Children with chronic cardiac disease often don’t get a flu vaccine because their primary care physicians and cardiologists fail to specifically recommend it and because their parents are unaware influenza is risky for their children, reported Gilat Livni, MD, and Alina Wainstein, MD, of Tel Aviv University and their associates.

The investigators surveyed 186 parents of children attending a cardiology institute in Israel regarding flu vaccination. Over a third (37%) of the children had received a flu vaccine during the last flu season. Those who had been vaccinated were significantly more likely to have parents and siblings who were vaccinated (P less than .01).The mean age of the children was 8 years.

The main underlying cardiac diseases in the 186 children were left-to-right shunt defect in 31%, obstructive lesions in 30%, and cyanotic defect in 16%. Other cardiac abnormalities included valvular insufficiency in 11%, cardiomyopathy in 8%, and complete atrioventricular block in 4%.

More than half of parents (59%) reported that a pediatrician had recommended that their child get a flu vaccine; of these parents, 53% complied. Only 13% of parents who did not get such a recommendation had their children vaccinated – a statistically significant difference. Findings were similar regarding recommendations from pediatric cardiologists. “The failure of parents to receive information or advice from a physician regarding vaccination was strongly inversely related to vaccination of the child,” the investigators concluded.

“Our results emphasize the need to raise awareness among physicians and other medical health care personnel dealing with children with heart disease of the importance of properly counseling parents regarding influenza vaccination. Recommending the vaccine should be made part of routine patient visits in fall and winter,” concluded Dr. Livni, Dr. Wainstein, and associates.

The full text is available online (Pediatr Infect Dis J. 2017 Nov;36[11]: e268-71. doi: 10.1097/INF.0000000000001579 ).


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