CDC considers flu vaccine for millions more children

ATLANTA -- Federal disease specialists are considering whether to routinely vaccinate millions more children against the flu, a measure designed to protect children and the adults they might expose to the virus.

A decision on whether to give flu shots to children 2 to 6 years old is expected by the end of the year, disease trackers from the US Centers for Disease Control and Prevention said yesterday at a flu vaccine summit. Already, federal guidelines advise flu immunizations for children 6 months to 23 months old because they are especially prone to complications from the respiratory illness.

''A lot of people think it makes sense to routinely offer influenza vaccine to more children," said Dr. Raymond Strikas, a top flu specialist at the CDC.

In the fall of 2003, a virulent strain of flu caused an unusual cluster of several dozen deaths among children, fueling calls for expanding the number of youngsters vaccinated.

Doctors and public health authorities also discussed making shots an annual ritual for all Americans.

''But if we were to say we want universal vaccination, that doesn't happen overnight," said Nicole Smith, an epidemiologist in the CDC's flu branch.

US health guidelines strongly urge that senior citizens, the very young, and the chronically ill be vaccinated against seasonal flu. (The flu vaccine is not considered safe for infants under 6 months.) Although that policy does not recommend shots for healthy adults under 65 and children over 2, there's no medical reason in most cases that they can't receive vaccine.

Instead, the current recommendations reflect a desire to get a limited supply of vaccine to patients who need it most. This year, about 86 million doses of vaccine are expected to be produced, but the CDC estimates that 180 million Americans are either at serious risk of complications from the flu, or have contact with those high-risk patients.

But with vaccine manufacturers promising to substantially increase the number of shots they make for future flu seasons, disease specialists are reviewing research to determine whether vaccinating children ages 2 to 6 makes sense. ''We've got to make sure there's a scientific base behind it," said Dr. Bruce Gellin, director of the National Vaccine Program Office.

Among the studies the federal specialists said they will review: a Harvard Medical School report that suggests 3- and 4-year-olds often spur flu outbreaks, showing respiratory symptoms weeks earlier than other children.

The Harvard and Children's Hospital Boston researchers have said they believe 3- and 4-year-olds should be routinely vaccinated to prevent spreading flu to older children and adults. If federal specialists go along with that recommendation, the new policy would not go into effect until the 2007-2008 flu season.

An estimated 20 million US children are between 2 and 6 years old, although some already get flu shots because of medical conditions or because they live with someone who is considered high-risk.