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Hak and colleagues¹ have performed a good case-control study, and the results are greatly in favor of influenza vaccination for persons at risk. However, their conclusion that influenza vaccination is also beneficial for persons at risk younger than 18 years is not convincing. The authors show a reduction of general practice visits among this age group, but these findings could not be confirmed in some recent randomized controlled trials.^2-3 It is surprising that the authors only refer to older studies that have serious flaws, as reported before by one of us.⁴ Hak et al¹ do not refer to the recent randomized controlled trial by Hoberman et al² in which no effect was found of influenza vaccination on acute otitis media or utilization of selected health care and related resources.

Certainly, because this is a case-control study, Hak and colleagues¹ should be reluctant in advising to vaccinate this younger group as . . . [Full Text of this Article]

AUTHOR INFORMATION
Roger Damoiseaux, PhD; Johannes C. van der Wouden, PhD; Herman Bueving, PhD

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