Study finds Tamiflu frequently prescribed for infants with flu

News brief
Topics
Influenza, General
Parent with sick infant
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A single-center study by researchers with the University of Pittsburgh School of Medicine found that adherence to national influenza antiviral treatment guidelines for children is high and has improved over time — but could be better. The findings were published yesterday in the Journal of the Pediatric Infectious Diseases Society.

Using electronic health record data from the University of Pittsburgh Medical Center, the researchers reviewed how provider prescribing of the antiviral oseltamivir (Tamiflu) for infants ages 12 months and younger with influenza changed from 2012 through 2019, along with the characteristics associated with non-prescription of oseltamivir. In 2011, the Centers for Disease Control and Prevention recommended that children under the age of 2 with suspected or confirmed flu to receive antiviral treatment "as soon as possible" because of their high risk for influenza-associated complications. But few studies have specifically looked at oseltamivir prescribing for infants since those recommendations were issued.

Lack of fever, more than 2 days of symptoms linked to non-prescription

Of the 457 infants (54% male, 67.6% White) with confirmed flu over the study period, 392 (85.7%) were prescribed oseltamivir. The proportion of infants prescribed oseltamivir increased from 64.6% during the 2012-2016 flu seasons to 90.4% during the 2016-2020 seasons. 

"This suggests a gradual adherence to the CDC’s antiviral guidelines after they were updated in 2011 to recommend antiviral treatment be given to children < 2 years of age as soon as possible," the study authors wrote.

Multivariable analysis revealed that, when adjusted for age, sex, and race, infants were more likely to not be prescribed oseltamivir if they experienced more than 2 days of influenza symptoms (odds ratio [OR], 9.4; 95% confidence interval [CI], 4.8 to 18.7), were diagnosed during the 2012-2016 influenza seasons (OR, 4.2; 95% CI: 1.8 to 9.5), tested positive for influenza via a multiplex/RT-PCR test (OR, 6.7; 95% CI, 2.7 to 16.3), or did not have a fever at point-of-care (OR, 2.3; 95% CI, 1.2 to 4.6).

The authors say the findings indicate antiviral prescribing for infants with flu can still be improved in inpatient and ED setting, with rapid testing playing an important role.

Review estimates impact of various vaccine strategies for flu, measles, polio, etc

News brief
Topics
Influenza Vaccines
Misc Emerging Topics
hpv vax
PAHO / Flickr cc

The Annenberg Public Policy Center (APPC) at the University of Pennsylvania has published new data in Nature Human Behavior identifying which vaccine strategies specific countries should adopt based on their needs to increase vaccine uptake.

In the past 20 years, rising vaccine hesitancy has led to suboptimal uptake of influenza, measles, polio, HPV, and other vaccines, while COVID-19 vaccines have also been met with skepticism. 

The recommendations are based on findings from 88 eligible randomized controlled trials testing interventions with 1,628,768 participants from 17 countries. 

Overall, interventions were associated with an estimated 50% higher chance of vaccination compared to "control" conditions with no intervention (odds ratio [OR], 1.5; 95% confidence interval (CI], 1.27 to 1.77).

Educational campaigns have no impact 

In general, educational campaigns aimed at correcting vaccine misinformation had no significant impact on vaccine uptake. Instead, efforts to increase access to vaccines had the most success. 

Vaccination rates tripled, however, with intervention aimed at offering free transportation to vaccine sites or at bringing vaccines to nursing homes and workplaces. Some studies showed offering financial incentives had minor success in increasing vaccine uptake. 

Even though misinformation undermines democracy and can be far-fetched, and thus highly salient, correcting it does not ensure health behaviors like vaccination.

"Public health officials often say that ensuring vaccine access is the first step to promoting immunization," said Dolores Albarracin, PhD, of the APPC, in a university press release. "Our meta-analysis provides hard evidence in support of this recommendation, and indicates that this should be a special priority in under-resourced areas with limited access to health care. 

"By contrast, even though misinformation undermines democracy and can be far-fetched, and thus highly salient, correcting it does not ensure health behaviors like vaccination."

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