Influenza Vaccine Recommendations in Pakistan
Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses.
Safe and effective vaccines have been available and used for more than 60 years. Among healthy adults, influenza vaccine can prevent 70% to 90% of influenza-specific illness. Among the elderly, the vaccine reduces severe illness and complications by up to 60%, and deaths by 80%.
Data from Pakistan shows burden of influenza which is similar to other countries in the region. The seasonality is spread year round, but major disease activity is seen during the winter months.
Vaccination is especially important for people at higher risk of serious influenza complications, and for people who live with or care for high risk individuals. These groups include (no hierarchy is implied by order of listing):
- all children aged 6 through 59 months;
- all persons aged ≥50 years;
- adults and children who have chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
- persons who have immunosuppression (including immunosuppression caused by medications or by HIV infection);
- women who are or will be pregnant during the influenza season;
- children and adolescents (aged 6 months through 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye's syndrome after influenza virus infection;
- residents of nursing homes and other long-term care facilities;
- persons who are morbidly obese (BMI ≥40).
World Health Organization particularly recommends annual vaccination for (in order of priority):
- nursing-home residents (the elderly or disabled);
- people with chronic medical conditions;
- elderly individuals; and
- other groups such as pregnant women, health care workers, those with essential functions in society, as well as children from ages six months to two years.
Influenza vaccines are not licensed for administration to infants younger than 6 months. Children 9 years and older as well as adults need only 1 dose every year. Children 6 months through 8 years of age receiving the seasonal influenza vaccine for the first time should receive a second dose this season at least 4 weeks after the first dose.
Influenza vaccine should be administered soon after vaccine becomes available and, if possible, by October. All children aged 6 months through 8 years who are recommended for 2 doses should receive their first dose as soon as possible after vaccine becomes available; these children should receive the second dose ≥4 weeks later. This practice increases the opportunity for both doses to be administered before or shortly after the onset of influenza activity.
3. Ali SA, Aziz F, Akhtar N, Qureshi S, Edwards K, Zaidi A. Pandemic influenza A(H1N1)pdm09: An unrecognized cause of mortality in children in Pakistan. Scand J Infect Dis 2013 Oct;45(10):791-5.
4. Ali A, Khowaja AR, Bashir MZ, Aziz F, Mustafa S, Zaidi A. Role of Human Metapneumovirus, Influenza A Virus and Respiratory Syncytial Virus in Causing WHO-Defined Severe Pneumonia in Children in a Developing Country. PLoS One 2013;8(9):e74756.