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Clinical effectiveness of conventional influenza vaccination in asthmatic children.

Abstract

Influenza immunization rates among young asthmatics remain unsatisfactory due to persistent concern about the impact of influenza and the benefits of the vaccine. We assessed the effectiveness of the conventional inactivated trivalent sub-unit influenza vaccine in reducing acute respiratory disease in asthmatic children. We conducted a two-season retrospective cohort study covering the 1995-6 and 1996-7 influenza outbreaks in 22 computerized primary care practices in The Netherlands. In total, 349 patients aged between 0 and 12 years meeting clinical asthma-criteria were included; 14 children were lost to follow-up in the second season. The occurrence of physician-diagnosed acute respiratory disease episodes including influenza-like illness, pneumonia. bronchitis, bronchiolitis, asthma exacerbation and acute otitis media in vaccinated and unvaccinated children were compared after adjustments for age, prior health care and medication use. The occurrence of acute respiratory disease in unvaccinated children was 28% and 24% in the 1995-6 and 1996-7 season, respectively, and was highest in children under 6 years of age (43%). The overall pooled clinical vaccine effectiveness was 27% (95% confidence interval -7 to 51%, P = 0.11) after adjustments. A statistically higher vaccine protectiveness of 55% (95% CI 20-75%, P = 0.01) was observed among asthmatics under 6 years of age compared with -5% in older children (95% CI -81 to 39%). The occurrence of acute respiratory disease among asthmatic children during influenza epidemics is very high, notably in the youngest. Influenza vaccination may reduce morbidity in asthmatic infants and pre-school children. However, larger, preferably experimental, studies are needed to establish the benefits of vaccination, notably in older asthmatic children.

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  • Authors+Show Affiliations

    ,

    University Medical Center Utrecht, Julius Center for General Practice and Patient Oriented Research, The Netherlands.

    , , , ,

    Source

    Epidemiology and infection 128:2 2002 Apr pg 205-11

    MeSH

    Age Factors
    Asthma
    Child
    Child, Preschool
    Cohort Studies
    Comorbidity
    Female
    Humans
    Immunization Programs
    Infant
    Infant, Newborn
    Influenza Vaccines
    Influenza, Human
    Male
    Morbidity
    Netherlands
    Retrospective Studies
    Seasons

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    12002538

    Citation

    Smits, A J., et al. "Clinical Effectiveness of Conventional Influenza Vaccination in Asthmatic Children." Epidemiology and Infection, vol. 128, no. 2, 2002, pp. 205-11.
    Smits AJ, Hak E, Stalman WA, et al. Clinical effectiveness of conventional influenza vaccination in asthmatic children. Epidemiol Infect. 2002;128(2):205-11.
    Smits, A. J., Hak, E., Stalman, W. A., van Essen, G. A., Hoes, A. W., & Verheij, T. J. (2002). Clinical effectiveness of conventional influenza vaccination in asthmatic children. Epidemiology and Infection, 128(2), pp. 205-11.
    Smits AJ, et al. Clinical Effectiveness of Conventional Influenza Vaccination in Asthmatic Children. Epidemiol Infect. 2002;128(2):205-11. PubMed PMID: 12002538.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical effectiveness of conventional influenza vaccination in asthmatic children. AU - Smits,A J, AU - Hak,E, AU - Stalman,W A B, AU - van Essen,G A, AU - Hoes,A W, AU - Verheij,Th J M, PY - 2002/5/11/pubmed PY - 2002/5/22/medline PY - 2002/5/11/entrez SP - 205 EP - 11 JF - Epidemiology and infection JO - Epidemiol. Infect. VL - 128 IS - 2 N2 - Influenza immunization rates among young asthmatics remain unsatisfactory due to persistent concern about the impact of influenza and the benefits of the vaccine. We assessed the effectiveness of the conventional inactivated trivalent sub-unit influenza vaccine in reducing acute respiratory disease in asthmatic children. We conducted a two-season retrospective cohort study covering the 1995-6 and 1996-7 influenza outbreaks in 22 computerized primary care practices in The Netherlands. In total, 349 patients aged between 0 and 12 years meeting clinical asthma-criteria were included; 14 children were lost to follow-up in the second season. The occurrence of physician-diagnosed acute respiratory disease episodes including influenza-like illness, pneumonia. bronchitis, bronchiolitis, asthma exacerbation and acute otitis media in vaccinated and unvaccinated children were compared after adjustments for age, prior health care and medication use. The occurrence of acute respiratory disease in unvaccinated children was 28% and 24% in the 1995-6 and 1996-7 season, respectively, and was highest in children under 6 years of age (43%). The overall pooled clinical vaccine effectiveness was 27% (95% confidence interval -7 to 51%, P = 0.11) after adjustments. A statistically higher vaccine protectiveness of 55% (95% CI 20-75%, P = 0.01) was observed among asthmatics under 6 years of age compared with -5% in older children (95% CI -81 to 39%). The occurrence of acute respiratory disease among asthmatic children during influenza epidemics is very high, notably in the youngest. Influenza vaccination may reduce morbidity in asthmatic infants and pre-school children. However, larger, preferably experimental, studies are needed to establish the benefits of vaccination, notably in older asthmatic children. SN - 0950-2688 UR - https://www.unboundmedicine.com/medline/citation/12002538/Clinical_effectiveness_of_conventional_influenza_vaccination_in_asthmatic_children_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/12002538/ DB - PRIME DP - Unbound Medicine ER -