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Published on: August 14, 2019
Influenza vaccination options to prevent hospitalization
Moshe Ipp Frcp1, Nancy L Young, Teresa To
1Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto;
Insights
Universal childhood influenza vaccination could prevent over half of hospitalizations, more than double targeted approaches. Targeted vaccination remains a viable option until universal strategy challenges are resolved.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health
Background:
- Influenza causes significant childhood illness, yet vaccination remains debated.
- Understanding the impact of different vaccination strategies is crucial for public health policy.
Purpose of the Study:
- To quantify the effectiveness of three distinct influenza vaccination strategies in preventing pediatric hospitalizations.
- To compare universal versus targeted vaccination approaches for children.
Main Methods:
- Retrospective chart review of children hospitalized with influenza over three seasons.
- Analysis included 208 children, categorized as high-risk or previously healthy.
- Evaluation of universal, selective (risk-based), and infant-only vaccination strategies.
Main Results:
- A universal vaccination strategy (all children >6 months) could have prevented 118 admissions.
- Targeted vaccination of high-risk children (>6 months) or infants (2-6 months) could have prevented 58 and 55 admissions, respectively.
- Universal vaccination prevented more than twice the number of admissions compared to targeted strategies.
Conclusions:
- Universal influenza vaccination offers substantial benefits, potentially preventing over 50% of pediatric hospitalizations.
- Targeted vaccination is an acceptable alternative, particularly while implementation challenges of universal vaccination are addressed.
- The findings support a strong public health recommendation for universal childhood influenza immunization.
Background:
Vaccination of children against influenza remains a controversial topic despite the substantial morbidity caused by this infection.
Objective:
To estimate the effect of three different vaccination strategies on preventing hospitalization due to influenza.
Methods:
A retrospective chart review was conducted of all children admitted to a tertiary health care centre who tested positive for influenza during three consecutive influenza seasons.
Results:
The final analysis included 208 cases with an age range of five days to 16.1 years. Seventy-six children were considered 'high-risk' and 132 were considered 'previously healthy'. Length of stay (LOS) ranged from one day to 46 days with a mean of 6.3 days. The mean LOS was 8.6 days for children with risk factors and 4.9 days for those without risk factors. The number of preventable influenza admissions was determined over three years and averaged over one year for the three vaccination strategies. A universal strategy of vaccinating all previously healthy and high-risk children over six months of age would have prevented 118 admissions. Using a selective strategy of vaccinating only children over six months of age with risk factors and a third strategy of vaccinating only two- to six-month-old infants would have prevented 58 and 55 admissions, respectively.
Clinical Implication:
Use of the universal vaccination strategy would have prevented over one-half of the influenza admissions, which was over twice that of targeted vaccination. Until the challenges of implementing universal vaccination are fully understood, targeted vaccination remains an acceptable alternative.
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