Influenza vaccine effectiveness against influenza-associated hospitalization in children: A systematic review and meta-analysis |
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| Affiliation: | 1. Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA;2. Vaccine Epidemiology and Modelling, Sanofi Pasteur, Swiftwater, PA, USA;3. Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;4. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada;1. State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China;2. Zhejiang Chinese Medical University, Hangzhou 310053, China;1. Artemis One Health, Utrecht, The Netherlands;2. Erasmus Medical Center, Department of Viroscience, Rotterdam, The Netherlands;3. FluPal Consultancy, Amstelveen, The Netherlands;4. University of Amsterdam, The Netherlands;5. University of Veterinary Medicine, Hannover, Germany;1. Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan;2. Department of Pediatrics, Keiyu Hospital, Yokohama, Kanagawa, Japan;3. Institute of Clinical Research Department of Infection & Allergy, National Hospital Organization Tochigi Medical Center, Utsunomiya, Tochigi, Japan;4. Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan;5. Department of Pediatrics, National Hospital Organization Saitama National Hospital, Wako, Saitama, Japan;6. Department of Pediatrics, Ota Memorial Hospital, Ota, Gunma, Japan;7. Department of Pediatrics, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan;8. Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, Ashikaga, Tochigi, Japan;9. Division of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan;10. Department of Pediatrics, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochgi, Japan;11. Department of Pediatrics, Nippon Kokan Hospital, Kawasaki, Kanagawa, Japan;12. Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, Japan;13. Department of Pediatrics, Shizuoka City Shimizu Hospital, Shizuoka, Japan;14. Department of Pediatrics, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan;15. Department of Pediatrics, Eiju General Hospital, Tokyo, Japan;1. School of Paediatrics and Child Health, University of Western Australia, Perth, Australia;2. Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia;3. Department of Microbiology, PathWest Laboratory Medicine WA, Princess Margaret Hospital for Children, Perth, Australia;4. Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia;5. Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;6. Communicable Disease Control Directorate, WA Department of Health, Perth, Australia;7. School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia;8. Department of Microbiology, QEII Medical Centre, PathWest Laboratory Medicine WA, Perth, Australia;9. Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia;10. Australian National University, Canberra, Australia;11. National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, University of Sydney, Sydney, Australia;12. Children''s Hospital Westmead, University of Sydney, Sydney, Australia;13. Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia;1. Communicable Diseases Branch, Queensland Health, Brisbane, Australia;2. National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia;3. Menzies School of Health Research, Charles Darwin University, Darwin, Australia;4. Menzies Health Institute Queensland, Griffith University, Brisbane, Australia |
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| Abstract: | Vaccination remains the most effective way to prevent influenza infection, albeit vaccine effectiveness (VE) varies by year. Compared to other age groups, children and elderly adults have the highest risk of developing influenza-related complications and requiring hospitalization. During the last years, “test negative design” (TND) studies have been implemented in order to estimate influenza VE. The aim of this systematic review and meta-analysis was to summarize the findings of TND studies reporting influenza VE against laboratory-confirmed influenza-related hospitalization in children aged 6 months to 17 years. We searched the PubMed and Embase databases and identified 2615 non-duplicate studies that required detailed review. Among them, 28 met our inclusion criteria and we performed a random-effects meta-analysis using adjusted VE estimates. In our primary analysis, influenza vaccine offered significant protection against any type influenza-related hospitalization (57.48%; 95% CI 49.46–65.49). When we examined influenza VE per type and strain, VE was higher against H1N1 (74.07%; 95% CI: 54.85–93.30) and influenza B (50.87%; 95% CI: 41.75–59.98), and moderate against H3N2 (40.77%; 95% CI: 25.65–55.89). Notably, influenza vaccination offered higher protection in children who were fully vaccinated (61.79%; 95% CI: 54.45–69.13), compared to those who were partially vaccinated (33.91%; 95% CI: 21.12 – 46.69). Also, influenza VE was high in children less than 5 years old (61.71%; 95% CI: 49.29–74.12) as well as in children 6–17 years old (54.37%; 95% CI: 35.14–73.60). In conclusion, in the pediatric population, influenza vaccination offered significant protection against influenza-related hospitalization and complete annual vaccination should be encouraged. |
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| Keywords: | Influenza Vaccine effectiveness Pediatric hospitalization Children Systematic review Meta-analysis |
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