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Report: U.S. disaster preparedness neglects kids

Despite significant efforts over the past decade, the U.S. remains ill-equipped to respond to the unique medical needs of children during public health emergencies, according to a new report from the American Academy of Pediatrics (AAP).

Kids are particularly vulnerable to illness and injury during pandemics, natural disasters such as hurricanes, and potential terrorist attacks. More planning and preparation needs to be done for communities to be able to ensure children's safety during such emergencies, the new policy statement, published today in Pediatrics, argues.

"Children represent nearly a quarter of the U.S. population, but they are affected disproportionately by most disasters and public health emergencies," the report states.

A major issue, the study authors say, is that although strides have been made to include more age-appropriate life-saving medical equipment, devices, supplies, and medications for children in the event of a disaster, many of the vaccines and pharmaceuticals in the nation's stockpile are currently only approved for use in adults. In many cases, pediatric formulations and dosing and safety information do not yet exist for kids.

The authors cite several challenges for this. First, many emergency medications and other countermeasures were initially developed for the military and have therefore only been evaluated and tested in adults. "As an example, vaccines for smallpox and anthrax have been studied and tested primarily in that population," Dr. Steven Krug,professor of pediatrics at Northwestern University Feinberg School of Medicine and chair of the AAP Disaster Preparedness Advisory Council, told CBS News.

But with the increasing concern of terrorism on U.S. soil, the risk is no longer contained to the military, and children need to be considered, the authors state.

Conducting certain types of medical research on children -- clinical drug trials, for example -- also comes with concerns about safety and kids' general inability to provide their own informed consent. The additional steps and protections required to deal with these issues come at a higher cost.

Additionally, because children often have trouble swallowing pills and may refuse to take medicines that taste bad, pediatric formulations are often liquid, which are bulky and expensive to store, may cost more per dose. Pediatric formulations also typically have a shorter shelf-life and are therefore more expensive to maintain.

But when it comes to the health and safety of children, the authors argue that cost should not play a role.

Study author Dr. David Schonfeld, a professor at the School of Social Work and Pediatrics at the University of Southern California and Children's Hospital Los Angeles, likened the scenario to a life boat that only stocked adult-sized life jackets because other sizes cost too much.

"So in this situation if the boat sinks, there's only going to be life vests for adults because that will save the most people per dollar. I don't think anyone would agree that that's acceptable," he told CBS News. "We're not implying that there's been any conscious decision to exclude children [from medical research] but we somehow got into this situation and now we need to remedy it."

The study authors include a list of recommendations for federal, state, and local governments. The first is that these organizations need to acquire and maintain adequate amounts of medical supplies and countermeasures for children of all age groups in case of a public health emergency.

For medications not approved for use in children, the federal government should establish a plan to collect critical data, such as safety and dosing information, should a disaster occur.

Finally, the authors point out that government officials need to have a plan in place for storage and distribution of emergency medications such as vaccines and antidotes for children.

"We must continue to build on our recent successes over the past few years with public private partnerships including our federal and state partners," lead study author Dr. Daniel Fagbuyi, adjunct professor of pediatrics and emergency medicine at the George Washington University School of Medicine, said. "The science is there. Innovation is around the corner. With good leadership, sustained attention, advocacy, consistent and continued involvement of pediatric subject matter experts in key decision-making roles at all levels, we can close the existing gap in medical countermeasures for children."

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