Weighing the benefits: When should kids get swine flu vaccines and drugs?

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A new study in the British medical journal, BMJ, suggests that big-name flu treatments oseltamivir (Tamiflu) and zanamivir (Relenza) have only a “small benefit” in kids under 12 — but can have serious side effects. Now, even though the study reviewed four trials in kids treated only for seasonal flu, people are already drawing conclusions about how to treat — or not to treat — kids against the “novel H1N1” pandemic strain as well.

ANDRES STAPFF/Reuters/Corbis

ANDRES STAPFF/Reuters/Corbis

Add to the confusion some legitimate concern about whether vaccine safety can be adequately tested in children in just a few short weeks, and you’ve got some seriously spooked moms, dads, watchdog agencies and health commentators. Their main worry: Should kids be treated or vaccinated against what is still largely an unknown disease? Some fear we could have a repeat of the deadly complications from a swine-flu vaccine used back in 1976. And as for the drugs, although some studies suggest that Tamiflu may be more useful for kids with chronic conditions, such as asthma, Tamiflu has also been linked in a handful of cases to serious (temporary) psychiatric dysfunction, including delirium and suicide attempts.

Public health agencies monitor disease spread and bad reactions to treatments, so pay attention to their recommendations over the next few months. But the fundamental problem here is just that, so far, no one can say for certain whether flu vaccines and treatments will be worthwhile — since we don’t know yet how severe the pandemic will be. Side effects from drugs are to some extent unavoidable. If the epidemic turns out to be swift and severe, a few kids with unsettled stomachs from Tamiflu will be no big deal. It’s more important to treat their deadly disease than to make sure they keep their dinners down. But if the flu just peters out and kids aren’t catching it, then even the sore arm from a flu vaccine will have been unnecessary suffering. The best strategy should become more clear over the next few weeks, as flu season ramps up. Most likely, however, there will no definitive answer until the pandemic is over.