Protect Children First with H1N1 Flu Vaccine, Says Pediatric Disease Expert

The optimal way to control swine flu, the new H1N1 virus that emerged as a global threat in 2009, is to vaccinate children with the planned H1N1 flu shot, says the co-director of the University of Alabama at Birmingham (UAB) Division of Pediatric Infectious Diseases.

"Children are the highest-risk group for spreading the virus among themselves, and as a consequence, spreading it around their community," says UAB's David Kimberlin, MD, one of four U.S. physicians serving on the federal Safety Monitoring Committee reviewing clinical trials of H1N1 vaccines. The committee is a part of the Division of Microbiology and Infectious Diseases at the National Institute of Allergy and Infectious Diseases.

"Like a bull's-eye, the middle of the target is what you vaccinate so you don't see infections in the concentric rings around the center," Kimberlin says. "The center of the protection bull's-eye should be children."

The United States' prospects for developing and distributing a safe and effective vaccine to prevent infection with the current H1N1 virus are excellent, Kimberlin says.

 "The National Institutes of Health are conducting a number of studies across the country at special vaccine evaluation sites they've had set up for 40 to 60 years, and they have enrolled several thousand patients into those studies," he says. "I'm on that federal monitoring board and we look at the vaccine-safety data constantly. These studies are going very well."

The reasoning behind making children the highest priority comes from decades of experience with flu transmission, prevention strategies, infection monitoring and many other factors. Additionally, children younger than age 5 are at higher risk of complications from influenza.

Once the vaccine is available, which is expected to be in mid to late October, children 6 months of age and older, teenagers and young adults through age 24 will be among the first groups targeted by the Centers for Disease Control Advisory Committee on Immunization Practices to receive the shots.

Pregnant women, adults who have high-risk medical conditions and health-care workers who are direct care providers are among the others who will be given the earliest shots, says Kimberlin, who is a member of the American Academy of Pediatrics Committee on Infectious Diseases and associate editor of the academy's Red Book, a pediatric treatment manual.

Decisions about expanding or establishing priorities for vaccination should be made in accordance with local circumstances based on the judgment of state and county health officials, advises Kimberlin.