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Influenza vaccine effectiveness among children 6 to 59 months of age during 2 influenza seasons: a case-cohort study.
Arch Pediatr Adolesc Med. 2008 Oct; 162(10):943-51.AP

Abstract

OBJECTIVE

To measure vaccine effectiveness (VE) in preventing influenza-related health care visits among children aged 6 to 59 months during 2 consecutive influenza seasons.

DESIGN

Case-cohort study estimating effectiveness of inactivated influenza vaccine in preventing inpatient/outpatient visits (emergency department [ED] and outpatient clinic). We compared vaccination status of laboratory-confirmed influenza cases with a cluster sample of children from a random sample of practices in 3 counties (subcohort) during the 2003-2004 and 2004-2005 seasons.

SETTING

Counties encompassing Rochester, New York, Nashville, Tennessee, and Cincinnati, Ohio.

PARTICIPANTS

Children aged 6 to 59 months seen in inpatient/ED or outpatient clinic settings for acute respiratory illnesses and community-based subcohort comparison. Main Exposure Influenza vaccination.

MAIN OUTCOME MEASURES

Influenza vaccination status of cases vs subcohort using time-dependent Cox proportional hazards models to estimate VE in preventing inpatient/ED and outpatient visits.

RESULTS

During the 2003-2004 and 2004-2005 seasons, 165 and 80 inpatient/ED and 74 and 95 outpatient influenza cases were enrolled, while more than 4500 inpatient/ED and more than 600 outpatient subcohorts were evaluated, respectively. In bivariate analyses, cases had lower vaccination rates than subcohorts. However, significant influenza VE could not be demonstrated for any season, age, or setting after adjusting for county, sex, insurance, chronic conditions recommended for influenza vaccination, and timing of influenza vaccination (VE estimates ranged from 7%-52% across settings and seasons for fully vaccinated 6- to 59-month-olds).

CONCLUSION

In 2 seasons with suboptimal antigenic match between vaccines and circulating strains, we could not demonstrate VE in preventing influenza-related inpatient/ED or outpatient visits in children younger than 5 years. Further study is needed during years with good vaccine match.

Authors+Show Affiliations

Strong Memorial Hospital, Rochester, NY 14642, USA. peter_szilagyi@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

18838647

Citation

Szilagyi, Peter G., et al. "Influenza Vaccine Effectiveness Among Children 6 to 59 Months of Age During 2 Influenza Seasons: a Case-cohort Study." Archives of Pediatrics & Adolescent Medicine, vol. 162, no. 10, 2008, pp. 943-51.
Szilagyi PG, Fairbrother G, Griffin MR, et al. Influenza vaccine effectiveness among children 6 to 59 months of age during 2 influenza seasons: a case-cohort study. Arch Pediatr Adolesc Med. 2008;162(10):943-51.
Szilagyi, P. G., Fairbrother, G., Griffin, M. R., Hornung, R. W., Donauer, S., Morrow, A., Altaye, M., Zhu, Y., Ambrose, S., Edwards, K. M., Poehling, K. A., Lofthus, G., Holloway, M., Finelli, L., Iwane, M., & Staat, M. A. (2008). Influenza vaccine effectiveness among children 6 to 59 months of age during 2 influenza seasons: a case-cohort study. Archives of Pediatrics & Adolescent Medicine, 162(10), 943-51. https://doi.org/10.1001/archpedi.162.10.943
Szilagyi PG, et al. Influenza Vaccine Effectiveness Among Children 6 to 59 Months of Age During 2 Influenza Seasons: a Case-cohort Study. Arch Pediatr Adolesc Med. 2008;162(10):943-51. PubMed PMID: 18838647.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza vaccine effectiveness among children 6 to 59 months of age during 2 influenza seasons: a case-cohort study. AU - Szilagyi,Peter G, AU - Fairbrother,Gerry, AU - Griffin,Marie R, AU - Hornung,Richard W, AU - Donauer,Stephanie, AU - Morrow,Ardythe, AU - Altaye,Mekibib, AU - Zhu,Yuwei, AU - Ambrose,Sandra, AU - Edwards,Kathryn M, AU - Poehling,Katherine A, AU - Lofthus,Geraldine, AU - Holloway,Michol, AU - Finelli,Lyn, AU - Iwane,Marika, AU - Staat,Mary Allen, AU - ,, PY - 2008/10/8/pubmed PY - 2008/11/5/medline PY - 2008/10/8/entrez SP - 943 EP - 51 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 162 IS - 10 N2 - OBJECTIVE: To measure vaccine effectiveness (VE) in preventing influenza-related health care visits among children aged 6 to 59 months during 2 consecutive influenza seasons. DESIGN: Case-cohort study estimating effectiveness of inactivated influenza vaccine in preventing inpatient/outpatient visits (emergency department [ED] and outpatient clinic). We compared vaccination status of laboratory-confirmed influenza cases with a cluster sample of children from a random sample of practices in 3 counties (subcohort) during the 2003-2004 and 2004-2005 seasons. SETTING: Counties encompassing Rochester, New York, Nashville, Tennessee, and Cincinnati, Ohio. PARTICIPANTS: Children aged 6 to 59 months seen in inpatient/ED or outpatient clinic settings for acute respiratory illnesses and community-based subcohort comparison. Main Exposure Influenza vaccination. MAIN OUTCOME MEASURES: Influenza vaccination status of cases vs subcohort using time-dependent Cox proportional hazards models to estimate VE in preventing inpatient/ED and outpatient visits. RESULTS: During the 2003-2004 and 2004-2005 seasons, 165 and 80 inpatient/ED and 74 and 95 outpatient influenza cases were enrolled, while more than 4500 inpatient/ED and more than 600 outpatient subcohorts were evaluated, respectively. In bivariate analyses, cases had lower vaccination rates than subcohorts. However, significant influenza VE could not be demonstrated for any season, age, or setting after adjusting for county, sex, insurance, chronic conditions recommended for influenza vaccination, and timing of influenza vaccination (VE estimates ranged from 7%-52% across settings and seasons for fully vaccinated 6- to 59-month-olds). CONCLUSION: In 2 seasons with suboptimal antigenic match between vaccines and circulating strains, we could not demonstrate VE in preventing influenza-related inpatient/ED or outpatient visits in children younger than 5 years. Further study is needed during years with good vaccine match. SN - 1538-3628 UR - https://www.unboundmedicine.com/medline/citation/18838647/Influenza_vaccine_effectiveness_among_children_6_to_59_months_of_age_during_2_influenza_seasons:_a_case_cohort_study_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.162.10.943 DB - PRIME DP - Unbound Medicine ER -