Two Cheers for the CDC on Flu Vaccine Recommendations for Kids

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Good news came from the Centers for Disease Control (CDC) this week, as an expert advisory panel recommended that preschoolers between the ages of two and five years receive annual influenza vaccinations. Why the change, one might ask, if the flu causes little serious trouble for youngsters as compared with other at-risk groups?

The answer is that this change is necessary, overdue, and still inadequate to accomplish its goal: to help save the lives of thousands of the elderly and sick who are at risk from complications of the flu. Indeed, approximately 36,000 Americans succumb to influenza and its complications each year -- sometimes more.

So how does vaccinating kids protect the older folks and those with chronic conditions from death by flu? Children, while (thankfully) rarely hospitalized or killed by the flu virus, act as reservoirs for the bug, which they pass on to their vulnerable grandparents or sickly relatives or schoolmates. Toddlers and infants in the six- to twenty-three-month age range have already been getting flu vaccine for the past few years, for this very reason. This change is welcome, but it is not itself adequate to accomplish its goal.

Why not include all schoolchildren in this recommendation? I made this suggestion last year, in a letter published in the medical journal Archives of Internal Medicine (Vaccinate Schoolchildren to Reduce Influenza Toll, Archives of Internal Medicine 2005: 165:2038 Sept. 26, 2005).

My proposal was based on the Japanese experience: in the 1970s and 1980s, Japan mandated vaccinating schoolchildren against the flu, and the death toll among the elderly fell dramatically, only to be reversed when the law was changed.

What would be required to convince the CDC to mandate this same program here, and perhaps reduce the toll of influenza among our elderly population? Since the side effects of flu vaccine are negligible, it seems like the right public health policy to me.

Gilbert Ross, M.D., is Executive and Medical Director of the American Council on Science and Health (,