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How to Vaccine Asthmatic Chlidren - Dr. Sheetu Singh

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Title: How to Vaccine Asthmatic Chlidren - Dr. Sheetu Singh


1
Effectiveness in asthmatic children
Randomized, double-blind placebo-controlled
study was conducted in children with asthma 6-18
yrs of age, who had used medication for asthma in
the previous year. They were recruited in general
practices during the seasons 1999-2000
2000-2001. A total of 696 children were enrolled,
of whom 347 were vaccinated with Influvac 349
were in the placebo group
  • No serious adverse events were observed
  • Apart from daytime cough, no differences were
    found for the frequency or severity of asthma
    symptoms as an adverse reaction to vaccination
  • Found to have a moderately beneficial effect on
    quality of life in influenza-positive weeks of
    illness in children with asthma
  • No evidence that vaccination increased the risk
    of exacerbations of asthma

2
Effectiveness in asthmatic children
Reduce the risk of asthma exacerbation by 22 to
411
Study in children 0 to 12 years old with asthma,
a beneficial clinical effect ( in no of lower
RTI acute otitis media) in vaccinated preschool
children2
Ong et al reported a reduction in the use of oral
steroids in vaccinated children with asthma3 
Source 1. Destefano F et al. Does influenza
vaccination prevent asthma exacerbations in
children?Kramarz P, J Pediatr. 2001 Mar
138(3)306-10. 2. Smits AJ et al. Clinical
effectiveness of conventional influenza
vaccination in asthmatic children. Epidemiol
Infect. 2002128(2)20511. 3. Ong BA, Forester
J, Fallot A. Does influenza vaccination improve
pediatric asthma outcomes? J Asthma.200946(5)477
80
3
Effectiveness in COPD pts
Source Poole PJ, et al. Influenza vaccine for
patients with chronic obstructive pulmonary
disease. Cochrane Database Syst Rev. 2006 Jan
25(1)CD002733.
4
Sub unit Vaccine vs Split Vaccine
Sr No   Sub unit Vaccine Split Vaccine
1 Generation of Influenza vaccine 3rd generation 2nd generation
2 Type of vaccine Contains only surface proteins H N without internal parts of virus Contains virus particles H N with core and lipid envelope
3 Serology protection rates in chronically ill pts vs H3N2 96.55 -96.961 82-911
4 Serology protection rates in residents of nursing home / home for aged vs H1N1 92.71 84.71
5 Reactogenicity ( local systemic reaction) Lower frequency of local systemic reactions vs split vaccines of virus. 1,2 Moderate frequency of local and systemic reactions vs Subunit vaccine 1,2
Source 1. Beyer WE, Palache AM, Osterhaus AD.
Comparison of Serology and Reactogenicity between
Influenza Subunit Vaccines and Whole Virus or
Split Vaccines A Review and Meta-Analysis of the
Literature. Clin Drug Investig. 199815(1)1-12.
2. Palache AM. Influenza vaccines. A reappraisal
of their use. Drugs. 1997 Dec54(6)841-56.
5
How to Vaccinate
6
Vaccination Schedules
Age group Dosage (im/sc) No. of doses
6-35 months 0.25 ml 1 or 2
3-8 years 0.5 ml 1 or 2
gt 9 years 0.5 ml 1
2 doses at least 1 month apart for children
receiving vaccine for the first time
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