Pandemic Influenza: Warning, Children At-Risk

October 2007

The American Academy of Pediatrics (AAP) and Trust for America's Health (TFAH) issued a report in October 2007, Pandemic Influenza: Warning, Children At-Risk, which finds that children and teens between the ages of 0-19 account for nearly 46 percent of all H5N1 "bird" flu deaths. The report also identifies gaps in U.S. preparedness for treating and caring for children during a possible pandemic flu outbreak.

Four key areas of concern raised in the report include: child-appropriate doses of vaccine and medications; management and treatment of children who become ill; including children in strategies to slow the spread of influenza in communities; and caring for and supervising the health of children if schools and childcare facilities are closed for extended periods of time.

The AAP and TFAH recommend specific actions to ensure the health and welfare of the nation's children are protected in the event of a flu pandemic:

• Pediatricians and pediatric medical and surgical subspecialists should be included in pandemic planning at all levels of government.
• The U.S. Department of Health and Human Services (HHS) should conduct additional studies on vaccine efficacy in young children, support the development of additional flu vaccine products, and conduct more studies of antiviral agents for infants.
• HHS should immediately convene an independent task force to study and make specific recommendations about the use of surgical masks, N95 respirators, and other personal protective equipment by children.
• HHS should conduct further studies on the feasibility of prolonged school and childcare center closures, including a more precise assessment of the long-term interruption of the school meals program and how to mitigate the impact on students who rely on them.
• The Federal government should ensure that the Strategic National Stockpile includes sufficient pediatric doses of antiviral medications to ensure treatment of 25 percent of the nation's children and adolescents, or about 18.4 million individuals.
• All schools should educate students in infection control. Children should receive grade-appropriate health education about communicable diseases and methods to interrupt disease spread (cover cough, wash hands, etc).
• Educators and school administrators should be encouraged to get an annual influenza vaccination and should remind families that public health experts recommend annual flu vaccines for 1) all children with high risk conditions who are 6 months of age and older, 2) all healthy children ages 6 months through 59 months, 3) all household contacts and out-of-home caregivers of children with high risk conditions and of children younger than 5 years if age, and 4) all health care professionals. CDC and state and local health departments should encourage and support seasonal flu vaccination clinics in school settings to maximize flu vaccine coverage rates.