Because this season seems to be more severe than the last two, the researchers expect to have more cases to analyze and improve the statistical odds.

Vaccines are typically designed to protect against the three strains of influenza. Experts determine the strains based on data from current seasonal transmission and their judgment about future activity. Usually one or two strains are changed in each year’s vaccine.

But committees from the World Health Organization and the United States Food and Drug Administration voted earlier this month to change all three strains in next season’s vaccine. It is the first time that all three strains were changed at once, Dr. Nancy Cox, an influenza expert at the C.D.C., said in a news conference on Feb. 22.

The centers recommendations for annual flu shots for adults include all Americans ages 50 and older; people with chronic lung, heart and other ailments; health care workers; and women who will be pregnant during the influenza season.
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 連邦政府の諮問機関が、6ヶ月から18才までの全ての子どもに毎年インフルエンザワクチンを接種するようにと水曜日に発表。
 従来、リスクの高い、50才以上、免疫力の弱い人、6ヶ月〜5才の子ども、に対してインフルエンザワクチンが推奨されてきた。5才〜18才の子どもは罹患率は高いが重症化しない。インフルエンザに起因して毎年約36,000人が死亡しているが、子どもの死者は25〜50にすぎない。
 しかし家にいる家族にうつすことになるので結果的に成人の感染を減らし、仕事を休む可能性が減る。はっきりとしたデータはないが、成人や高齢者の病気を減らすと信じている。
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All Kids Need Flu Shots, CDC Says
CDC Panel Recommends Flu Shots for All Kids in 2009-2010 Season
http://abcnews.go.com/Health/ColdFlu/story?id=4353731&page=1

By MIKE STOBBE
Feb. 27, 2008

ATLANTA (AP) - Annual flu vaccinations should be given to all children ages 6 months through 18 years of age, a federal advisory panel said Wednesday.
The panel's decision represents a call for roughly 30 million more kids to get vaccinated. If heeded, it would prompt one of the largest expansions in flu vaccination coverage in U.S. history.
The Advisory Committee on Immunization Practices said the recommendation should kick in no later than the 2009-2010 flu season, saying the vaccinations should be given as soon as feasible but acknowledging that many doctors have already ordered their vaccine for the 2008-2009 season.
The panel's advice is routinely adopted by the federal Centers for Disease Control and Prevention, which issues vaccination guidelines to doctors and hospitals.
The panel -- and the CDC -- have in the past recommended flu shots for people considered to be at highest risk of death or serious illness from the flu. The list includes children ages 6 months to 5 years of age, for adults 50 and older, and people with weakened immune systems.
Kids ages 5 to 18 get flu at higher rates than other age groups, but they don't tend to get as sick from it: Of the 36,000 estimated annual deaths attributed to the flu, only 25 to 50 occur in children in that age bracket, CDC officials said.
But kids who stay home sick from school cause parents to stay home, so reducing the illness in this group should cut down days of lost work in their parents and adult contacts, some experts said.
Experts believe the recommendation may also reduce illness in adults and the elderly, although studies haven't clearly established that will happen.
(Copyright 2008 by The Associated Press. All Rights Reserved.)

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 18才までのすべての子どもにインフルエンザワクチン接種を推奨と発表された。既に6ヶ月から5才までに推奨されているが、CDCは子どもどうしの感染を防ぐために学校での予防に狙いを定めた。毎年30%の就学している子どもがインフルエンザに感染している。シカゴ近郊の小学校では半分以上が欠席して、休校となった。いくつかの研究で、就学している子どもへのワクチン接種で地域の感染流行を抑えられると報告された。
 既に11種のワクチン接種があり、12番目となるには反対の意見もある。しかし、一般的には就学している子どものリスクは高くないが、今シーズン既に24人が死亡している。
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Is It Safe for Your Children to Get the Flu Shot?
Doctors and Parents Have Differing Views on Necessity of Flu Shot
http://abcnews.go.com/Health/story?id=4355886&page=1
Feb. 27, 2008

An advisory panel today recommended all kids up to age 18 get the flu vaccine. Though the vaccine is already recommended for those 6 months to 5 years old, this new proposal is a huge expansion, affecting nearly 60 million kids.
Schools are the perfect place for kids to swap germs, and that's a big reason why the Centers for Disease Control and Prevention is now targeting school-age kids.
"[Children] are the great distributors. They run around the community, give it to mom, dad, Aunt Susie and to the new baby next door," Dr. William Schaffner at Vanderbilt University.
It's estimated that as many as 30 percent of school-age children come down with the flu each year.
At St. Mary's Elementary outside Chicago, more than half the students are out sick -- so many that on Tuesday administrators had to cancel school.
Some studies have suggested that vaccinating school-age children can reduce the spread of flu in the general population..
"So we think that vaccinated children should help those children; it should also help the families, and it may even help the community itself," said Dr. Anne Schuchat at the CDC.
The CDC expects an extra 7 million school-age children to get vaccinated next year because of the new recommendation, with the number of vaccinated children growing after that.
Between the injectable vaccine and flu-mist there should be plenty of supply, CDC officials said. But some people worry about adding a 12th vaccine to the 11 already recommended for children.
"Vaccinations are not risk free, and the flu vaccine is not a perfect vaccine either," said Dr. Bryan Jepsen, an autism expert.
Parents who spoke with ABC News today had mixed views. Some said that they, not the CDC, should dictate which vaccinations their children should receive, while others said their children received the flu shot religiously.
School-age children are not generally at high risk for dangerous flu complications, though 24 children have died from the flu so far this year --
half of them between the ages of 5 and 18.
"I think parents need to understand that flu is not just another winter respiratory virus. It is a life-threatening disease," said Dr. Carol Baker, a pediatrician.

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