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Pediatrics . Vaccine Effectiveness Against Pediatric Influenza Hospitalizations and Emergency Visits

tetano

Editor, Senior Moderator
Pediatrics


. 2020 Oct 5;e20201368.
doi: 10.1542/peds.2020-1368. Online ahead of print.
Vaccine Effectiveness Against Pediatric Influenza Hospitalizations and Emergency Visits


Angela P Campbell[SUP] 1 [/SUP], Constance Ogokeh[SUP] 2 3 [/SUP], Joana Y Lively[SUP] 4 5 [/SUP], Mary A Staat[SUP] 6 [/SUP], Rangaraj Selvarangan[SUP] 7 8 [/SUP], Natasha B Halasa[SUP] 9 [/SUP], Janet A Englund[SUP] 10 11 [/SUP], Julie A Boom[SUP] 12 13 [/SUP], Geoffrey A Weinberg[SUP] 14 [/SUP], John V Williams[SUP] 15 [/SUP], Monica McNeal[SUP] 6 [/SUP], Christopher J Harrison[SUP] 15 [/SUP], Laura S Stewart[SUP] 9 [/SUP], Eileen J Klein[SUP] 10 11 [/SUP], Leila C Sahni[SUP] 12 13 [/SUP], Peter G Szilagyi[SUP] 14 16 [/SUP], Marian G Michaels[SUP] 15 [/SUP], Robert W Hickey[SUP] 15 [/SUP], Mary E Moffat[SUP] 17 [/SUP], Barbara A Pahud[SUP] 15 [/SUP], Jennifer E Schuster[SUP] 15 [/SUP], Gina M Weddle[SUP] 15 [/SUP], Brian Rha[SUP] 4 [/SUP], Alicia M Fry[SUP] 2 [/SUP], Manish Patel[SUP] 2 [/SUP]



Affiliations

Abstract

Background: Influenza A(H1N1)pdm09 viruses initially predominated during the US 2018-2019 season, with antigenically drifted influenza A(H3N2) viruses peaking later. We estimated vaccine effectiveness (VE) against laboratory-confirmed influenza-associated hospitalizations and emergency department (ED) visits among children in the New Vaccine Surveillance Network.
Methods: We tested children 6 months to 17 years with acute respiratory illness for influenza using molecular assays at 7 pediatric hospitals (ED patients <5 years at 3 sites). Vaccination status sources were parental report, state immunization information systems and/or provider records for inpatients, and parental report alone for ED patients. We estimated VE using a test-negative design, comparing odds of vaccination among children testing positive versus negative for influenza using multivariable logistic regression.
Results: Of 1792 inpatients, 226 (13%) were influenza-positive: 47% for influenza A(H3N2), 36% for A(H1N1)pdm09, 9% for A (not subtyped), and 7% for B viruses. Among 1944 ED children, 420 (22%) were influenza-positive: 48% for A(H3N2), 35% for A(H1N1)pdm09, 11% for A (not subtyped), and 5% for B viruses. VE was 41% (95% confidence interval [CI], 20% to 56%) against any influenza-related hospitalizations, 41% (95% CI, 11% to 61%) for A(H3N2), and 47% (95% CI, 16% to 67%) for A(H1N1)pdm09. VE was 51% (95% CI, 38% to 62%) against any influenza-related ED visits, 39% (95% CI, 15% to 56%) against A(H3N2), and 61% (95% CI, 44% to 73%) against A(H1N1)pdm09.
Conclusions: The 2018-2019 influenza vaccine reduced pediatric influenza A-associated hospitalizations and ED visits by 40% to 60%, despite circulation of a drifted A(H3N2) clade.
 
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