Associate Professor Hannah Moore

The STAMP RSV Program

STAMP-RSV is guided by a community reference group with lived experiences of RSV. The goal is to translate research findings into effective and efficient RSV control policies to reduce the health and economic burden of RSV.

Infection Transmission in Early Childhood Education and Care: a mixed methods study to inform future interventions

The COVID-19 pandemic has exposed many uncertainties and incorrect assumptions about respiratory pathogen transmission.

Preparing for prevention: Assessing the community awareness of RSV and other childhood infections

Respiratory Syncytial Virus (RSV) is one of the most common reasons babies are admitted to hospital – with Aboriginal and preterm infants at greatest risk.

Targeting interventions to improve influenza control: a proof of principle geomapping study

Characterising the epidemiology of RSV in Australian children through record linkage: clinical burden, outcomes and risk factors

“It’s all gone quiet…” MUSIC from COVID19

Understanding the true burden of paediatric respiratory syncytial virus (RSV) in order to optimise prevention programs

Optimising influenza vaccine uptake in children with medical comorbidities

The pathogen specific burden of hospitalisation for enteric and blood stream infection in children and young people in Western Australia

Linkage of the Australian Childhood Immunisation Register (ACIR) and state-based registers to evaluate and inform Australia’s immunisation program

Integrate, Identify, Intervene (Triple I Project): Identifying opportunities for preventing respiratory infections in children through integrating population-based health and laboratory data

Influenza vaccination in Western Australian children: an economic evaluation to inform future state and national programs

Evaluating the use and effectiveness of passive immunization in reducing RSV-associated morbidity in high risk infants

Determining the off-target effects of infant vaccines on respiratory infection outcomes in Western Australian children

Childhood pneumonia in the Eastern Highlands Province of Papua New Guinea: clinical, microbiological and immunological predictors of disease

Epidemiology of Otitis Media hospitalisations in Western Australia: a retrospective population cohort study (1996-2012)

Centre of Linked Data Analytics and Social Policy (CLASP)

The Kids Research Institute Australia was awarded funding to establish a whole-of-state Centre of Linked Data Analytics and Social Policy.

Transmission potential of Streptococcus pyogenes during a controlled human infection trial of pharyngitis

Controlled human infection (CHI) models can provide insights into transmission of pathogens such as Streptococcus pyogenes (Strep A). As part of the Controlled Human Infection with Penicillin for Streptococcus pyogenes (CHIPS) trial, we explored the potential for transmission among participants deliberately infected with the Strep A emm75 strain.

Impact of early childhood infection on child development and school performance: a population-based study

Childhood infection might be associated with adverse child development and neurocognitive outcomes, but the results have been inconsistent. 

Respiratory Viral Testing Rate Patterns in Young Children Attending Tertiary Care Across Western Australia: A Population-Based Birth Cohort Study

Modelling respiratory syncytial virus age-specific risk of hospitalisation in term and preterm infants

Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infections in children worldwide. The highest incidence of severe disease is in the first 6 months of life, with infants born preterm at greatest risk for severe RSV infections. 

The Changing Detection Rate of Respiratory Syncytial Virus in Adults in Western Australia between 2017 and 2023

The incidence of respiratory syncytial virus (RSV) in adults is inadequately defined and the impact of SARS-CoV-2-related non-pharmaceutical interventions (NPIs) is underexplored. Using laboratory data, we described the detection rate of RSV in adults ≥16 years in Western Australia (WA) between 2017 and 2023.

Cohort profile: A population-based record linkage platform to address critical epidemiological evidence gaps in respiratory syncytial virus and other respiratory infections

The Western Australia (WA) Respiratory Infections Linked Data Platform is a population-based cohort established to investigate the epidemiology of RSV and other respiratory infections in children aged 0-10 years, incorporating microbiological testing patterns, hospital admissions, emergency department presentations, and socio-demographic data.

Clinical predictors of hypoxic pneumonia in children from the Eastern Highlands Province, Papua New Guinea: secondary analysis of two prospective observational studies

Pneumonia is the leading cause of death in young children globally and is prevalent in the Papua New Guinea highlands. We investigated clinical predictors of hypoxic pneumonia to inform local treatment guidelines in this resource-limited setting.

Parental awareness and attitudes towards prevention of respiratory syncytial virus in infants and young children in Australia

To assess parental awareness of respiratory syncytial virus (RSV) and the level of acceptance of future RSV prevention strategies. A cross-sectional online survey was implemented targeting "future" and "current" parents of children aged ≤5 years in Australia.

The effectiveness of maternal pertussis vaccination for protecting Aboriginal and Torres Strait Islander infants against infection, 2012–2017: a retrospective cohort study

To evaluate the effectiveness of maternal pertussis vaccination for preventing pertussis infections in Aboriginal and Torres Strait Islander infants under seven months of age.

Infant Whole-Cell Versus Acellular Pertussis Vaccination in 1997 to 1999 and Risk of Childhood Hospitalization for Food-Induced Anaphylaxis: Linked Administrative Databases Cohort Study

Evidence suggests that children who had received an initial priming dose of whole-cell pertussis (wP) vaccine, rather than acellular pertussis (aP) vaccine, had a lower risk of developing IgE-mediated food allergy, the most common cause of anaphylaxis-related hospital presentations of childhood.

Subcutaneous infusion of high-dose benzathine penicillin G is safe, tolerable, and suitable for less-frequent dosing for rheumatic heart disease secondary prophylaxis: a phase 1 open-label population pharmacokinetic study

Since 1955, the recommended strategy for rheumatic heart disease secondary prophylaxis has been benzathine penicillin G injections administered intramuscularly every 4 weeks. Due to dosing frequency, pain, and programmatic challenges, adherence is suboptimal. It has previously been demonstrated that BPG delivered subcutaneously at a standard dose is safe and tolerable and has favorable pharmacokinetics, setting the scene for improved regimens with less frequent administration.

Respiratory Syncytial Virus Reinfections in Children in Western Australia

Respiratory syncytial virus (RSV) reinfection in children is poorly understood. We examined the incidence, characteristics, and outcomes of hospital-attended RSV reinfections in children <16 years in Western Australia between 2012 and 2022.

Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19

Respiratory syncytial virus (RSV) remains a leading cause of mortality and morbidity worldwide. RSV seasonality was disrupted by COVID-19-associated nonpharmaceutical interventions (NPIs). We review RSV seasonality, molecular epidemiology, clinical manifestations, and community awareness to inform future prevention strategies. 

Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19

Respiratory syncytial virus (RSV) remains a leading cause of mortality and morbidity worldwide. RSV seasonality was disrupted by COVID-19-associated nonpharmaceutical interventions (NPIs). We review RSV seasonality, molecular epidemiology, clinical manifestations, and community awareness to inform future prevention strategies.

Factors Predicting Secondary Respiratory Morbidity Following Early-Life Respiratory Syncytial Virus Infections: Population-Based Cohort Study

The association between early-life respiratory syncytial virus infections and later respiratory morbidity is well established. However, there is limited evidence on factors that influence this risk. We examined sociodemographic and perinatal factors associated with later childhood respiratory morbidity requiring secondary care following exposure to a laboratory-confirmed RSV episode in the first 2 years.

Maternal Pertussis Vaccination, Infant Immunization, and Risk of Pertussis

Following the introduction of jurisdictional maternal pertussis vaccination programs in Australia, we estimated maternal vaccine effectiveness (VE) and whether maternal pertussis vaccination modified the effectiveness of the first 3 primary doses of pertussis-containing vaccines.

Influenza vaccination in Western Australian children: Exploring the health benefits and cost savings of increased vaccine coverage in children

To assess potential benefits and direct healthcare cost savings with expansion of an existing childhood influenza immunisation program, we developed a dynamic transmission model for the state of Western Australia, evaluating increasing coverage in children < 5 years and routinely immunising school-aged children.

Association between pertussis vaccination in infancy and childhood asthma: A population-based record linkage cohort study

Asthma is among the commonest noncommunicable diseases of childhood and often occurs with other atopic comorbidities. A previous case-control study found evidence that compared to children who received acellular pertussis (aP) vaccines in early infancy, children who received one or more doses of whole-cell pertussis (wP) vaccine had lower risk of developing IgE-mediated food allergy. We hypothesized that wP vaccination in early infancy might protect against atopic asthma in childhood. 

Incremental effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumonia hospitalisation among Australian Indigenous children: A record linkage study

The impact of pneumococcal conjugate vaccines (PCVs) on pneumonia in children is well-documented but data on 23-valent pneumococcal polysaccharide vaccine (PPV23) are lacking. Between 2001 and 2011, Indigenous children in Western Australia (WA) were recommended to receive PPV23 at 18-24 months of age following 3 doses of 7-valent PCV. We evaluated the incremental effectiveness of PPV23 against pneumonia hospitalisation.

Determining the true incidence of seasonal respiratory syncytial virus-confirmed hospitalizations in preterm and term infants in Western Australia

Respiratory syncytial virus contributes to significant global infant morbidity and mortality. We applied a previously developed statistical prediction model incorporating pre-pandemic RSV testing data and hospital admission data to estimate infant RSV-hospitalizations by birth month and prematurity, focused on infants aged <1 year.

Non-specific benefit of seasonal influenza vaccine on respiratory syncytial virus-hospitalisations in children: An instrumental variable approach using population-based data

Seasonal influenza vaccine is effective against influenza hospitalisations, but little is known about non-specific effects of the vaccine on other respiratory pathogens with similar seasonal patterns. We aimed to assess the causal impact of seasonal influenza vaccine on laboratory-confirmed hospitalisations for respiratory syncytial virus (RSV) in children using an instrumental variable strategy.

Health service utilisation for acute respiratory infections in infants graduating from the neonatal intensive care unit: a population-based cohort study

Despite advances in neonatal intensive care, babies admitted to Neonatal Intensive Care Units (NICU) suffer from adverse outcomes. We aim to describe the longer-term respiratory infectious morbidity of infants discharged from NICU using state-wide population-based linked data in Western Australia.

Modeling the potential health impact of prospective Strep A vaccines

The World Health Organization published the preferred product characteristics for a Group A Streptococcus (Strep A) vaccine in 2018. Based on these parameters for the age of vaccination, vaccine efficacy, duration of protection from vaccine-derived immunity, and vaccination coverage, we developed a static cohort model to estimate the projected health impact of Strep A vaccination at the global, regional, and national levels and by country-income category.

Pneumococcal Conjugate Vaccines Are Protective Against Respiratory Syncytial Virus Hospitalizations in Infants: A Population-Based Observational Study

Pneumococcal conjugate vaccines (PCV) reduced the risk of respiratory syncytial virus (RSV) in a randomized clinical trial. We aimed to assess the real-world effectiveness of PCV on RSV-hospitalizations among Western Australian infants.

A surge in human metapneumovirus paediatric respiratory admissions in Western Australia following the reduction of SARS-CoV-2 non-pharmaceutical interventions

Western Australian laboratory data demonstrated a decrease in human metapneumovirus detections through 2020 associated with SARS-CoV-2-related non-pharmaceutical interventions, followed by a subsequent surge in metropolitan region in mid-2021. We aimed to assess the impact of the surge in hMPV on paediatric hospital admissions and the contribution of changes in testing.

Inequity of antenatal influenza and pertussis vaccine coverage in Australia: the Links2HealthierBubs record linkage cohort study, 2012–2017

Pregnancy and early infancy are increased risk periods for severe adverse effects of respiratory infections. Aboriginal and/or Torres Strait Islander (respectfully referred to as First Nations) women and children in Australia bear a disproportionately higher burden of respiratory diseases compared to non-Indigenous women and infants. Influenza vaccines and whooping cough (pertussis) vaccines are recommended and free in every Australian pregnancy to combat these infections.

Association between maternal influenza vaccination and neurodevelopmental disorders in childhood: a longitudinal, population-based linked cohort study

To assess the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and the risk of a diagnosis of a neurodevelopmental disorder in early childhood.

Standardization of Epidemiological Surveillance of Acute Poststreptococcal Glomerulonephritis

Acute poststreptococcal glomerulonephritis (APSGN) is an immune complex-induced glomerulonephritis that develops as a sequela of streptococcal infections. This article provides guidelines for the surveillance of APSGN due to group A Streptococcus (Strep A). The primary objectives of APSGN surveillance are to monitor trends in age- and sex-specific incidence, describe the demographic and clinical characteristics of patients with APSGN, document accompanying risk factors, then monitor trends in frequency of complications, illness duration, hospitalization rates, and mortality.

Standardization of Epidemiological Surveillance of Group A Streptococcal Pharyngitis

Pharyngitis, more commonly known as sore throat, is caused by viral and/or bacterial infections. Group A Streptococcus (Strep A) is the most common bacterial cause of pharyngitis. Strep A pharyngitis is an acute, self-limiting disease but if undertreated can lead to suppurative complications, nonsuppurative poststreptococcal immune-mediated diseases, and toxigenic presentations.

Standardization of Epidemiological Surveillance of Invasive Group A Streptococcal Infections

Invasive group A streptococcal (Strep A) infections occur when Streptococcus pyogenes, also known as beta-hemolytic group A Streptococcus, invades a normally sterile site in the body. This article provides guidelines for establishing surveillance for invasive Strep A infections. The primary objective of invasive Strep A surveillance is to monitor trends in rates of infection and determine the demographic and clinical characteristics of patients with laboratory-confirmed invasive Strep A infection, the age- and sex-specific incidence in the population of a defined geographic area, trends in risk factors, and the mortality rates and rates of nonfatal sequelae caused by invasive Strep A infections.

Standardization of Epidemiological Surveillance of Acute Rheumatic Fever

Acute rheumatic fever (ARF) is a multiorgan inflammatory disorder that results from the body's autoimmune response to pharyngitis or a skin infection caused by Streptococcus pyogenes (Strep A). Acute rheumatic fever mainly affects those in low- and middle-income nations, as well as in indigenous populations in wealthy nations, where initial Strep A infections may go undetected.

Standardization of Epidemiological Surveillance of Group A Streptococcal Impetigo

Impetigo is a highly contagious bacterial infection of the superficial layer of skin. Impetigo is caused by group A Streptococcus (Strep A) and Staphylococcus aureus, alone or in combination, with the former predominating in many tropical climates. Strep A impetigo occurs mainly in early childhood, and the burden varies worldwide. It is an acute, self-limited disease, but many children experience frequent recurrences that make it a chronic illness in some endemic settings.

Harmonizing Surveillance Methodologies for Group A Streptococcal Diseases

Group A Streptococcus (Strep A) is responsible for a significant global health and economic burden. The recent prioritization of Strep A vaccine development by the World Health Organization has prompted global research activities and collaborations. To progress this prioritization, establishment of robust surveillance for Strep A to generate updated regional disease burden estimates and to establish platforms for future impact evaluation is essential.

Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis

Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide.

Off-season RSV epidemics in Australia after easing of COVID-19 restrictions

Human respiratory syncytial virus (RSV) is an important cause of acute respiratory infection with the most severe disease in the young and elderly. Non-pharmaceutical interventions and travel restrictions for controlling COVID-19 have impacted the circulation of most respiratory viruses including RSV globally, particularly in Australia, where during 2020 the normal winter epidemics were notably absent.

Timing and temporal trends of influenza and pertussis vaccinations during pregnancy in three Australian jurisdictions: The Links2HealthierBubs population-based linked cohort study, 2012–2017

Antenatal inactivated influenza and pertussis-containing vaccines offer protection against severe respiratory infections for pregnant women and infants <6 months of age. Both vaccines are recommended in pregnancy; however, little is known about temporal or jurisdictional trends and predictors of uptake.

Estimating the excess burden of pertussis disease in Australia within the first year of life, that might have been prevented through timely vaccination

Previous Australian studies have shown that delayed vaccination with each of the three primary doses of diphtheria-tetanus-pertussis-containing vaccines (DTP) is up to 50 % in certain subpopulations. We estimated the excess burden of pertussis that might have been prevented if (i) all primary doses and (ii) each dose was given on time.

Australian hospital paediatricians and nurses’ perspectives and practices for influenza vaccine delivery in children with medical comorbidities

Influenza vaccination of children with medical comorbidities is critical due their increased risks for severe influenza disease. In Australia, hospitals are an avenue for influenza vaccine delivery to children with comorbidities but are not always effectively utilised. Qualitative enquiry sought to ascertainment the barriers and enablers for influenza vaccination recommendation, delivery, and recording of these children at Australian hospitals.

An Unusual Resurgence of Human Metapneumovirus in Western Australia Following the Reduction of Non-Pharmaceutical Interventions to Prevent SARS-CoV-2 Transmission

Non-pharmaceutical interventions (NPIs) to reduce SARS-CoV-2 transmission disrupted respiratory virus seasonality. We examined the unusual return of human metapneumovirus (hMPV) in Western Australia following a period of absence in 2020.

Effectiveness of 7-Valent Pneumococcal Conjugate Vaccine Against Invasive Pneumococcal Disease in Medically At-Risk Children in Australia: A Record Linkage Study

Children with chronic medical conditions are at higher risk of invasive pneumococcal disease (IPD), but little is known about the effectiveness of the primary course of pneumococcal conjugate vaccine (PCV) in these children.

A Systematic Framework for Prioritizing Burden of Disease Data Required for Vaccine Development and Implementation: The Case for Group A Streptococcal Diseases

Vaccine development and implementation decisions need to be guided by accurate and robust burden of disease data. We developed an innovative systematic framework outlining the properties of such data that are needed to advance vaccine development and evaluation, and prioritize research and surveillance activities.

Prevalence of respiratory viruses in community-acquired pneumonia in children: a systematic review and meta-analysis

Respiratory viruses are increasingly detected in children with community-acquired pneumonia but prevalence estimates vary substantially. We aimed to systematically review and pool estimates for 22 viruses commonly associated with community-acquired pneumonia.

Modelled estimates of hospitalisations attributable to respiratory syncytial virus and influenza in Australia, 2009–2017

Respiratory syncytial virus (RSV) and influenza are important causes of disease in children and adults. In Australia, information on the burden of RSV in adults is particularly limited.

The global burden of sore throat and group A Streptococcus pharyngitis: A systematic review and meta-analysis

Contemporary data for the global burden of sore throat and group A Streptococcus (Strep A) pharyngitis are required to understand the frequency of disease and develop value propositions for Strep A vaccines.

Maternal influenza vaccination and child mortality: Longitudinal, population-based linked cohort study

Influenza vaccination is recommended to protect mothers and their infants from influenza. Few studies have evaluated the association between maternal influenza vaccination and child mortality. We aimed to evaluate the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and mortality among young children.

Prenatal influenza vaccination and allergic and autoimmune diseases in childhood: A longitudinal, population-based linked cohort study

Few studies have evaluated the effect of maternal influenza vaccination on the development of allergic and autoimmune diseases in children beyond 6 months of age. We aimed to investigate the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and subsequent diagnosis of allergic and autoimmune diseases.

Excess respiratory mortality and hospitalizations associated with influenza in Australia, 2007-2015

Influenza is the most common vaccine-preventable disease in Australia, causing significant morbidity and mortality. We assessed the burden of influenza across all ages in terms of influenza-associated mortality and hospitalizations using national mortality, hospital-discharge and influenza surveillance data.

Examining the entire delayed respiratory syncytial virus season in Western Australia

An interseasonal resurgence of respiratory syncytial virus (RSV) was observed in Western Australia at the end of 2020. Our previous report describing this resurgence compared the 2019 and 2020 calendar years, capturing only part of the 2020/21 season.

The Interseasonal Resurgence of Respiratory Syncytial Virus in Australian Children Following the Reduction of Coronavirus Disease 2019-Related Public

Following the end of winter, there has been a persistent absence of severe acute respiratory syndrome coronavirus 2 community transmission and no increase in influenza detections. Limited physical distancing measures have remained in place, with largely no restrictions on gathering sizes and no mandate for wearing masks.

Examining the interseasonal resurgence of respiratory syncytial virus in Western Australia

Following a relative absence in winter 2020, a large resurgence of respiratory syncytial virus (RSV) detections occurred during the 2020/2021 summer in Western Australia. This seasonal shift was linked to SARS-CoV-2 public health measures. We examine the epidemiology and RSV testing of respiratory-coded admissions, and compare clinical phenotype of RSV-positive admissions between 2019 and 2020.

Vaccine coverage in children born to migrant mothers in Australia: A population-based cohort study

Overall, infant immunisation coverage is currently >90% in Australia, but there are pockets of under-immunised children including children from migrant backgrounds.

Pertussis burden and acellular pertussis vaccine effectiveness in high risk children

Pertussis hospitalisation is more common among infants born prematurely, who have significant comorbidities, or are Indigenous, but acellular pertussis (aP) vaccine effectiveness (VE) estimates in these sub-groups are lacking. We measured aP VE by Indigenous status, and policy-relevant categories of prematurity and comorbidity, in a population-based Australian cohort.

Developing a prediction model to estimate the true burden of respiratory syncytial virus (RSV) in hospitalised children in Western Australia

Respiratory syncytial virus (RSV) is a leading cause of childhood morbidity, however there is no systematic testing in children hospitalised with respiratory symptoms. Therefore, current RSV incidence likely underestimates the true burden.

Longitudinal, population-based cohort study of prenatal influenza vaccination and influenza infection in childhood

Influenza vaccination is recommended to protect mothers and their infants from influenza infection. Few studies have evaluated the health impacts of in utero exposure to influenza vaccine among children more than six months of age.

Interrupted time-series analysis showed unintended consequences of non-pharmaceutical interventions on paediatric hospital admissions

COVID-19-associated non-pharmaceutical interventions (NPI) have disrupted respiratory viral transmission. We quantified the changes in paediatric hospital admissions in 2020 from five different NPI phases in Western Australia for acute lower respiratory infections (ALRI) in children in the context of all-cause admissions.

Influenza hospitalizations in Australian children 2010–2019: The impact of medical comorbidities on outcomes, vaccine coverage, and effectiveness

Children with comorbidities are at greater risk of severe influenza outcomes compared with healthy children. In Australia, influenza vaccination was funded for those with comorbidities from 2010 and all children aged <5 years from 2018. Influenza vaccine coverage remains inadequate in children with and without comorbidities.

Children with secondary care episodes for otitis media have poor literacy and numeracy outcomes: A data linkage study

We examined the association between otitis media and educational attainment in a retrospective population cohort of Western Australian children who participated in the Grade 3 National Assessment Program—Literacy and Numeracy in 2012.

Lack of effectiveness of 13-valent pneumococcal conjugate vaccination against pneumococcal carriage density in Papua New Guinean infants

Papua New Guinea (PNG) introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in 2014, with administration at 1, 2, and 3 months of age. PCV13 has reduced or eliminated carriage of vaccine types in populations with low pneumococcal carriage prevalence, carriage density and serotype diversity.

Levels of pneumococcal conjugate vaccine coverage and indirect protection against invasive pneumococcal disease and pneumonia hospitalisations in Australia: An observational study

There is limited empiric evidence on the coverage of pneumococcal conjugate vaccines (PCVs) required to generate substantial indirect protection. We investigate the association between population PCV coverage and indirect protection against invasive pneumococcal disease (IPD) and pneumonia hospitalisations among undervaccinated Australian children.

Childhood vaccination coverage in Australia: an equity perspective

This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW).

Impact of Coronavirus Disease 2019 Public Health Measures on Detections of Influenza and Respiratory Syncytial Virus in Children During the 2020 Australian Winter

Public health measures targeting coronavirus disease 2019 have potential to impact transmission of other respiratory viruses. We found 98.0% and 99.4% reductions in respiratory syncytial virus and influenza detections, respectively, in Western Australian children through winter 2020 despite schools reopening. Border closures have likely been important in limiting external introductions.

The Collaboration for Increasing Influenza Vaccination in Children (CIIVIC): a meeting report

The burden of seasonal influenza disease in Australian children is substantial, especially for those with medical comorbidities including chronic cardiac, respiratory, neurological and immunosuppressive conditions. Influenza is more likely to be severe in children with comorbidities compared to previously healthy children (e.g. more frequent and longer hospitalisation, more frequent intensive care unit admission and requiring respiratory support). Direct protection against influenza by vaccination is critical for children with comorbidities and remains the most effective tool for influenza prevention.

Infant, maternal and demographic predictors of delayed vaccination: A population-based cohort study

Receiving vaccines at or close to their due date (vaccination timeliness) is a now key measure of program performance. However, studies comprehensively examining predictors of delayed infant vaccination are lacking. We aimed to identify predictors of short and longer-term delays in diphtheria-tetanus-pertussis (DTP) vaccination by dose number and ethnicity.

Improving Influenza Vaccination in Children With Comorbidities: A Systematic Review

Children with medical comorbidities are at greater risk for severe influenza and poorer clinical outcomes. Despite recommendations and funding, influenza vaccine coverage remains inadequate in these children. We aimed to systematically review literature assessing interventions targeting influenza vaccine coverage in children with comorbidities and assess the impact on influenza vaccine coverage.

Estimating pneumococcal vaccine coverage among Australian Indigenous children and children with medically at-risk conditions using record linkage

Risk-based recommendations are common for pneumococcal vaccines but little is known about their uptake. In Australia, pneumococcal conjugate vaccine (PCV) was funded only for Aboriginal or Torres Strait Islander (Indigenous) children and those with underlying medical conditions in 2001, and then there were different booster dose recommendations depending on risk after the introduction of universal PCV vaccination in 2005.

Maternal prenatal stress exposure and sex-specific risk of severe infection in offspring

Maternal stressful life events during pregnancy have been associated with immune dysregulation and increased risk for asthma and atopy in offspring. Few studies have investigated whether prenatal stress is associated with increased overall or specific infectious diseases in childhood, nor explored sex differences. We sought to examine the relationship between the nature and timing of maternal stress in pregnancy and hospitalisation with infection in offspring.

Epidemiology and seasonality of human parainfluenza serotypes 1-3 in Australian children

Parainfluenza viruses are significant contributors to childhood respiratory illness worldwide, although detailed epidemiological studies are lacking. Few recent Australian studies have investigated serotype-specific PIV epidemiology, and there is a paucity of southern hemisphere PIV reports. We report age-stratified PIV hospitalisation rates and a mathematical model of PIV seasonality and dynamics in Western Australia (WA).

Predictors of hospital readmission in infants less than 3 months old

To examine rates and predictors of 7-day readmission in infants hospitalised before 3 months of age with infectious and non-infectious conditions. A retrospective population-based data-linkage study of 121 854 infants from a 5-year metropolitan birth cohort (2008-2012). Cox proportional hazard models were used to examine associations between infant and maternal factors with 7-day readmission.

Mode of birth and risk of infection-related hospitalisation in childhood: A population cohort study of 7.17 million births from 4 high-income countries

The proportion of births via cesarean section (CS) varies worldwide and in many countries exceeds WHO-recommended rates. Long-term health outcomes for children born by CS are poorly understood, but limited data suggest that CS is associated with increased infection-related hospitalisation. We investigated the relationship between mode of birth and childhood infection-related hospitalisation in high-income countries with varying CS rates.

RSV prophylaxis use in high-risk infants in Western Australia, 2002-2013: a record linkage cohort study

The monoclonal antibody, palivizumab is licensed for use in high-risk infants to prevent severe illness caused by respiratory syncytial virus (RSV). The level of its use and compliance with current jurisdictional guidelines which were amended in 2010, is unknown.

Assessing the burden of laboratory-confirmed respiratory syncytial virus infection in a population cohort of Australian children through record linkage

Respiratory syncytial virus is pervasive across multiple severity levels and diagnoses. Vaccines targeting children <3 months must be prioritized

Spatial patterns of tuberculosis and HIV coinfection in Ethiopia

Our study provides evidence for geographic clustering of tuberculosis/human immunodeficiency virus co-infection in Ethiopia

Effectiveness of Palivizumab against Respiratory Syncytial Virus: Cohort and Case Series Analysis

Palivizumab appeared effective for reducing virologically confirmed respiratory syncytial virus in this high-risk cohort

Effectiveness of pneumococcal conjugate vaccine against hospital admissions for pneumonia in Australian children

Reductions in pneumonia-coded hospital admissions in unvaccinated children predominated in non-Aboriginal children with low incidence of pneumonia

Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children: A record linkage cohort study

Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher

Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children

We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children

Impact of Childhood Pneumococcal Conjugate Vaccine on Nonnotified Clinically Suspected Invasive Pneumococcal Disease in Australia

This study provides a quantitative estimate of the total burden of invasive pneumococcal disease preventable by vaccination programs in Australia

Temporal trends and socioeconomic differences in acute respiratory infection hospitalisations in children: an intercountry comparison of birth cohort studies

Admissions for ARI were higher in Western Australia and displayed greater socioeconomic disparities than England and Scotland, where ARI rates are increasing

Australian Aboriginal children have higher hospitalization rates for otitis media but lower surgical procedures than non-Aboriginal children

Aboriginal children and children from lower socio-economic backgrounds were over-represented with OM-related hospitalizations but had fewer TTIs

Caregiver’s attitudes, beliefs, and experiences for influenza vaccination in Australian children with medical comorbidities

Influenza vaccination recommendation by children’s hospital physicians and previous vaccine receipt in hospital was associated with vaccine uptake

Geographical disparities in emergency department presentations for acute respiratory infections and risk factors for presenting

One in four ED presentations in WA children are for ARIs, representing a significant out-of-hospital burden with some evidence of geographical disparity

Perinatal Risk Factors Associated With Gastroenteritis Hospitalizations in Aboriginal and Non-Aboriginal Children in Western Australia (2000-2012)

Given the beneficial effect of infant rotavirus vaccination efforts should be taken to optimize rotavirus vaccine coverage in those at highest risk

Assessment of on-time vaccination coverage in population subgroups: A record linkage cohort study

On-time coverage of the 2-4-6 month schedule is only 50-60% across specific population subgroups representing a significant avoidable public health risk

Optimising the use of linked administrative data for infectious diseases research in Australia

Increased collaboration and engagement across all sectors can optimise the use of linked data to help reduce the burden of infectious diseases

Effectiveness of a 3 + 0 pneumococcal conjugate vaccine schedule against invasive pneumococcal disease among a birth cohort of 1.4 million children in Australia

Our population-based cohort study demonstrates that >90% coverage in the first year of a universal 3 + 0 PCV program provided high population-level protection

The Impact of Pneumococcal Vaccination on Bacterial and Viral Pneumonia in Western Australian Children: Record Linkage Cohort Study of 469589 Births, 1996-2012

We assessed the impact of PCV on all-cause and pathogen-specific pneumonia hospitalizations in Western Australian (WA) children aged 16 years.

Advances in Vaccines to Prevent Viral Respiratory Illnesses in Children

Childhood vaccination has played a critical role in the reduction of morbidity and mortality from communicable diseases, including specific respiratory pathogens

Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012

Skin infections are a significant cause of severe disease, requiring hospitalization in Western Australian children, particularly with Aboriginal children

Record linkage study of the pathogen-specific burden of respiratory viruses in children

Reliance on hospital discharge diagnosis codes alone will likely underestimate the burden of respiratory viruses

Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012

The objective of this study was to describe the occurrence of skin infection associated hospitalizations in children born in Western Australia (WA).

Viral etiology and the impact of codetection in young children presenting with influenza-like illness

Children with acute respiratory tract infection (ARTI) frequently exhibit virus-virus codetection, yet the clinical significance of ARTI remains contentious.

Epidemiology of seasonal influenza infection in pregnant women and its impact on birth outcomes

Results from this linked population study suggests that there are differences in maternal infection by virus type and support the provision of seasonal vaccines

Probabilistic linkage of national immunisation and state-based health records for a cohort of 1.9 million births to evaluate Australia’s childhood immunisation program

To describe the process for assembling a linked study that will enable the conduct of population-based studies related to immunisation and immunisation policy.

Using record linkage to validate notification and laboratory data for a more accurate assessment of notifiable infectious diseases

Studies investigating pathogen-specific infectious disease would benefit from using multiple data sources.

Using record linkage to examine testing patterns for respiratory viruses among children born in Western Australia

Using linked data, we describe changes in respiratory virus testing among children born in Western Australia in 1996-2012

Population-based estimates of the effectiveness of pneumococcal vaccination in Australia

Australia’s Childhood Immunisation Register (ACIR) is one of only a handful of national immunisation registers world-wide.

Characterizing the risk of respiratory syncytial virus in infants with older siblings: a population-based birth cohort study

Our results lend support to a vaccination strategy which includes family members in order to provide maximum protection for newborn babies.

Effect of Maternal Influenza Vaccination on Hospitalization for Respiratory Infections in Newborns: A Retrospective Cohort Study

Maternal influenza vaccination was associated with a reduction in the incidence of hospital admission for acute respiratory illness among infants <6 months old

Association of gestational age and growth measures at birth with infection-related admissions to hospital throughout childhood

Children who were born with reduced gestational age, birthweight, and birth length have persistently increased rates of infection-related admissions to hospital until age 18 years

Effectiveness of seasonal trivalent influenza vaccination against hospital-attended acute respiratory infections in pregnant women

Influenza vaccination during pregnancy was associated with significantly fewer hospital attendances for ARI in pregnant women

Time series analysis of RSV and bronchiolitis seasonality in temperate and tropical Western Australia

Bronchiolitis hospitalisations are a reasonable proxy for the timing of RSV detections, but may not fully capture the magnitude of RSV epidemics

Seasonal trivalent influenza vaccination during pregnancy and the incidence of stillbirth: Population-based retrospective cohort study

Although antenatal influenza vaccination is an important public health intervention for preventing serious infection in pregnant women and newborns, reported...

Establishing a process for conducting cross-jurisdictional record linkage in Australia

We outline the processes involved in conducting a Proof of Concept data linkage project including the implementation of national data integration principles

Exploring the dynamics of respiratory syncytial virus (RSV) transmission in children

We develop a compartmental model for RSV infection, driven by a seasonal forcing function, and conduct parameter space and bifurcation analyses to document...

Systematic review and meta-analysis of respiratory viral coinfections in children

Coinfection is not associated with increased clinical severity, but further investigations by pathogen pairs are warranted

Optimization is required when using linked hospital and laboratory data to investigate respiratory infections

Chart review to validate linked microbiological data

Infant respiratory infections and later respiratory hospitalisation in childhood

The aim of this study was to use total-population based data on an otherwise healthy population of children to assess the relationship between early...

Childhood Hospitalisation with Infection and Cardiovascular Disease in Early-Mid Adulthood: A Longitudinal Population-Based Study

We investigated whether childhood infection-related hospitalisation (IRH, a marker of severity) was associated with subsequent adult CVD hospitalisation.

Surveillance of antenatal influenza vaccination: Validity of current systems and recommendations for improvement

Although influenza vaccination is recommended during pregnancy as standard of care, limited surveillance data are available for monitoring uptake.

Optimization is required when using linked hospital and laboratory data to investigate respiratory infections

Despite a recommendation for microbiological testing, only 45% of children hospitalized for respiratory infections in our previous data linkage study linked...

Risk factors and comorbidities for invasive pneumococcal disease in Western Australian Aboriginal and non-Aboriginal people

Australian Aboriginal people have among the highest rates of invasive pneumococcal disease (IPD) worldwide. This paper investigates clinical diagnosis, risk...

Modelling the seasonal epidemics of respiratory syncytial virus in young children

This paper describes a mathematical model used to predict when an epidemic of respiratory syncytial virus (RSV) will occur so that preventive measures, such...

Morbidity due to acute lower respiratory infection in children with birth defects: A total population-based linked data study

Children with birth defects experience higher rates of hospitalisation for ALRIs before age 2 years than children with no birth defects.

Modelling the seasonality of respiratory syncytial virus in young children

The transmission dynamics of RSV infection among young children are still poorly understood and mathematical modelling can be used to better understand...

Diverging Trends in Gastroenteritis Hospitalizations during Two Decades in Western Australian Aboriginal and Non-Aboriginal Children

Our findings highlight the need to consider age, ethnicity, seasonality and climate when evaluating rotavirus vaccine programs.

How Accurate Are International Classification of Diseases-10 Diagnosis Codes in Detecting Influenza and Pertussis Hospitalizations in Children?

Influenza diagnosis codes had high specificity (98.6%) and modest positive predictive value (PPV; 84.1%) and sensitivity (86.1%) for a laboratory-confirmed...

Can linked emergency department data help assess the out-of-hospital burden of acute lower respiratory infections

There is a lack of data on the out-of-hospital burden of acute lower respiratory infections (ALRI) in developed countries.

Prevalence of and risk factors for human rhinovirus infection in healthy aboriginal and non-aboriginal western australian children

Human rhinovirus (HRV) species C (HRV-C) have been associated with frequent and severe acute lower respiratory infections and asthma in hospitalized children.

Reduction in disparity for pneumonia hospitalisations between Australian indigenous and non-Indigenous children

In the 1990s pneumonia hospitalisation rates in Western Australia (WA) were 13 times higher in Indigenous children than in non-Indigenous children...

Hospitalisation for bronchiolitis in infants is more common after elective caesarean delivery

The authors previously reported an increased risk of hospitalisation for acute lower respiratory infection up to age 2 years in children delivered by...

Use of data linkage to investigate the aetiology of acute lower respiratory infection hospitalisations in children

The aim was to document the aetiology of acute lower respiratory infection (ALRI) hospitalisations in Western Australian children

Hospitalisation for bronchiolitis in infants is more common after elective caesarean delivery

The authors previously reported an increased risk of hospitalisation for acute lower respiratory infection up to age 2 years in children delivered by...

Acute lower respiratory infections (ALRI) in Indigenous and non-Indigenous children

In Australia and many other developed countries, acute lower respiratory infection (ALRI) is one of the most common reasons for hospitalisation in young...

Influenza vaccine effectiveness against laboratory-confirmed influenza in healthy children aged 6-59 months:

The Western Australian Influenza Vaccine Effectiveness study commenced in 2008 to evaluate a new program to provide free influenza vaccine to all children...

A retrospective population-based cohort study identifying target areas for prevention of acute lower respiratory infections in children

Acute lower respiratory infections (ALRI) are a major cause of hospitalisation in young children

Assessing the protective effect of influenza vaccine against laboratory confirmed influenza in hospitalised children aged 6-59 months

Influenza vaccine was offered to all children aged 6-59 months resident in Western Australia in 2008, and we wished to evaluate the effectiveness of this immunisation programme.

Lessons from the first year of the WAIVE study investigating the protective effect of influenza vaccine

Influenza is major cause of paediatric hospitalisation. Influenza vaccine was offered to all children aged 6-59 months resident in Western Australia in 2008

The changing epidemiology of invasive pneumococcal disease

We investigated trends in invasive pneumococcal disease (IPD) in Western Australia (WA).

The interaction between respiratory viruses and pathogenic bacteria

Data on asymptomatic identification rates of respiratory viruses are limited, particularly in Indigenous populations, who suffer a high burden of OM.

Diverging trends for lower respiratory infections in non-Aboriginal and Aboriginal children

To investigate temporal trends in admission rates for acute lower respiratory infections (ALRI) in a total population birth cohort of non-Aboriginal and...

Infection is the major component of the disease burden in Aboriginal and non-Aboriginal Australian children: a population-based study

Infection accounts for the majority of pediatric mortality and morbidity in developing countries, but there are limited data on the infectious diseases...