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Flu jab funding for over-65s should go to children, say researchers

Money spent on a UK flu vaccination programme for people aged 65 and over would have been better targeted at children, experts have said.

Children are the main spreaders of flu and vaccination protects not only them but others too, said a team writing in the journal PLoS Medicine.

The research, looking at 14 flu seasons in England and Wales, “suggests the targeting all individuals 65 years and older that occurred in 2000 in the UK was not the best strategy.

“Targeting children would likely have prevented more cases and deaths for similar numbers of doses, even if low levels of coverage (30%) had been achieved.”

Study lead author Dr Marc Baguelin, a mathematical modeller at the London School of Hygiene and Tropical Medicine, said vaccinating people aged 65 years and over had worked quite well in terms of reducing death rates in this age group.

“But in terms of efficiency, the potential is that child vaccination at this point would have been a more efficient use of resources.”

About 600 people a year die from flu in the UK, rising to around 13,000 during an epidemic.

At present, people aged 65 and over and those at high risk, such as with diabetes or heart disease or who are pregnant, are vaccinated annually.

Since September, an annual nasal spray flu vaccine has also been made available to all children aged two and three years as part of the NHS childhood vaccination programme in the UK.

Over time, all children between the ages of two and 16 will be vaccinated against flu each year with the nasal spray.

The spray - Fluenz - works better than the injected flu vaccine in children and is expected eventually to prevent at least 2,000 deaths from flu in the general population and lead to 11,000 fewer hospital admissions.

The latest research said: “The most efficient way of reducing overall influenza-attributable morbidity and mortality appears to be to target the key spreaders - children.

“Targeting at-risk individuals and elderly adults offers some protection to those immunised, but little to others in the population.

“Adoption of more innovative strategies that aim to block transmission (in addition to targeting those most at risk) should be more widely adopted. Even with modest coverage, substantial further reductions in morbidity and mortality could be achieved.”

The authors found that the current programme has averted 0.39 infections per dose of vaccine and 1.74 deaths per 1,000 doses.

Extending the programme to five to 16-year-olds would “increase the efficiency of the total programme, resulting in an overall reduction of 0.70 infections per dose and 1.95 deaths per 1,000 doses.

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Readers' comments (19)

  • How clever - now instead of blaming the over 65's for all the ills of the NHS-nay- the country, now we must choose whether we treat our children or our elderly. How long before euthanasia becomes legal, and then morally acceptable for the elderly so they do not become a 'burden' to the state!!

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  • they faught our wars supported the state and system all their lives now some bright sparkwants to stop them having a flu vaccine. Pathetic! Stop the immigrants bringing in diseases such as TB that takes money out of the NHS. Leave the elderly alone. soon forgot the Dignity for the Elderly haven't we.

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  • The researchers reports that children are the main spreaders of flu.
    Flu can be spead by any one with the flu.
    In the area I live which is highly populated by the elderly, they spread the flu amongst themselves and to the rest of us.
    The elderly here are not kept locked away.

    Note the words targeting children would LIKELY have prevented ....

    A detailed Demography is not taken into account for age groups in particular, only a general population summary.
    I suppose at this present time, in general children will be the main spreaders, however, as we are becoming more active in old age, the mean and modal statistical figures will increase and may even by pass the statistics mean for children.

    Extending the programme to more people of course will protect more people in the overall population -- nothing new there.

    When we have research like this I always wonder about motives and who is to benifit.

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  • The elderly are just as important as children, and should be offered the vaccine if they want it. Elderly people are discriminated against enough without this

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  • As usual, a misleading headline lifted from "The Press Association", a simplistic and inaccurate summary, followed by the inevitable expressions of faux outrage from those who have clearly not read the research.

    Go read the actual findings and educate yourselves folks:

    http://dx.doi.org/10.1371.journal.pmed.1?001527

    Then again, why let science, methodology and actual facts get in the way a good, old fashioned festival of shock, horror and immigrant bashing, eh?!

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  • Why was the full report not here then? Elderly more likely to die from it, that's the point but I can see that they are more likley to be less socialising and so not spread the virus as much as children but THERE SHOULD BE FUNDS FOR ALL VULNERABLE AGES.I do believe that the elderly are being sacrificed though, as Carol and Lorraine have stated. as we have seen in so many hospitals-poor care, poor nutrition, dehydrated, pressure sores, lying in their own excreta LCP etc. Would this happen in a children's hospital? No there would and should be an uproar.- and rightly so. And, yes, immigrants should be screened BEFORE entry or asap. We have to be screened to emegrate-equality for ALL

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  • sally carson | 10-Oct-2013 5:05 pm

    "Why was the full report not here then?"

    You have not read it or you wouldn't have asked such a silly question.

    If you believe that the "...elderly are being sacrificed...", do you mean in the context of the research you haven't read, or in the wider social context? Either way, that has nothing to do with the findings of the report, which actually recommended, "..FUNDS FOR ALL VULNERABLE AGES." You would have known that had you read the research.

    With regard to immigration, I would direct you to current UK government policy on pre-migration screening. It might lessen the OTT expressions of mock shock spouted from a positions of pure ignorance.

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  • Agree with 8:16 above.

    A little bit of histrionics from reviewers??
    "The elderly 'faught' our wars - aye??" Is this from a degree nursing student??
    "Elderly being sacrificed?" Oh please!

    Or maybe most of the above are written by a group of disgruntled 65yr olds, many of whom DID NOT "faught out wars" as they were far too young for WW2, even 85 year olds were only 11 yrs old when WW2 started! They were too old for the last terrible conflicts in Iraq and Afghanistan which has left many young people disabled and traumatised, who are now struggling to support their families having been kicked out of services accommodation.

    Added to this, this current young generation who have "faught" our wars will not have the choice of retiring at 65 (or even 60), will not have the pensions that are paid out nowadays, will have to see their own children priced out of university and they are unlikely to have the NHS that the pensioners nowadays enjoy.

    Oh, and by the way, the 65 yr olds today had nothing to do with the creation of the NHS. They were too young.

    It seems to me we should be protecting the tax payers of the future as well as golden generation who are enjoying record pensions now.

    As said before, read the research.

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  • Anon 8:16pm
    There is a policy for every thingh.
    I am an immigrant, I was asked by the British to come to this country to work.
    I do not feel hurt by someone saying immigrants should be screened.
    No one wants more disease in their country. I worked in the prison and a lot of the immigrant prisoners had TB.
    The thingh I feel wrong is not having proper Boarder control and because of the government's very poor management of Boarder control, illegal immigrants are here. The government want to charge these people for care to make it difficult for them, they think they can kill them off like rats. That is so savage and stupid. These people will just florish 'underground' with more problems from gang leaders.

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  • Anonymous | 10-Oct-2013 9:25 pm
    from
    Anonymous | 10-Oct-2013 8:16 pm

    So why are you addressing your comment to me?

    I directed another commentator to read the UK Border Policy on pre-migration screening. The policy is to screen immigrants; a fact about which the commentator was clearly unaware. It is of no interest to me whether or not you are 'hurt' at having to be screened. It is what should happen and it is government policy.

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  • Some strange comments on here, and spelling mistakes. I think we have to distinguish between a world war and wars that have been fought since. Britain in WW2 was bombed and citizens were killed and injured on home turf. That wasn't the end of it, there was the rebuilding and rationing that followed for years. Food rationing ended on 4 July 1954, 9 years after WW2 ended (approx). Having said that, I don't decry what our troops and their families have been through since.

    Well, all that as nothing to do with the flu jab. When it seems that the aim was to get as many people vaccinated as possible to meet % targets, the goal posts are changing?? As a sceptic, are children an easier target to achieve it? I wonder?

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  • Sorry, my maths was wrong rationing ended 5 years (approx) after WW2 ended!

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  • Funding high quality unbiased information for the public might be helpful.

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  • Once again. Perhaps reading the research, in full, might encourage less ignorance and fewer silly comments.

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  • Anonymous | 13-Oct-2013 9:51 am

    For information on the study author who is based in The London School of Hygiene and Tropical Medicine and works for the Health Protection Agency, his credentials, funding and other research.

    http://www.lshtm.ac.uk/aboutus/people/baguelin.marc

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  • Anonymous | 13-Oct-2013 12:20 pm

    from Anonymous | 13-Oct-2013 9:51 am

    I am not sure the average member of public is going to do a search for academic papers. they need simple unbiased information which they can access easily to help their understanding of the need for the vaccine.

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  • Anonymous | 13-Oct-2013 12:55 pm

    That's odd. I thought that this was a publication aimed at nurses. Perhaps I wrongly assumed that those who were making the daft comments were just lazy, ignorant nurses who should be able to cope with reading a research paper, but hadn't bothered? Obviously I was mistaken, and those posts were written by average members of the public. (Although, I suspect my original assertion is true and also believe that an average member of the public would not have much trouble understanding the research paper.)

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  • Anonymous | 13-Oct-2013 2:13 pm

    try reading the comments. it helps!

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  • Anonymous | 13-Oct-2013 2:13 pm

    ...if you wish to criticise them that is. otherwise maybe best not to bother!

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