The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Letter to the Editor

Editor, – I have an unanswered question after reading the article by Paul Dugdale (Aust Prescr 2007;30:35-7).

I have tended to discourage vaccinating young healthy adults with influenza vaccine as I was under the impression that an occasional bout of influenza in their younger years would prime the immune system and produce much better immune responses for future attacks that would keep them in good stead in their later years.

Is there any evidence for this? Is it a reasonable approach?

Lou Zaninovich
General practitioner
West Perth

Author's comments

Dr Paul Dugdale, author of the article, comments:

There is a health benefit of infection with one subtype of influenza because, like vaccination with that subtype, it will produce immunity to that subtype and can produce partial immunity to other subtypes. However, compared to vaccination, any possible increased efficacy of wild infection in preventing future infection would be more than offset by the health cost of actually having the bout of influenza. Therefore choosing not to be vaccinated on the grounds of possible net future benefit is not reasonable.

It may of course be quite reasonable for a healthy adult to decline vaccination on the grounds that it is not worth their while to reduce their chance of getting wild influenza. A discussion of their particular life circumstances will assist such a decision.