These Findings Are Not Consistent With National Data Response

I found this paper1 interesting because this is an important issue. However, I have concerns that the findings in this paper are not consistent with national trends.The authors found that children in Oregon have hovered in the mid-30% range for influenza vaccination over the last 5 years and that this rate did not change with the removal of the live attenuated influenza vaccine (LAIV) recommendation. This rate of vaccination is far below what the Centers for Disease Control and Prevention (CDC) reports nationally for influenza vaccine coverage, which is more in the high 50% to low 60% range.2In fact, when one reviews the 2016–2017 CDC FluVaxView influenza vaccine coverage data from last season in Table 2 and Fig 2, the rate of vaccination for children ages 5 to 12 years did go down by ∼2% to <60% for the first time in several years. The rate of vaccination in children 2 to 4 years old went down by ∼0.5%.Given that the national decline is just <2% and the influenza vaccination rate was so much lower in this Oregon cohort, it is not likely that a decreased rate of vaccination would have been detected. However, the authors have made the conclusion that the Advisory Committee on Immunization Practices’ decision to withdraw the recommendation for LAIV did not have any effect on vaccination rates. Although this may be true for their Oregon cohort, this is not true for the rest of the country.