Playing Kids' Odds with the Flu

Children with neurological disorders more likely to suffer complications from flu

(RxWiki News) Even though the flu is a common illness each winter, that doesn't mean it's not a dangerous one. Children with certain chronic conditions are especially prone to complications from influenza.

A recent report, however, found that children with these conditions were not vaccinated at any higher rate than other children in the US.

Children with neurological conditions such as epilepsy or intellectual disability are at greater risk for flu-related complications. Yet only half these children received the flu vaccine during the 2011-2012 flu season.

Nearly half the children who died in the 2009 flu pandemic had a neurological disorder.

"Ask your child's pediatrician about the flu shot."

This report, authored by a team led by Michael J. Smith, MD, of the University of Louisville School of Medicine, came from the US Centers for Disease Control and Prevention (CDC).

The researchers surveyed parents of 1,940 children with chronic medical conditions about what they knew, what they thought and what they did related to vaccinating their children against the flu.

Only children aged 6 months (the minimum age for the flu vaccine) and older were included.

Chronic conditions that can increase the risk of flu complications include cognitive dysfunction, seizures disorders such as epilepsy and other neurological disorders.

For example, during the 2009 flu season, 336 children died, and almost half of these deaths (146 of them) occurred among children who had underlying neurological disorders.

Coverage rates for other children in the survey varied. The lowest percentage of 41 percent coverage occurred for children with metabolic disorders.

The highest rate of coverage was 78 percent, for children with chronic lung disease.

However, the 1,005 children in the survey who had neurological disorders had poor overall rates of vaccination coverage.

The results revealed that exactly half of these children had been vaccinated against the flu or had a medical appointment scheduled to receive the vaccine.

Among children with intellectual disability, only 52 percent of the children had received their flu vaccine or were scheduled to.

Among those with epilepsy, only 59 percent had received the seasonal flu vaccine or were scheduled to get it.

The most common source of information for parents about the flu vaccine was a healthcare provider, reported by 75 percent of the parents.

Other sources included the Internet, reported by 24 percent of the parents, and family support or disability advocacy organizations, reported by 22 percent.

In addition to the family surveys, the researchers also surveyed 412 doctors regarding their knowledge of which conditions could increase a child's risk of complications from the flu.

Of these doctors, 44 percent were primary care doctors, and others included neurologists, emergency room doctors, critical care doctors and metabolism doctors.

Only 46 percent of doctors knew that intellectual disability could increase a child's risk of flu complications.

Similarly, only 52 percent of pediatricians surveyed knew that epilepsy increased a child's likelihood of developing complications from influenza.

Neurologists were the doctors most likely to recognize that cerebral palsy, epilepsy, spinal cord conditions, stroke and other brain conditions increased the risk for flu complications.

"The results of these surveys demonstrate that children with neurologic or neurodevelopment conditions are no more likely to be vaccinated than healthy children, despite the fact that they are at increased risk for poor outcomes," the researchers wrote.

"Intellectual disability and epilepsy were the two most common neurologic or neurodevelopment conditions among children who died during the 2009 influenza pandemic but were two of the three conditions least likely to be recognized as high-risk by physicians," they wrote.

Ryan Coates, MD, a board certified physician in pediatrics as well as psychiatry and neurology at Loyola University Health System, said this article addresses a significant issue within neurology and pediatrics.

"Children with neurologic disorders are in the category of individuals at risk of developing serious complications if they have the flu," he said.

"Unfortunately, families may not be getting information about how important and necessary this vaccination is for these children," Dr. Coates said. "Families should talk to their pediatrician and neurologists about this article and how it applies to any at risk children."

This report was published September 13 in the CDC's Morbidity and Mortality Weekly Report (MMWR). The report was internally funded.

Review Date: 
September 13, 2013