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The effectiveness of influenza vaccination in preventing hospitalisation in children in Western Australia

This study aimed to determine the vaccine effectiveness of the southern hemisphere trivalent inactivated influenza vaccine (TIV) in preventing...

Authors:
Blyth CC, Cheng AC, Finucane C, Jacoby P, Effler PV, Smith DW, ... Richmond PC.

Authors notes:
Vaccine. 2015;33(51):7239-44.

Keywords:
Influenza, Influenza vaccine, Vaccine effectiveness

Abstract:
There is increasing evidence demonstrating influenza vaccine effectiveness (VE) in the prevention of influenza in children, including the very young.

Data demonstrating the effectiveness against severe disease, including hospitalisation, are limited.

We aimed to determine the VE of the southern hemisphere trivalent inactivated influenza vaccine (TIV) in preventing laboratory-confirmed influenza-associated hospitalisation in children.

Laboratory records were used to identify children with confirmed influenza hospitalised during a 5 year period at the only tertiary paediatric facility in Western Australia.

Cases and time, age and ward matched controls were retrospectively reviewed to determine risk factors, vaccination status and outcome.

Three hundred and eighty five cases were identified (Influenza A, 64.9%; Influenza B, 35.1%).

Influenza-like illness and pneumonia were the most frequent presentation (74.5% and 23.9%, respectively).

The median length of stay was 2 days.

Twenty children required admission to the intensive care unit.

Vaccine uptake in cases and controls was low (4.9% and 8.5%, respectively).

Three hundred and six case-control pairs were included in the VE analysis, of which 19 pairs were

informative with discrepant vaccination status.

VE (fully vaccinated vs. unvaccinated) was estimated to be 62.3%

CONCLUSIONS:

In this study, the point estimate for the effectiveness of TIV in preventing influenza-associated hospitalisation in children was similar to that reported for emergency or outpatient attended, laboratory-confirmed influenza, yet confidence intervals were wide.

Vaccine uptake remains low.

Studies, enroling larger numbers of children, ideally with higher vaccine uptake, are needed to provide additional evidence on TIV protection against influenza hospitalisation in children.