Call for all children to be vaccinated against swine flu

ALL children should be immunised against swine flu, according to leading doctors after a study found that youngsters were particularly vulnerable to the disease.

The study by the UK government's former chief medical officer Sir Liam Donaldson found that a fifth of children who died of the disease during last winter's outbreak were previously healthy.

The swine flu death toll for children was greater than that caused each year by leukaemia, said the researchers. Such a high death rate for a single infectious disease was last seen in 2001, during an outbreak of meningitis.

The authors called for a full immunisation programme for children due to the high number of fatalities. They also called for international data to be pooled to provide a higher number of cases for analysis. They wrote: "Our findings support the vaccination of children against pandemic influenza A H1N1. Children at greatest risk of severe illness or death should be prioritised.

"Our data indicates that risk groups include children with pre-existing illness, including chronic neurological or gastrointestinal disease, and those in ethnic minority groups (including Bangladeshi and Pakistani children). However, our findings also suggest that protection cannot be confined to risk groups as 21 per cent of deaths in our study occurred in healthy children."

Commenting on the report, Dr Robert Fowler, from the University of Toronto and Dr Phillipe Jouvet, from the University of Montreal, wrote: "We now know that the 2009 H1N1 infection was associated with severe illness and death in greater numbers of children and young adults than previous influenza seasons and other influenza viruses.

"Any talk of over-reaction to 2009 H1N1 virus might lead to an under-appreciation of the very real risks of influenza."

The Scottish Government last night insisted that its swine flu immunisation programme - which targeted those in "at-risk" groups - had worked well in preventing more fatalities. A spokesperson said: "Any child over the age of six months who is in an at-risk group is eligible for the seasonal flu vaccine.

"Expert advice is that children with no underlying health conditions are not at particular risk this year. The priority of the seasonal flu vaccination programme is to ensure the available vaccine is targeted at those most at risk.

"It is expected that H1N1 will be the main flu virus circulating during the 2010-11 season.

As a result of exposure to the virus during the pandemic, it is expected that there will be some built-up immunity within the community to this virus strain.

"This contrasts with last year when the H1N1 flu virus was an entirely new strain and there was little or no immunity.

"Decisions on who should receive the seasonal flu vaccine are based on recommendations from the Joint Committee on Vaccination and Immunisation, an independent panel of experts that provides advice to all UK health departments."

The study examined the cases of the 70 children and teenagers who died from swine flu in England over a nine-month period between 2009 and 2010. Those from Bangladeshi and Pakistani communities, and with pre- existing conditions - especially neurological diseases such as cerebral palsy - were hardest hit.

However, a fifth of the young people who died were previously healthy.

Doctors said the evidence suggested that all children should be vaccinated against swine flu, especially those in high-risk groups.

The findings, from an investigation into the impact of swine flu on children and teenagers aged 18 and under, were published yesterday in an early online edition of the Lancet medical journal.

The study found that overall childhood mortality for H1N1 was six deaths per million of population. The highest death rate of 14 per million was for children aged less than a year old. About a fifth of children who died were previously healthy or had only mild pre-existing disorders.

Overall, 64 per cent of children had been vaccinated with Tamiflu. But only seven received the drug within 48 hours of the onset of symptoms and just three before their admission to hospital.

Two children who died received the vaccine too late for it to be effective.