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The Pediatric Forum |

Interpretation of Maternal Influenza Study Should Not Discourage Immunization Efforts

Shetal I. Shah, MD
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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

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Arch Pediatr Adolesc Med. 2007;161(6):618-618. doi:10.1001/archpedi.161.6.618-a
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I read with interest the article by France et al1 in the December issue of the Archives, which is the second article to demonstrate that influenza vaccination in mothers does not impact respiratory tract illness rates in their infants.2 While the authors state that vaccination is still recommended, pediatricians must ensure the data are interpreted in the proper context.

Of concern is that internal medicine and obstetric colleagues who are disinclined to immunize, because they face financial constraints regarding vaccine administration and thus have not achieved high vaccine coverage rates in pregnant mothers, will cite this data as justification to further reduce their efforts.3 However, it should be noted that protection of infants from hospitalization and influenza-like illness requires a cocoon of protection of all the infant's close contacts, not solely mothers.4 Paternal immunization, which is not addressed in the article, and immunization of other siblings are also required to reduce influenza-like illness in children.

This article should have provided further justification of offering immunization services to all members of an infant's household when requesting medical care. Such programs, for example those using the hospital nursery staff to immunize both parents of newborns, have been shown to reduce influenza in children younger than 6 months old.5

AUTHOR INFORMATION

Correspondence: Dr Shah, Department of Pediatrics, State University of New York at Stonybrook, 130 Post Ave, Suite 418, Westbury, NY 11590 (shetaldoc@hotmail.com).

Financial Disclosure: None reported.

France  EK, Smith-Ray  R, McClure  D.  et al.  Impact of maternal influenza vaccination during pregnancy on the incidence of acute respiratory illness visits among infants. Arch Pediatr Adolesc Med 2006;1601277- 1283
PubMed
Black  SB, Shinefield  HR, France  EK.  et al.  Effectiveness of influenza vaccine during pregnancy in preventing hospitalizations and outpatient visits for respiratory illness in pregnant women and their infants. Am J Perinatol 2004;21333- 339
PubMed
Centers for Disease Control and Prevention,  Estimated influenza vaccination coverage among adults and children: United States September 1, 2004–January 31, 2005. MMWR Morb Mortal Wkly Rep 2005;54304- 307
PubMed
Advisory Committee on Immunization Practices, Smith  NM, Bresee  JS, Shay  DK, Uyeki  TM, Cox  NJ, Strikas  RA. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;551- 42[erratum in MMWR Morb Mortal Wkly Rep. 2006;55:800].
Shah  S, Caprio  M. Optimizing long-term care by administration of influenza vaccine to parents of NICU patients. J Perinatol 2004;24273- 274
PubMed

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France  EK, Smith-Ray  R, McClure  D.  et al.  Impact of maternal influenza vaccination during pregnancy on the incidence of acute respiratory illness visits among infants. Arch Pediatr Adolesc Med 2006;1601277- 1283
PubMed
Black  SB, Shinefield  HR, France  EK.  et al.  Effectiveness of influenza vaccine during pregnancy in preventing hospitalizations and outpatient visits for respiratory illness in pregnant women and their infants. Am J Perinatol 2004;21333- 339
PubMed
Centers for Disease Control and Prevention,  Estimated influenza vaccination coverage among adults and children: United States September 1, 2004–January 31, 2005. MMWR Morb Mortal Wkly Rep 2005;54304- 307
PubMed
Advisory Committee on Immunization Practices, Smith  NM, Bresee  JS, Shay  DK, Uyeki  TM, Cox  NJ, Strikas  RA. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006;551- 42[erratum in MMWR Morb Mortal Wkly Rep. 2006;55:800].
Shah  S, Caprio  M. Optimizing long-term care by administration of influenza vaccine to parents of NICU patients. J Perinatol 2004;24273- 274
PubMed

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