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Effectiveness of trivalent flu vaccine in healthy young children.

Abstract

BACKGROUND

There are few studies evaluating the effectiveness of trivalent influenza vaccination (TIV) in young children, particularly in children <2 years. The Western Australian Influenza Vaccine Effectiveness Study commenced in 2008 to evaluate a program providing TIV to children aged 6 to 59 months.

METHODS

An observational study enrolling children with influenza-like illness presenting to a tertiary pediatric hospital was conducted (2008-2012). Vaccination status was determined by parental questionnaire and confirmed via the national immunization register and/or vaccine providers. Respiratory virus polymerase chain reaction and culture were performed on nasopharyngeal samples. The test-negative design was used to estimate vaccine effectiveness (VE) by using 2 control groups: all influenza test-negative subjects and other-virus-detected (OVD) subjects. Adjusted odds ratios were estimated from models with season, month of disease onset, age, gender, indigenous status, prematurity, and comorbidities as covariates. Subjects enrolled in 2009 were excluded from VE calculations.

RESULTS

Of 2001 children enrolled, influenza was identified in 389 (20.4%) children. Another respiratory virus was identified in 1134 (59.6%) children. Overall, 295 of 1903 (15.5%) children were fully vaccinated and 161 of 1903 (8.4%) children were partially vaccinated. Vaccine uptake was significantly lower in 2010-2012 after increased febrile adverse events observed in 2010. Using test-negative controls, VE was 64.7% (95% confidence interval [CI]: 33.7%-81.2%). No difference in VE was observed with OVD controls (65.8%; 95% CI: 32.1%-82.8%). The VE for children <2 years was 85.8% (95% CI: 37.9%-96.7%).

CONCLUSIONS

This study reveals the effectiveness of TIV in young children over 4 seasons by using test-negative and OVD controls. TIV was effective in children aged <2 years. Despite demonstrated vaccine effectiveness, uptake of TIV remains suboptimal.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    School of Paediatrics and Child Health and Princess Margaret Hospital for Children, Perth, Australia; Telethon Institute of Child Health Research, West Perth, Australia; PathWest Laboratory Medicine, Nedlands, Australia; christopher.blyth@uwa.edu.au.

    ,

    Telethon Institute of Child Health Research, West Perth, Australia;

    ,

    Communicable Disease Control Directorate, Department of Health, Perth, Australia;

    ,

    Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia; and Australian National University, Australian Capital Territory, Australia.

    ,

    PathWest Laboratory Medicine, Nedlands, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia;

    ,

    Telethon Institute of Child Health Research, West Perth, Australia;

    ,

    Telethon Institute of Child Health Research, West Perth, Australia;

    ,

    PathWest Laboratory Medicine, Nedlands, Australia;

    ,

    PathWest Laboratory Medicine, Nedlands, Australia;

    ,

    School of Paediatrics and Child Health and Princess Margaret Hospital for Children, Perth, Australia; Telethon Institute of Child Health Research, West Perth, Australia;

    Source

    Pediatrics 133:5 2014 May pg e1218-25

    MeSH

    Antibodies, Viral
    Child, Preschool
    Female
    Humans
    Immunization, Secondary
    Infant
    Influenza Vaccines
    Influenza, Human
    Male
    Treatment Outcome
    Western Australia

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24753525

    Citation

    Blyth, Christopher C., et al. "Effectiveness of Trivalent Flu Vaccine in Healthy Young Children." Pediatrics, vol. 133, no. 5, 2014, pp. e1218-25.
    Blyth CC, Jacoby P, Effler PV, et al. Effectiveness of trivalent flu vaccine in healthy young children. Pediatrics. 2014;133(5):e1218-25.
    Blyth, C. C., Jacoby, P., Effler, P. V., Kelly, H., Smith, D. W., Robins, C., ... Richmond, P. C. (2014). Effectiveness of trivalent flu vaccine in healthy young children. Pediatrics, 133(5), pp. e1218-25. doi:10.1542/peds.2013-3707.
    Blyth CC, et al. Effectiveness of Trivalent Flu Vaccine in Healthy Young Children. Pediatrics. 2014;133(5):e1218-25. PubMed PMID: 24753525.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effectiveness of trivalent flu vaccine in healthy young children. AU - Blyth,Christopher C, AU - Jacoby,Peter, AU - Effler,Paul V, AU - Kelly,Heath, AU - Smith,David W, AU - Robins,Christine, AU - Willis,Gabriela A, AU - Levy,Avram, AU - Keil,Anthony D, AU - Richmond,Peter C, AU - ,, Y1 - 2014/04/21/ PY - 2014/4/23/entrez PY - 2014/4/23/pubmed PY - 2015/2/19/medline KW - children KW - influenza KW - trivalent influenza vaccine KW - vaccine effectiveness SP - e1218 EP - 25 JF - Pediatrics JO - Pediatrics VL - 133 IS - 5 N2 - BACKGROUND: There are few studies evaluating the effectiveness of trivalent influenza vaccination (TIV) in young children, particularly in children <2 years. The Western Australian Influenza Vaccine Effectiveness Study commenced in 2008 to evaluate a program providing TIV to children aged 6 to 59 months. METHODS: An observational study enrolling children with influenza-like illness presenting to a tertiary pediatric hospital was conducted (2008-2012). Vaccination status was determined by parental questionnaire and confirmed via the national immunization register and/or vaccine providers. Respiratory virus polymerase chain reaction and culture were performed on nasopharyngeal samples. The test-negative design was used to estimate vaccine effectiveness (VE) by using 2 control groups: all influenza test-negative subjects and other-virus-detected (OVD) subjects. Adjusted odds ratios were estimated from models with season, month of disease onset, age, gender, indigenous status, prematurity, and comorbidities as covariates. Subjects enrolled in 2009 were excluded from VE calculations. RESULTS: Of 2001 children enrolled, influenza was identified in 389 (20.4%) children. Another respiratory virus was identified in 1134 (59.6%) children. Overall, 295 of 1903 (15.5%) children were fully vaccinated and 161 of 1903 (8.4%) children were partially vaccinated. Vaccine uptake was significantly lower in 2010-2012 after increased febrile adverse events observed in 2010. Using test-negative controls, VE was 64.7% (95% confidence interval [CI]: 33.7%-81.2%). No difference in VE was observed with OVD controls (65.8%; 95% CI: 32.1%-82.8%). The VE for children <2 years was 85.8% (95% CI: 37.9%-96.7%). CONCLUSIONS: This study reveals the effectiveness of TIV in young children over 4 seasons by using test-negative and OVD controls. TIV was effective in children aged <2 years. Despite demonstrated vaccine effectiveness, uptake of TIV remains suboptimal. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/24753525/Effectiveness_of_trivalent_flu_vaccine_in_healthy_young_children_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=24753525 DB - PRIME DP - Unbound Medicine ER -