Effectiveness of influenza vaccine in children in preventing influenza associated hospitalisation, 2018/19, England |
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| Affiliation: | 1. Public Health England National Infection Service, Colindale, London, UK;2. Public Health England National Infection Service, Bristol, UK;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. School of Public Health, Texas A&M University, 212 Adriance Drive, College Station, TX 77843, United States;2. School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia;3. Communicable Disease Control Directorate, Department of Health Western Australia, 227 Stubbs Terrace, Shenton Park, WA 6008, Australia;4. Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6008, Australia;5. Victorian Infectious Diseases Reference Laboratory, 792 Elizabeth Street, Melbourne, VIC 3000, Australia;6. Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC 3010, Australia;7. Discipline of General Practice, University of Adelaide, North Terrace, Adelaide, SA 5005, Australia;8. PathWest Laboratory Medicine WA, Locked Bag 2009, Nedlands, WA 6909, Australia;9. SA Pathology, Frome Road, Adelaide, SA 5000, Australia;10. WHO Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia;11. Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr South, Los Angeles, CA 90095, United States;1. Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;2. Department of Infectious Diseases and Centre for Global Health, Clinical Institute, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark;3. Department of Infectious Disease Epidemiology & Prevention, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;4. Department of Clinical Microbiology, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark;5. Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 18, 4200 Slagelse, Denmark;6. Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark;7. Department of Clinical Microbiology, Vejle Sygehus, Beriderbakken 4, 7100 Vejle, Denmark;8. Department of Clinical Microbiology, Odense University Hospital, Søndre Blvd. 29, 5000 Odense C, Denmark;9. Department of Clinical Microbiology, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark;1. Victorian Infectious Diseases Reference Laboratory, The Doherty Institute, Melbourne, Victoria, Australia;2. National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia;3. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia;4. PathWest Laboratory Medicine WA, Perth, Western Australia, Australia;5. School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia;6. Discipline of General Practice, University of Adelaide, Adelaide, South Australia, Australia;7. World Health Organization Collaborating Centre for Reference and Research on Influenza, The Doherty Institute, Melbourne, Victoria, Australia;8. Communicable Disease Control Directorate, Western Australia Department of Health, Perth, Western Australia, Australia;9. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA;1. Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain;2. CIBER Epidemiología y Salud Pública (CIBERESP), Spain;3. Complejo Hospitalario de Navarra – IdiSNA, Pamplona, Spain;4. Centro Nacional de Microbiología (WHO National Influenza Centre – Madrid), Instituto de Salud Carlos III, Majadahonda, Spain;1. Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China;2. Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China;3. Beijing Research Center for Preventive Medicine, Beijing, China;4. School of Public Health, Capital Medical University, Beijing, China |
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| Abstract: | 2013/14 saw the start of the introduction of a new live attenuated influenza vaccine (LAIV) programme for children in England. 2018/19 saw co-circulation of both A(H1N1)pdm09 and A(H3N2), when LAIV was offered to all healthy children 2–9 years of age. LAIV effectiveness against influenza hospitalisation is not well described. This paper presents the 2018/19 end-of-season adjusted vaccine effectiveness (aVE) against laboratory confirmed influenza related hospitalisation in children aged 2–17. The test negative case control approach was used to estimate aVE by influenza A subtype and vaccine type. Cases and controls were selected from a sentinel laboratory surveillance system which collates details of individuals tested for influenza with reverse-transcription polymerase chain reaction (RT-PCR) on respiratory samples. Vaccine and clinical history was obtained from general practitioners of study participants. There were 307 hospitalised cases and 679 hospitalised controls. End-of-season influenza aVE was 53.0% (95% CI: 33.3, 66.8) against influenza confirmed hospitalisation; 63.5% (95% CI: 34.4, 79.7) against influenza A(H1N1)pdm09 hospitalisation and 31.1% (95% CI: −53.9, 69.2) against influenza A(H3N2). LAIV aVE was 49.1% (95% CI: 25.9, 65.0) for any influenza and 70.7% (95% CI: 41.8, 85.3) for A(H1N1)pdm09, whereas for those receiving quadrivalent inactivated influenza vaccine (QIV), aVE was 64.4% (95% CI: 29.4, 82.0) and 44.4% (95% CI: −51.9, 79.6) respectively. We provide evidence of overall significant VE for both LAIV and QIV against influenza associated hospitalisation in children 2–17 years of age, most notably against influenza A(H1N1)pdm09, with non-significant protection against A(H3N2). |
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| Keywords: | Influenza vaccine effectiveness Children LAIV Hospitalisation |
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