Key points

• Influenza vaccination is more effective in children aged over 3 years than in older adult age groups.

• It takes fewer doses of vaccine in children to protect against influenza than adults – the number needed to be vaccinated to prevent one case of influenza is predicted to be five.

• Vaccination attenuates disease severity.

• By encompassing all children into the vaccination programme, a greater level of protection will be provided to children at higher risk of severe outcomes than targeted vaccination of children within defined risk groups.

• Routine population influenza vaccination of children reduces antibiotic prescribing, school absenteeism and general practice visits.

• Individual vaccination plays a key role in reducing severe influenza outcomes.

• Some immunocompromised individuals, such as elderly adults, do not respond as well to standard influenza vaccines as healthy adults and children, and are likely to benefit from recombinant, adjuvanted or high dose vaccines. Individuals who are morbidly obese should also be considered among this group.

• By reducing the spread of influenza, broad population-based approaches can help to provide additional protection to the most at risk.

• All Māori and Pacific peoples from age 6 months would benefit from funded influenza vaccine.

• School-based vaccination provides the greatest protection directly to the children themselves.

• An additional benefit of school-based vaccination is to help reduce the spread of influenza to the wider community.

• Vaccination of workers in the health and education sectors reduces the impact influenza on these services through staff absenteeism as well directly protecting these staff. Patients and young children are also indirectly protected from being infected.

• Vaccination of all young children aged 6 months to 4 years is required to directly reduce the burden of influenza in these age groups. Vaccination in pregnancy provides passive protection to infants too young to receive influenza vaccine.

• Consideration is required as to how and where vaccine is accessed; targeted approaches are likely to be require in areas of high deprivation.

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