Do European and Japanese health authorities recommend annual COVID-19 (Coronavirus Disease 2019) booster and influenza (flu) vaccinations for 12-month-old children?

COVID-19 and Influenza Vaccination Recommendations for 12-Month-Old Children in Europe and Japan

Neither European nor Japanese health authorities currently recommend annual COVID-19 boosters for 12-month-old children, while both recommend annual influenza vaccination starting at 6 months of age. 1

Influenza Vaccination Recommendations

United States (for comparison)

• The American Academy of Pediatrics (AAP) and Advisory Committee on Immunization Practices (ACIP) recommend annual influenza vaccination for all children 6 months of age and older 1
• Children 6 months through 8 years receiving influenza vaccine for the first time require 2 doses administered at least 4 weeks apart 1, 2
• For children 6-35 months, various influenza vaccine formulations are available with either 0.25 mL or 0.5 mL dosing depending on the specific product 2

European Recommendations

• European health authorities recommend annual influenza vaccination for children 6 months and older, with special emphasis on children with underlying medical conditions 1, 3
• Unlike the US, not all European countries have universal influenza vaccination recommendations for all children; some focus primarily on high-risk groups 3
• European guidelines do not recommend annual COVID-19 boosters for 12-month-old children 1, 4

Japanese Recommendations

• Japan recommends annual influenza vaccination for children starting at 6 months of age 1, 3
• Similar to Europe, Japan does not currently recommend annual COVID-19 boosters for 12-month-old children 5, 4

COVID-19 Vaccination Recommendations

Current Status for Young Children

• COVID-19 vaccination for children 6 months to 4 years has had significantly lower uptake compared to older age groups, with only 5.5% coverage in this age group in the US as of May 2023 5
• Neither European nor Japanese health authorities have implemented recommendations for annual COVID-19 boosters in 12-month-old children 1, 4
• The primary COVID-19 vaccine series is available for children 6 months and older in many countries, but booster recommendations vary significantly by country and are generally not recommended annually for this age group 5, 6

Considerations for Vaccination in Young Children

Influenza Vaccination Benefits

• Children under 5 years, particularly those under 2 years, are at higher risk for influenza-related complications and hospitalizations 1
• Influenza vaccination has been shown to reduce hospitalization rates in children by approximately 53.9% when fully vaccinated 1
• Up to 80% of influenza-associated pediatric deaths have occurred in unvaccinated children 6 months and older 1

COVID-19 Vaccination Considerations

• The risk-benefit calculation for COVID-19 vaccination in young children is more complex due to the relatively lower risk of severe COVID-19 in this age group 4
• Vaccination can help protect against multisystem inflammatory syndrome in children (MIS-C) and other potential complications 6
• Policy decisions regarding COVID-19 vaccination in young children must consider multiple factors including community transmission, vaccine supply, and potential impact on reducing school disruptions 4

Common Pitfalls to Avoid

• Delaying the second dose of influenza vaccine beyond the recommended interval may leave children inadequately protected during peak influenza season 2
• Using incorrect dosage based on age and specific influenza vaccine product 2
• Assuming vaccination recommendations are uniform across different countries - significant variations exist in both influenza and COVID-19 vaccination policies 4, 3
• Failing to recognize that recommendations evolve as new evidence emerges and as the epidemiology of respiratory viruses changes 1, 6