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Association between vaccination status,symptom identification and healthcare use: Implications for test negative design observational studies |
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| Institution: | 1. School of Medicine and Dentistry and Menzies Health Institute Queensland, Griffith University, Parklands Drive, Gold Coast, QLD 4222, Australia;2. Departments of Paediatrics and Infectious Diseases, Gold Coast Health, Gold Coast, QLD 4215, Australia;3. Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia;4. Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia;5. Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA 6009, Australia |
| Abstract: | AimTo test the internal validity of the test-negative design (TND) by investigating associations between maternal influenza vaccination, and new virus detection episodes (VDEs), acute respiratory illness, and healthcare visits in their children.MethodsEighty-five children from a birth cohort provided daily symptoms, weekly nasal swabs, and healthcare use data until age 2-years. Effect estimates are summarised as incidence rate ratios (IRR).ResultsThere was no association between maternal vaccination and VDEs in children (IRR = 1.1; 95 %CI = 0.9–1.2). Influenza-vaccinated mothers were more likely than unvaccinated mothers to both report, and seek healthcare for, acute lower respiratory illness in their children, IRR = 2.4; 95 %CI = 1.2–4.8 and IRR = 2.2; 95 %CI = 1.1–4.3, respectively.ConclusionA key assumption of the TND, that healthcare seeking behaviour for conditions of the same severity is not associated with vaccine receipt, did not hold. Further studies of the performance of the TND in different populations are required to confirm its validity. |
| Keywords: | Influenza vaccination Test-negative design Acute respiratory illness Respiratory viruses Healthcare seeking behaviour aIRR"} {"#name":"keyword" "$":{"id":"pc_oDURqhDPu5"} "$$":[{"#name":"text" "_":"adjusted incidence rate ratio ALRI"} {"#name":"keyword" "$":{"id":"pc_dTRQevbHtH"} "$$":[{"#name":"text" "_":"acute lower respiratory illness ARI"} {"#name":"keyword" "$":{"id":"pc_ZmAuJ1wX8Q"} "$$":[{"#name":"text" "_":"acute respiratory illness CI"} {"#name":"keyword" "$":{"id":"pc_Z3YaPAajGq"} "$$":[{"#name":"text" "_":"confidence interval Ct"} {"#name":"keyword" "$":{"id":"pc_maMnqYur6k"} "$$":[{"#name":"text" "_":"cycle threshold ERV-3"} {"#name":"keyword" "$":{"id":"pc_87HoWhhpVM"} "$$":[{"#name":"text" "_":"endogenous retrovirus-3 IR"} {"#name":"keyword" "$":{"id":"pc_HImxg71Ei6"} "$$":[{"#name":"text" "_":"incidence rate IRR"} {"#name":"keyword" "$":{"id":"pc_neT5eCAtQT"} "$$":[{"#name":"text" "_":"incidence rate ratio ORChID"} {"#name":"keyword" "$":{"id":"pc_DKCcOHk0v6"} "$$":[{"#name":"text" "_":"Observational Research in Childhood Infectious Diseases sALRI"} {"#name":"keyword" "$":{"id":"pc_mBjlIa68Km"} "$$":[{"#name":"text" "_":"severe acute lower respiratory illness TND"} {"#name":"keyword" "$":{"id":"pc_y5nOc0ZOz7"} "$$":[{"#name":"text" "_":"test-negative design URI"} {"#name":"keyword" "$":{"id":"pc_24dFaYClBE"} "$$":[{"#name":"text" "_":"upper respiratory illness VDE"} {"#name":"keyword" "$":{"id":"pc_QD43cVKTRt"} "$$":[{"#name":"text" "_":"virus detection episode VE"} {"#name":"keyword" "$":{"id":"pc_vZdDTuWO46"} "$$":[{"#name":"text" "_":"vaccine effectiveness |
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