Studies split on flu vaccine's value

CHICAGO (AP) -- Flu vaccines could help day-care children and their school-aged siblings stay well and reduce the use of over-prescribed antibiotics, a new study suggests.

But while the vaccine could also help keep adults under age 65 healthy and reduce missed work days, a cost-analysis conducted in another study found no savings in giving the flu shots to those adults.

The day-care study, led by Dr. Eugene S. Hurwitz of the Centers for Disease Control and Prevention, appears along with the cost-analysis, done by another CDC researcher, in Wednesday's Journal of the American Medical Association.

The studies follow a CDC recommendation earlier this year for people to take annual flu shots as of age 50, rather than 65. Data have suggested that many people 50 to 65 have chronic conditions that put them at risk for hospitalization or even death if they get the flu.

With a lag in vaccine production this year, federal health officials said last month that the ill and elderly should be given first priority this season.

But researchers who examined youngsters under age 5 said the benefits of their vaccination extends beyond their health.

The authors noted that 70 percent of children under 5 spend several hours weekly in day care. Such children are considered high-risk for flu, with as many as half contracting it in a single season.

Hurwitz's 1996-97 study considered 127 children in day-care centers in San Diego. Half of the subjects, ages 2 to 5, received the flu vaccine.

He focused on the vaccination's impact on family members. The most notable effect -- an 80 percent reduction in potential flu cases -- occurred among the vaccinated children's school-aged family members.

But also reduced among the family members, by more than 70 percent, were: absences from school, absences from work to care for sick children, doctor visits, earaches and antibiotics prescribed.

In JAMA's accompanying cost-analysis, researchers charted 1,184 healthy employees at Ford Motor Co. in Dearborn, Mich., through 1997-98 and 1,191 the next flu season. Half the subjects, ages 18-64, received the vaccine.

The vaccine was calculated at $24.70 per person to administer, including the cost of the shot and time spent waiting to receive it.

It did not prevent a flu strain that surfaced in the first season, nor did it reduce flu-like illnesses, doctors' visits or work absences. Ultimately, giving the shot cost about $65 per worker more than not vaccinating. In the second season, all three factors were reduced with an efficacy rate against the flu of 86 percent. Nonetheless, the net cost was still $11 per person.

A previous study suggested that flu shots make sense for working adults. But to see a cost-savings, "flu rates had to be over 35 percent, which are very high and not typically seen in healthy working-age adults," said Dr. Carolyn Buxton Bridges of the CDC.