Children with neurological or neuromuscular diseases may benefit by getting a flu vaccine, new research shows.

The U.S. Advisory Committee on Immunization Practices (ACIP) recommends annual flu shots for kids who are at least 6 months old and have certain risk factors including (but not limited to) asthma, cardiac disease, sickle cell disease, HIV, and diabetes.

Healthy children 6 to 23 months and close contacts of healthy children 0 to 23 months are also recommended to be vaccinated because children in this age group have increased risk for hospitalization related to influenza.

The ACIP recently recommended adding neurological and neuromuscular diseases to the list. The new study supports that recommendation, write Ron Keren, MD, MPH, and colleagues.

Keren works at The Children’s Hospital in Philadelphia. The study appears in The Journal of the American Medical Association.

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Hospital Study

Keren’s team tracked all patients aged 21 and younger who were hospitalized with flu at The Children’s Hospital in Philadelphia over four straight flu seasons.

That added up to 745 kids. More than 40 percent of them had at least one risk factor on the ACIP’s list.

Asthma was the most common risk factor. It was noted in about a quarter of the kids, the researchers write.

Twelve percent of the kids had neurological and neuromuscular diseases. Their most common conditions were seizure disorders and cerebral palsy. Other conditions included muscular dystrophy, stroke, and brain abnormalities.

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Flu Complications

The researchers counted 32 children who needed a ventilator machine to help them breathe because of respiratory failure.

Neurological and neuromuscular diseases made that complication more likely, the researchers calculated.

Kids with neurological and neuromuscular diseases were six times as likely to have that complication as children without those diseases, the researchers report. However, when seizure disorder was analyzed separately, there was no significant association with respiratory failure.

This supported the researchers’ reasoning that the respiratory failure in children with neurological and neuromuscular diseases and flu may be due to muscular weakness and decreased muscle tone, which make it harder to clear secretions from the throat and airways.

Chronic lung diseases (other than asthma) and cardiac diseases also raised the risk of respiratory failure, but not by as much, write Keren and colleagues.

Study’s Limits

The study has some limits, the researchers note.

Only one hospital was included. It’s not known if the results would be the same elsewhere.

Also, the researchers didn’t know if most of the kids had gotten a flu vaccine or not. So they don’t know how much a flu vaccine would have helped avoid respiratory failure.

In addition, relatively few kids had respiratory failure. That could make it harder to generalize which kids were particularly at risk.

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By Miranda Hitti, reviewed by Louise Chang, MD

SOURCES: Keren, R. The Journal of the American Medical Association, Nov. 2, 2005; vol 294: pp 2188-2194. Advisory Committee on Immunization Practices: “Recommended Childhood and Adolescent Immunization Schedule.”