Toward a consensus on fighting flu: prioritising childhood vaccination

If I asked you to name an infectious disease that globally is associated with 9.5 million hospitalisations and around 145,000 deaths each year, how long would it take before you thought of influenza?

Peter Openshaw is a Professor of Experimental Medicine in Imperial College London.

Also referred to as simply ‘flu’, it is often thought that because seasonal influenza is common it is also harmless. While it is true that most people recover fully from flu, for certain high-risk groups – including the elderly, pregnant women and those with certain pre-existing medical conditions –influenza can cause severe illness and even death. Children are among those who may experience severe outcomes, with around 4 million influenza-related hospitalisations in those under 18 years, each year. Of children hospitalised with flu, about 1 in 5 need escalated care.

The severe impact influenza can have on individual children consequently places a significant strain on healthcare systems. Seasonal influenza is associated with increased emergency admissions and use of inpatient critical beds, surges in hospitalisation causing cancellations of elective surgical procedures and depletion of the adult workforce.

It is also notable that people most at risk of flu may also be vulnerable to other viral infections such as COVID-19; those with multiple simultaneous viral infections are at higher risk of severe illness and death.

Harnessing the power of childhood influenza vaccination

The good news is that seasonal influenza is largely preventable. Vaccination is the single most effective way that we have to protect against flu. Moreover, childhood flu vaccination programmes not only protect children, but also reduce community transmission and secondary cases amongst those at high risk and unprotected by vaccination.

This is because children are important in community and household transmission of flu. They are responsible for up to 20% of all flu transmission outside the household and play a central role in transmission within households, but generally respond well to influenza vaccination.

Vaccinating children therefore not only offers important protection to children themselves, but also may reduce transmission, thereby protecting the communities within which they reside.

Moving toward a consensus

It was this – the significant unmet opportunity presented by childhood influenza vaccination - that formed the focus of the inaugural Childhood Influenza Policy Steering Committee (CIPSC), organised and funded by AstraZeneca. Comprised of 15 experts from across the globe, we came together with the aim of establishing a consensus on how we can realise the potential benefits of widespread childhood flu vaccination.

From a lively exchange of the committee’s wide-ranging expertise, experiences and ideas, several key areas of focus and alignment emerged:

• Access to flu vaccination must be convenient and make use of as many channels as possible: Making national vaccination programmes as efficient, accessible and convenient as possible is critical to increasing reach and uptake. School, nursery and community-based programmes – for example making vaccination available in local schools and pharmacies – means we can meet parents and children where they already are. By working with institutions that are already woven into the fabric of communities offers greater convenience, trust and familiarity which in turn can reduce missed appointments and improve vaccine uptake.
• Clear, consistent and compelling public health messaging should be a priority: Access is not enough without education. Myths and misunderstandings about flu and the role of vaccination persist and can act as barriers to vaccination. Regular reminders of the importance of taking steps to reduce risk of flu are needed annually so that members of the public can be reminded of the information they need to take steps to protect their health, their families and communities. Personal and specific anecdotes are also vital to engage those making choices about vaccination, as is listening to the doubts and concerns of those giving and receiving vaccines.
• We need to collect, report and share more data: Timely, accurate data is critical for helping us to change hearts and minds when it comes to the importance of childhood flu immunisation programmes. Currently, we have significant national variations and critical gaps in how we track and report seasonal influenza spread and the impact of annual flu vaccination. Introducing more robust surveillance mechanisms and better leveraging the data we do have is important for supporting effective decision-making and ensuring implementation of efficient and cost-effective vaccination programmes.
• We must continue to share best practice to inform national planning: Different countries and regions take diverse approaches to flu vaccine delivery. Regional, cultural and national variations are important and must be considered when we talk about the role of childhood flu immunisation. We have much to gain from listening to and learning from one another. We therefore encourage governments to explore and adapt current global best practice initiatives, depending on their national health and education systems.

As I reflect on the rich discussion at our expert roundtable, I am inspired by the immense opportunity we have to reduce the personal, societal and economic burden of seasonal influenza by taking action to increase vaccine uptake in children. We urge governments and policymakers around the world to take specific actions to increase influenza vaccine coverage among children.

You can read our joint consensus statement here.

This non-promotional roundtable was organised and funded by AstraZeneca. Z4-68759