After years of debate, French children could be vaccinated en masse against the flu. The High Authority for Health (HAS) recommended, Thursday, February 9, “that vaccination against seasonal influenza be integrated into the vaccination schedule to be offered each year to children without comorbidities aged 2 to 17 years old, without making it compulsory”.
Concretely, this would mean that, from the age of 2, all minors could be vaccinated against the flu every year, as is already the case for people over 65. The opinion of the HAS is theoretically only advisory, but the Ministry of Health tends to systematically follow its positions. This therefore paves the way for a massive childhood vaccination campaign from the end of 2023.
Even if it is not a question of making the vaccine compulsory for children, such a development would mark an important change of direction. Until now, in fact, vaccination against influenza primarily targeted people at high risk of complications. This is particularly the case for the elderly, but also for patients suffering from diseases such as asthma or certain cardiac pathologies, including children. But most of the latter, that is to say those without “comorbidity”were not concerned, the idea being that a child in good health has little interest in being vaccinated, given the low risk of complications in this age group.
Nevertheless, a debate has been taking place for several years on the collective interest of such vaccination. Several countries, such as the United Kingdom and Spain, have already made this choice, in the idea that children constitute an important breeding ground for the transmission of the virus, in particular among older relatives. For the past two years, these debates have also found a particular resonance with the question, quite close, of anti-Covid vaccination. This was eventually extended to most children, not only in France, but in other countries such as the United States.
There is a risk that such a vaccination will be poorly accepted by parents.
In the case of influenza, it is indeed the collective interest that the HAS puts forward: ” The objective is (…) to limit the spread and impact of influenza on the population”, she notes. However, she takes care to emphasize that the individual benefit is not non-existent for children. After examining several recent large-scale studies, in particular reviews that compile pre-existing work, she concludes that the existing vaccines are effective and well tolerated in children over 2 years of age.
To support the individual interest of the vaccine in the youngest, the HAS insists in particular on the fact that the under 15s have accounted for a lot in the hospitalizations linked to the flu during the last epidemics. This large proportion of hospitalized children is, however, largely due to the fact that the oldest are widely vaccinated, and therefore less prone to complications, rather than to a particularly high dangerousness of the current viruses in the youngest.
Finally, one point particularly holds the attention of the health authorities: the risk that such a vaccination will be poorly accepted by the parents. This concern is part of a context where the Covid pandemic has made certain vaccinesceptic discourses more visible. This concern explains in particular that the HAS does not recommend the vaccine below 2 years of age. Not only does she feel there is a lack of data on effectiveness for these toddlers, but she also acknowledges that such a measure ” raised (would) questions of acceptability”.
As such, if the authority recommends all available flu vaccines, it advises instead to use a vaccine by nasal spray, developed by the AstraZeneca laboratory and currently not very present in vaccination campaigns. Here again, rather than better efficiency, it is a question of favoring a less tense gesture than an injection. “This simpler mode of administration – spraying in the nose – should indeed be better accepted by children and their parents”judges the HAS.
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