On 2016 Mar 04, Chris Del Mar commented:

Between 1 - 5/1,000 children aged <5 years in developed countries may need hospital admission each year because of influenza infections, (PMID: 26111238) -- much lower (e.g. 0.6/1,000 children when based on laboratory confirmation of influenza, (http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19365). The benefits of influenza vaccination in children are a NNTB of 28 to prevent one child age aged >6 years getting influenza, but there is no effect on any downstream consequences such as secondary infections, nor benefit for children aged <2 years, from a Cochrane review (PMID 22895945). This systematic review estimates a rate of fevers of 6-7%, and of febrile convulsions at ~1/1,000 from inactivated vaccine fever in children aged >6 years (NNTH of 16 and 1,000 respectively) -- in the same range as those who might be prevented from a post-influenza admission. This suggests the decision about influenza vaccination needs discussion with parents to balance benefits against harms, perhaps using shared decision making (patient decision aid might be ideal), rather than public health pronouncements. Peer Collingnon collignon.peter@gmail.com; Chris Del Mar cdelmar@bond.edu.au

On 2016 Mar 04, Chris Del Mar commented:

Between 1 - 5/1,000 children aged <5 years in developed countries may need hospital admission each year because of influenza infections, (PMID: 26111238) -- much lower (e.g. 0.6/1,000 children when based on laboratory confirmation of influenza, (http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19365). The benefits of influenza vaccination in children are a NNTB of 28 to prevent one child age aged >6 years getting influenza, but there is no effect on any downstream consequences such as secondary infections, nor benefit for children aged <2 years, from a Cochrane review (PMID 22895945). This systematic review estimates a rate of fevers of 6-7%, and of febrile convulsions at ~1/1,000 from inactivated vaccine fever in children aged >6 years (NNTH of 16 and 1,000 respectively) -- in the same range as those who might be prevented from a post-influenza admission. This suggests the decision about influenza vaccination needs discussion with parents to balance benefits against harms, perhaps using shared decision making (patient decision aid might be ideal), rather than public health pronouncements. Peer Collingnon collignon.peter@gmail.com; Chris Del Mar cdelmar@bond.edu.au