FLU SHOTS A MUST FOR KIDS WITH SICKLE CELL DISEASE
-Children with sickle cell disease hospitalized frequently with the flu
Embargoed for release until 12:01 A.M. EDT, Saturday, May 2
Children with sickle cell disease are hospitalized with influenza
nearly 80 times more often than other children, a finding that should
be a wake-up call for both pediatricians and health insurance
providers, say researchers from Johns Hopkins Children's Center.
In the study, the Johns Hopkins team combed through records from
several state databases tracking flu hospitalizations from the
2003-2004 and 2004-2005 flu seasons and found that 5,256 children
were hospitalized with the flu. Among children with sickle cell
disease, there were 201 flu-related hospitalizations per 10,000
children per year compared to 2.6 flu-related hospitalizations per
10,000 children among those without sickle cell disease per year.
The CDC considers children with sickle cell disease, a genetic
disorder marked by abnormally shaped red blood cells, to be at high
risk for complications from the flu. However, to date, there has been
little evidence to prove it. The Johns Hopkins report is the first
study to quantify the risk and to show how often these children end
up in the hospital with the flu, pointing to the need for aggressive
immunization efforts in children with sickle cell disease, much like
in children with other chronic conditions, including asthma, diabetes
and heart disease.
"Kids with sickle cell disease are hospitalized often enough for
their disease, and the last thing they need is to be in the hospital
for a preventable complication," says lead investigator David Bundy,
M.D., M.P.H., of Johns Hopkins Children's. "We know from other
studies that children with sickle cell disease get flu shots less
than half of the time and may be overlooked as a risk category by
doctors and insurance providers and within the sickle cell community itself."
Because past research has shown dismal flu vaccination rates among
children with sickle cell disease, Bundy and colleagues recommend
that pediatricians treating these patients should have proactive
immunization plans rather than wait to vaccinate children when and if
they come to the office. Because sickle cell disease is a relatively
rare condition, affecting 72,000 Americans, most pediatric practices
do not have many sickle cell patients. Consequently, it would not be
burdensome to launch proactive vaccination efforts, such as mail
alerts and phone calls, Bundy says.
He adds that another way to mass-immunize children with sickle cell
disease is through Medicaid-based vaccination efforts. Medicaid is
the public health insurance program for low-income children. In the
study, 64 percent of the children with sickle cell disease who were
hospitalized with the flu were insured by Medicaid.
"Medicaid-based efforts could be that silver bullet of mass
immunization for many U.S. children with sickle-cell disease," Bundy
says. "A cheap flu shot program could save millions of dollars by
preventing flu-related hospitalizations, providing a great return on
investment for Medicaid," Bundy says.
Abnormal, crescent-shaped red blood cells that give the disease its
name block the normal flow in blood vessels and can cause organ
damage. Each year, 2,000 U.S. babies are born with the disorder.
The CDC recommends that all children over 6 months of age get a flu
shot, except those who are allergic to eggs or have had a severe
reaction to a flu vaccine in the past.
Other investigators in the study include John Strouse, M.D., Marlene
Miller, M.D., and James Casella, M.D., all of Hopkins Children's.