Flu jab funds for over-65s slammed
Tuesday 8th October 2013, 10:10PM BST.
Money spent on a UK flu vaccination programme for people aged 65 and over would have been better targeted at children, experts have said.
Children are the main spreaders of flu and vaccination protects not only them but others too, said a team writing in the journal PLoS Medicine.
The research, looking at 14 flu seasons in England and Wales, “suggests the targeting all individuals 65 years and older that occurred in 2000 in the UK was not the best strategy.
“Targeting children would likely have prevented more cases and deaths for similar numbers of doses, even if low levels of coverage (30%) had been achieved.”
Study lead author Dr Marc Baguelin, a mathematical modeller at the London School of Hygiene and Tropical Medicine, said vaccinating people aged 65 years and over had worked quite well in terms of reducing death rates in this age group.
“But in terms of efficiency, the potential is that child vaccination at this point would have been a more efficient use of resources.”
About 600 people a year die from flu in the UK, rising to around 13,000 during an epidemic.
At present, people aged 65 and over and those at high risk, such as with diabetes or heart disease or who are pregnant, are vaccinated annually.
Since September, an annual nasal spray flu vaccine has also been made available to all children aged two and three years as part of the NHS childhood vaccination programme in the UK.
Over time, all children between the ages of two and 16 will be vaccinated against flu each year with the nasal spray.
The spray – Fluenz – works better than the injected flu vaccine in children and is expected eventually to prevent at least 2,000 deaths from flu in the general population and lead to 11,000 fewer hospitalisations.
Today’s research said: “The most efficient way of reducing overall influenza-attributable morbidity and mortality appears to be to target the key spreaders – children.
“Targeting at-risk individuals and elderly adults offers some protection to those immunised, but little to others in the population.
“Adoption of more innovative strategies that aim to block transmission (in addition to targeting those most at risk) should be more widely adopted. Even with modest coverage, substantial further reductions in morbidity and mortality could be achieved.”
The authors found that the current programme has averted 0.39 infections per dose of vaccine and 1.74 deaths per 1,000 doses.
Extending the programme to five to 16-year-olds would “increase the efficiency of the total programme, resulting in an overall reduction of 0.70 infections per dose and 1.95 deaths per 1,000 doses.
“In comparison, choosing the next group most at risk (50-64-year-olds) would prevent only 0.43 infections per dose and 1.77 deaths per 1,000 doses.”
Dr Baguelin said: “Traditionally, vaccination programmes have targeted over-65s or people with health conditions who are most at risk of serious complications from flu.
“But by targeting children, who our study confirms are the main spreaders of the flu virus, we would expect to see significantly fewer cases of flu in the wider population and a reduction in flu-related deaths among elderly people.
“The roll-out of the new children’s flu vaccine is already under way in England, Wales and Scotland this year.
“Improving vaccine coverage among children should be a priority for similar countries considering their vaccination policies, as our findings suggest there will be great benefits to the community as a whole.”
Figures on the number of vaccines given in England last winter show uptake of 73.4% for those aged 65 years and over and 51.3% for at-risk groups.
Uptake by pregnant women was 40.3%.
Children in the US have been vaccinated against flu since 2002.
Dr Richard Pebody, responsible for flu surveillance in the Respiratory Diseases Department at Public Health England, said: “The results of this study show that the current flu vaccination policy that targets people aged 65 years and over and also those in high risk groups has reduced the number of flu infections and associated deaths in these groups over the past 14 years.
“In addition, the authors show that offering the flu vaccine to children will have beneficial effects especially as children are key ‘spreaders’ of the flu virus.
“From this flu season, vaccination against flu will be offered to of all children aged two and three, and pilots for primary school children in some areas will also take place.
“This new vaccine will not only protect healthy children from flu, but will also help to reduce the spread of flu and protect many others, such as younger siblings, grandparents and those who are at increased risk of becoming seriously ill from flu.”