It Doesn’t Have to be EviDense

[摘要] Attending physicians do it. Residents do it. Hospitalists, emergency department doctors, general pediatricians…we all do it. In fact, in the United States, we do it >10 million times a year. We order the flu shot for our patients and often probably don’t think too much of it (unless, of course, we have a patient with Kawasaki disease). But does the vaccine really work?### The study.A 2012 Cochrane Review by Jefferson et al attempted to answer this question. This systematic review and meta-analysis included randomized controlled trials (RCTs), comparative trials, and cohort and case-controlled studies of healthy children in whom vaccination with influenza vaccine was compared with placebo or a control. The primary outcome measure was confirmed influenza illness along with an examination of several secondary outcomes.### The key findings.Seventy-five studies were included in the systematic review and 41 in the meta-analysis. Based on a compilation of 17 RCTs, 6 children aged 2 to 6 years and 28 children aged >6 years need to be vaccinated to prevent a case of influenza within the respective age groups. Based on a single RCT in children aged <2 years, the vaccine demonstrated effectiveness similar to placebo (relative risk [RR]: 0.55 [95% CI: 0.18–1.69]). Furthermore, compared with placebo, the vaccine showed little or no benefit for other outcomes such as prescriptions given (RR: 0.99 [95% CI: 0.87–1.12]), incidence of lower respiratory tract disease (RR: 0.20 [95% CI: 0.03–1.54]), socioeconomic impact (RR: 0.69 [95% CI: 0.46–1.03]), school absenteeism (RR: 0.49 [95% CI: 0.26– 0.92]), and physician visits for pneumonia and influenza (RR: 0.76 [95% CI: 0.59–0.98]). The review did not find enough data to conduct an analysis of the safety of the flu vaccine.#### Why do we care?Public health policy in much of the developed world recommends vaccinating healthy children aged >6 months, resulting in millions of doses given to children …

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob