Influenza Vaccination
(influenza)

Children who live in residential institutions for the developmentally disabled should receive routine childhood immunizations and an annual immunization against influenza as recommended. Immunization against influenza is important because the infection can spread rapidly in an institution, and these children are more likely to have complications with the infection.

The influenza vaccine

• available in three different forms
  • the inactivated whole virus
  • subvirion vaccines (a "split-virus" vaccine)
  • purified surface antigen vaccines (a "split-virus" vaccine).
• The split-virus vaccine should be used in children younger than 12 years of age because it is associated with a lower incidence of side effects in this age group.
• Either whole virus or split-virus vaccine can be administered to adults and adolescents.
• Children younger than 9 years who have not received the vaccine previously require administration of two doses 1 month apart. There is no need to administer the vaccine in divided doses.

The incubation period for influenza is 1 to 3 days, and the antibody response is seen 1 to 2 weeks after influenza vaccine administration. Thus, if administration of vaccine is delayed until after there is documented infection in the residential home, it will not prevent disease. If no vaccine is given and the infection is diagnosed within 48 hours of symptoms, treatment with antiviral medication may be helpful, but it is not appropriate as prophylaxis.

References:
American Academy of Pediatrics. Children in residential institutions.
In: Pickering LK, ed. 2000 Red Book: Report of the Committee on
Infectious Diseases. 25th ed. Elk Grove Village, Ill: American Academy
of Pediatrics; 2000:70-72
Centers for Disease Control and Prevention. Prevention and control of
influenza: recommendations of the Advisory Committee on Immunization
Practices (ACIP). MMWR Morb Mortal Wkly Rep. 1999;48(RR-4):1-28
Available at: http://www.cdc.gov/ncidoddiseases/flu/fluvirus.htm.