Pediatr Blood Cancer Influenza Vaccine Effectiveness and Disease Burden in Children and Adolescents With Sickle Cell Disease: 2012-2017

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Pediatr Blood Cancer


. 2020 May 29;e28358.
doi: 10.1002/pbc.28358. Online ahead of print.
Influenza Vaccine Effectiveness and Disease Burden in Children and Adolescents With Sickle Cell Disease: 2012-2017


Carol M Kao ¹ , Kristina Lai ² , John M McAteer ¹ , Mohnd Elmontser ¹ , Elizabeth M Quincer ¹ , Marianne E M Yee ^{3 2} , Ashley Tippet ¹ , Robert C Jerris ¹ , Peter A Lane ^{3 2} , Evan J Anderson ¹ , Nitya Bakshi ^{3 2} , Inci Yildirim ^{1 4}



Affiliations

• PMID: 32469138
• DOI: 10.1002/pbc.28358

Abstract

Background: Data are limited on the burden of influenza and seasonal influenza vaccine effectiveness (VE) in children with sickle cell disease (SCD).
Methods: We used a prospectively collected clinical registry of SCD patients 6 months to 21 years of age to determine the influenza cases per 100 patient-years, vaccination rates, and a test-negative case-control study design to estimate influenza VE against medically attended laboratory-confirmed influenza infection. Influenza-positive cases were randomly matched to test-negative controls on age and influenza season in 1:1 ratio. We used adjusted logistic regression models to compare odds ratio (OR) of vaccination in cases to controls. We calculated VE as [100% ? (1 - adjusted OR)] and computed 95% confidence intervals (CIs) around the estimate.
Results: There were 1037 children with SCD who were tested for influenza, 307 children (29.6%) had at least one influenza infection (338 infections, incidence rate 3.7 per 100 person-years; 95% CI, 3.4-4.1) and 56.2% of those tested received annual influenza vaccine. Overall VE pooled over five seasons was 22.3% (95% CI, -7.3% to 43.7%). Adjusted VE estimates ranged from 39.7% (95% CI, -70.1% to 78.6%) in 2015/2016 to -5.9% (95% CI, -88.4% to 40.4%) in the 2016/17 seasons. Influenza VE varied by age and was highest in children 1-5 years of age (66.6%; 95% CI, 30.3-84.0). Adjusted VE against acute chest syndrome during influenza infection was 39.4% (95% CI, -113.0 to 82.8%).
Conclusions: Influenza VE in patients with SCD varies by season and age. Multicenter prospective studies are needed to better establish and monitor influenza VE among children with SCD.

Keywords: influenza; sickle cell disease; test-negative; vaccine effectiveness.