tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Kristina Lai[SUP] 2 [/SUP], John M McAteer[SUP] 1 [/SUP], Mohnd Elmontser[SUP] 1 [/SUP], Elizabeth M Quincer[SUP] 1 [/SUP], Marianne E M Yee[SUP] 3 2 [/SUP], Ashley Tippet[SUP] 1 [/SUP], Robert C Jerris[SUP] 1 [/SUP], Peter A Lane[SUP] 3 2 [/SUP], Evan J Anderson[SUP] 1 [/SUP], Nitya Bakshi[SUP] 3 2 [/SUP], Inci Yildirim[SUP] 1 4 [/SUP]
Affiliations
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.
. 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[SUP] 1 [/SUP], Kristina Lai[SUP] 2 [/SUP], John M McAteer[SUP] 1 [/SUP], Mohnd Elmontser[SUP] 1 [/SUP], Elizabeth M Quincer[SUP] 1 [/SUP], Marianne E M Yee[SUP] 3 2 [/SUP], Ashley Tippet[SUP] 1 [/SUP], Robert C Jerris[SUP] 1 [/SUP], Peter A Lane[SUP] 3 2 [/SUP], Evan J Anderson[SUP] 1 [/SUP], Nitya Bakshi[SUP] 3 2 [/SUP], Inci Yildirim[SUP] 1 4 [/SUP]
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.