Influenza vaccine: an updated position statement of the Society for Adolescent Health and Medicine.

Globally each year, 5%e10% of adults and 20%e30% of children experience influenza infections [1]. During the 2009e2010 H1N1 influenza pandemic, these rates were higher and children and adolescents were disproportionately affected [2]. Specifically, in the United States this pandemic was estimated to have caused 86,000 hospitalizations and 1,280 deaths among children 0e17 years of age [2]. Worldwide, it is estimated that there were 44,500 deaths among youth 0e17 years attributable to pandemic influenza infection [3]. Most adolescents with influenza experience a self-limited illness characterized by fever, cough, headache, sore throat, and body aches. However, among adolescents who are pregnant or morbidly obese, as well as those with chronic medical problems, including asthma and diabetes, influenza can result in a more severe disease course. In addition, school-aged children and adolescents serve as reservoirs for spreading influenza within their communities. The economic burden of influenza infection (during pandemic and non-pandemic years) has been substantial owing to days missed from school, parental absenteeism from work, and costs associated with over-the-counter medications, clinician visits, and hospitalizations. Furthermore, for young adults, other important benefits of influenza vaccination include preventing absenteeism from college, training, and work. Initially, influenza vaccination policy used a targeted approach, focusing on populations at higher risk for influenzarelated morbidity and mortality. However, these strategies were not effective in preventing widespread disease. In 2008, the Advisory Committee on Immunization Practices (ACIP) recommended that all adolescents up through age 18 years receive annual influenza vaccination. Starting in 2009, these recommendations were further expanded to include vaccination of everyone 6 months of age [4]. The Society for Adolescent Health and Medicine (SAHM) suggests that health care providers adhere to their country-specific policies or the broader World Health Organization guidelines regarding influenza [1]. SAHM strongly supports the broad ACIP recommendations and urges all United Statesebased providers to