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Nasal flu vaccine may help reduce cases of group A strep - Gov.UK

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  • Nasal flu vaccine may help reduce cases of group A strep - Gov.UK

    Analysis by UKHSA suggests a nasal spray vaccine that offers protection to children against flu may also help reduce the rate of group A strep infections.

    Published16 December 2022
    From: UK Health Security Agency

    The live attenuated influenza vaccine (LAIV) is a nasal spray offered each season to most children aged 2 and 3 years old, and to school-aged children, to help protect against flu.

    It was first rolled out in England from 2013, adding a school year each calendar year. In some pilot areas, the vaccine was given to all primary school years from 2013 onwards.

    The new study looked back at data from 2013 to 2017, comparing rates of group A strep (GAS) infections in pilot areas and comparing them to other areas where the vaccine was not being offered as widely.

    The study found that incidence of GAS was lower in pilot areas where the LAIV vaccine was being offered to all primary school children, compared to areas where it was being incrementally rolled out.

    In 2 to 4 year olds, rates of GAS were 73.5 per 100,000 children in pilot areas, compared to 93 per 100,000 children in non-pilot areas.

    In 5 to 10 year olds, rates of GAS were 50.3 per 100,000 children in pilot areas, compared to 57.8 per 100,000 in non-pilot areas.

    There was no difference in scarlet fever or invasive group A strep (iGAS) notifications.

    Dr Jamie Lopez Bernal, Consultant Epidemiologist for Immunisation and Countermeasures at UKHSA, said:
    Our findings suggest that the nasal spray vaccine programme, which offers very good protection against flu, may also help contribute to reductions in the rates of GASinfections among children.

    Children who catch influenza are at greater risk from subsequent infections, including group A strep, so these findings provide yet more reasons for parents of eligible children to bring them forward for the flu vaccine.

    This is particularly important at this time when we are seeing unusually high rates of group A strep infection across the population.

    The nasal spray flu vaccine given to school-aged children and pre-schoolers has an excellent safety record and has been given to millions of children in the UK and worldwide.

    It is not too late for children to get the flu vaccine. Parents and guardians of any reception and primary school aged children who missed their vaccination should contact their local school-aged vaccination service, or ask at their school if you are unsure.

    This winter the vaccine is being offered to secondary school aged children from school years 7, 8 and 9 in December and January, so if you have yet to send back your consent form it’s not too late. Parents and guardians of children aged 2 and 3 and children in a high-risk group can make an appointment through their GP surgery.

    UK Health Security Agency press office

    Analysis by UKHSA suggests a nasal spray vaccine that offers protection to children against flu may also help reduce the rate of group A strep infections.





  • #2
    This is a pre-print and has not yet been peer reviewed

    Epidemiological impact of the paediatric live attenuated influenza vaccine (LAIV) programme on group A Streptococcus (GAS) infections in England

    Mary A Sinnathamby1, Fiona Warburton1, Rebecca Guy1, Nick Andrews1, Theresa Lamagni1, Conall Watson1, Jamie Lopez Bernal1

    Affiliations

    1. UK Health Security Agency (UKHSA), London, United Kingdom

    Abstract

    Influenza is known to predispose to secondary bacterial infections including group A streptococcal infection (GAS) and invasive (iGAS) disease.

    The universal paediatric live attenuated influenza vaccine (LAIV) programme was introduced in England during the 2013/2014 influenza season to directly protect children as well as indirectly protect the wider population through reduction in transmission. Nationally, the programme was implemented incrementally introducing cohorts of children from pre-school age to school age children year on year towards 2 to 16 year old coverage. In addition, a series of discrete geographical areas (pilot areas) offered LAIV vaccination to all primary school age children, allowing for a unique assessment and comparison of infection rates between pilot and non-pilot areas during roll-out.

    Overall reductions in incidence rates of GAS and scarlet fever were observed within most of post-LAIV programme seasons when assessing the impact of the LAIV programme among the targeted (2 to 4 years and 5 to 10 years) and non-targeted groups using incidence rate ratios (IRRs) from Poisson regressions.

    We assessed the overall effect of the pilot programme between the pre-introduction (2010/2011 to 2012/2013 influenza seasons) and post-introduction (2013/2014 to 2016/2017 influenza) periods using negative binomial regression by comparing the pre- to -post programme changes in incidence between the pilot and non-pilot areas (rIRR = ratio of incidence rate ratios). This showed significant reductions among the 5 to 10 years (rIRR of 0.57 (95% CI: 0.45 to 0.71; p-value: <0.001)); the 2 to 4 years (rIRR of 0.62 (95% CI:0.43 to 0.90; p-value: 0.011)) and the 11 to 16 years (rIRR of 0.63 (95% CI: 0.43 to 0.90; p-value: 0.018)) for GAS infections. A non-significant reduction was also seen for iGAS in 2-4 year olds (rIRR of 0.58 (95% CI: 0.21 to 1.65; p-value=0.31)). No difference was seen for iGAS 5 to 10 year olds, or for scarlet fever in both age groups (rIRRs (95% CI) of 1.1 (0.34-3.6), 0.96 (0.66-1.39), 1.16 (0.75-1.81) for iGAS age 5 to 10, scarlet fever age 2 to 4 and 5 to 10, respectively).

    Our findings are compatible with the paediatric LAIV programme reducing the incidence of GAS and iGAS infections among children and support attaining high uptake of childhood influenza vaccination.


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