Currently, in Italy, two inactivated vaccines and a attenuated vaccine are available for vaccinations in pediatric age. What are the differences and what is their effectiveness on children?
The influence, respiratory disease caused by influenza type A or b viruses (more rarely type C), generally has a benign course. Therefore, it is natural to ask what the role of the flu vaccine is in children.
During the winter, the influence is responsible for about 9% of viral ailments, sharing with them a combination of symptoms including fever, cough, nose that colas, headache and muscle pain.
Only rarely, especially in children at risk, can present a more serious course.
In this article we will examine the vaccine against influence for children. Does it make sense to do it? When? As? Are there risks?
Is it worth making the flu vaccine to children?
Is it convenient to have children’s influence vaccine? Before decreasing an answer, let’s examine pros and cons. Let’s start from the first:
- Reduction of the risk of illness. The influence vaccine for children reduces the risk of getting sick, which implies less school absences and less inconvenience for families. However, as we will analyze shortly, it must be said that the effectiveness in preventing the risk of influence is relatively low.
- Protection from serious forms. The vaccine protects from rare serious shapes of influence, which can lead to hospitalizations, secondary respiratory infections and other complications.
The latter point is a priority when we speak of children particularly “at risk”, that is, suffering from pre -existing conditions that favor the surplus of complications.
The list of these conditions is long and includes chronic diseases of various types, which involve one or more apparatuses: asthma, bronchopulmonary dysplasia, cystic fibrosis, congenital and acquired heart disease, diabetes mellitus, kidney failure, Chronic inflammatory diseases and tumor pathologies.
Let’s move on to the cons:
- The effectiveness of the vaccine is relatively low. According to a systematic review of 2018, inactivated vaccines reduce the risk of contracting the influence from 30% to 11% and of flu-like syndrome from 28% to 20%; vaccines attenuated from 18% to 4% and from 17% to 12% (the range of varies according to the populations studied).
- There are few studies on the effectiveness of the vaccine before 2 years of life.
- Not everyone can perform the flu vaccine.
The main contraindications concern:
- Age. The Split inactivated vaccine should not be administered in the first 6 months of life. The inactivated vaccine cultivated on cell crops and the attenuated live one are contraindicated in children under 2 years;
- Guillain-Barré syndrome. If this disease has developed (which affects the nerves) within 6 weeks from the previous administration of the vaccine, it is contraindicated to repeat it.
- Acute diseases. In the event of an acute or serious acute disease, with or without fever, the vaccine must be postponed (it can instead be administered in the course of slight diseases, such as a cold).
- Severe allergies. Children who have had serious allergic reactions to components of the vaccine or previous doses must not be vaccinated.
- Times between vaccinations. A child who has recently performed a mitigated virus vaccine will have to wait at least four weeks before receiving the administration of the nasal spray vaccine with a fluctuated flu virus-unless the vaccinations are co-administered.;
- Other cases. The mitigated virus vaccine should not be administered in case of immunosuppression, unstressed asthma or in the case of severe allergic reaction history to egg proteins or gentamicin (because this vaccine can contain it in traces) and children in drug therapy based on salicylates.
Speaking of egg allergy and inactivated vaccine, there are generally no contraindications, because the risk of allergic reactions is remote.
However, the children with an anamnesis of severe egg allergy must be vaccinated in a protected environment, or under the supervision of a doctor prepared to recognize and promptly intervene for any allergic reactions.
It should also not be forgotten that, among the inactive flu vaccines, there is one based on a virus grown in cell crops (Viqcc), administered starting from 2 years of life, completely without egg protein and therefore free of risks.
When to make the vaccine and what it covers
When to make the flu vaccine? Considering that this disease usually appears during the winter season, compatibly with availability it would be ideal to have vaccination during the autumn season, between October and mid -November (to deepen the theme, we recommend reading this article), since the immune system It takes about two weeks to develop a complete response to vaccination. In this way, “unprepared” winter is not reached.
Obviously, even if you arrive in December or go further, you can still get vaccinated (better late than never!).
But which vaccine do? Currently, in Italy, two inactive vaccines are available for vaccinations in pediatric ages (administered by injection) and a attenuated live vaccine (administered via nasal spray). Both are quadrivalent, that is, they contain two strains of viruses and two strains of viruses B.
Inactive vaccines are administered through an intramuscular puncture on the external part of the thigh up to 2 years of life or on the arm (deltoid muscle) over 2 years. In particular:
- The inactivate vaccine shoulder or subunitity (VIQ) can be administered from the age of 6 months up to 9 years;
- The inactivated vaccine grown on cell crops (Viqcc) can be administered from 2 years upwards.
The attenuated live vaccine, on the other hand, is administered with an intranasal spray, spraying half dose for nostril. It can be received between 2 and 18 years.
Inactivated or attenuated, in both cases, in boys and girls under the age of 9 never previously vaccinated, two doses of vaccine are recommended at least four weeks later, from each other.
The effectiveness is similar for both vaccines, but the indication on which to use, as well as on the age of the child and the availability of the doses, depends on the pediatrician’s decision that the patient knows.
How long does the flu vaccine last in children? In this way the little ones are also protected by other ailments?
The coverage of the flu vaccine in children lasts about six months. As for the “spectrum of action”, the vaccine covers only against influenza viruses and does not protect from seasonal ailments other than flu. Each year, the vaccine is in fact “updated” to include the strains of flu viruses which, in anticipation, will be the most common and virulent and, although effective, does not guarantee 100%protection.
Flu vaccine: are there risks for children?
Can reactions occur after the flu vaccine in children? Just as it can happen after taking any drug, side effects can occur even after the vaccine, but almost always mild and temporary. In fact, the flu vaccination has a high safety profile.
Fever, pain and redness at the point of injection, muscle pain, general malaise and headache are the most frequent side effects. These symptoms generally disappear in about 48 hours, and can still resolve with antipyretics/painkillers if necessary.
The vaccine via spray can involve nasal congestion, nose that colas, cough, general malaise and in appearance, also intended to resolve approximately within 48 hours of administration.
Much more rarely, the flu vaccination is followed by hypersensitivity reactions, anaphylaxis and slight increases in feverish convulsive rates.
As regards the possibility that children vaccinated with lively lively live flu strains can transmit the disease to others, this is somewhat far -fetched. A study found that the probability of transmission to a child after contact with a vaccinated child is 0.58%.
In summary, what to expect by doing the flu vaccine to children?
Let’s summarize the focal points before giving a final response:
- Protective efficacy is not high;
- The flu vaccination is safe and any side effects are mild and temporary;
- The usefulness of vaccination as a method of preventing contagion and the risk of developing complications, particularly in children with less than 2 years of life, is still debated.
For this reason, although it is actively and free of charge in children from 6 months to 6 years and in the most fragile ones due to pre -existing pathologies and conditions, the last word belongs to the pediatrician, who knows the child’s clinical history in depth.
