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Clin Infect Dis . A Retrospective Test-Negative Case-Control Study to Evaluate Influenza Vaccine Effectiveness in Preventing Hospitalizations in Ch

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2021 Aug 19;ciab709.
doi: 10.1093/cid/ciab709. Online ahead of print.
A Retrospective Test-Negative Case-Control Study to Evaluate Influenza Vaccine Effectiveness in Preventing Hospitalizations in Children


Inci Yildirim[SUP] 1 2 3 [/SUP], Carol M Kao[SUP] 1 [/SUP], Ashley Tippett[SUP] 1 [/SUP], Piyarat Suntarattiwong[SUP] 4 [/SUP], Mohamed Munye[SUP] 1 [/SUP], Jumi Yi[SUP] 1 5 [/SUP], Mohnd Elmontser[SUP] 1 [/SUP], Elizabeth Quincer[SUP] 1 [/SUP], Chris Focht[SUP] 6 [/SUP], Nora Watson[SUP] 6 [/SUP], Hande Bilen[SUP] 1 [/SUP], Julia M Baker[SUP] 2 [/SUP], Ben Lopman[SUP] 2 [/SUP], Elena Hogenesch[SUP] 1 [/SUP], Christina A Rostad[SUP] 1 [/SUP], Evan J Anderson[SUP] 1 7 [/SUP]



Affiliations

Abstract

Background: Vaccination is the primary strategy to reduce influenza burden. Influenza vaccine effectiveness (VE) can vary annually depending on circulating strains.
Methods: We used a test-negative case-control study design to estimate influenza VE against laboratory-confirmed influenza-related hospitalizations among children (6 months-17 years) across 5 influenza seasons in Atlanta, Georgia from 2012-13 to 2016-17.Influenza-positive cases were randomly matched to test-negative controls based on age and influenza season in a 1:1 ratio. We used logistic regression models to compare odds ratios (OR) of vaccination in cases to controls. We calculated VE as [100% x (1-adjusted OR)] and computed 95% confidence intervals (CIs) around the estimates.
Results: We identified 14,596 hospitalizations of children who were tested for influenza using multiplex respiratory molecular panel; influenza infection was detected in 1,017 (7.0%). After exclusions, we included 512 influenza-positive cases and 512 influenza-negative controls; median age was 5.9 years (IQR 2.7-10.3); 497 (48.5%) were female, 567 (55.4%) were non-Hispanic Black and 654 (63.9%) children were unvaccinated. Influenza A accounted for 370 (72.3%) of 512 cases and predominated during all five seasons. The adjusted VE against influenza-related hospitalizations during 2012-13 to 2016-17 was 51.3% (95% CI 34.8-63.6%) and varied by season. Influenza VE was 54.7% (95% CI 37.4-67.3%) for influenza A and 37.1% (95% CI 2.3-59.5%) for influenza B.
Conclusions: Influenza vaccination decreased the risk of influenza-related pediatric hospitalizations by >50% across five influenza seasons.

Keywords: Influenza vaccine effectiveness; adolescent; immunization; pediatric.
 
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