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Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010-2014
Brendan Flannery1, Sue B Reynolds2, Lenee Blanton2
1Influenza Division and bif4@cdc.gov.
Insights
Influenza vaccination significantly reduces the risk of death in children and adolescents. This study highlights that vaccinating children against influenza can prevent fatal outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Epidemiology
Background:
- Influenza-associated pediatric deaths predominantly occur in unvaccinated children.
- Surveillance data since 2004 indicates a trend of deaths in unvaccinated populations.
Purpose of the Study:
- To assess the effectiveness of influenza vaccination in reducing the risk of influenza-associated death in children and adolescents.
- To analyze vaccination uptake in pediatric deaths compared to general coverage rates.
Main Methods:
- A case-cohort analysis was conducted comparing vaccination status of pediatric influenza deaths with national vaccination coverage data.
- Logistic regression and Bayesian methods were used to calculate vaccine effectiveness (VE).
- Data from July 2010 to June 2014 included laboratory-confirmed influenza-associated pediatric deaths.
Main Results:
- Overall vaccine effectiveness (VE) against death was 65% (95% CI, 54% to 74%).
- Among 358 reported deaths, 26% of cases were vaccinated.
- VE was 51% in high-risk children and 65% in children without high-risk conditions.
Conclusions:
- Influenza vaccination is associated with a significantly reduced risk of laboratory-confirmed influenza-associated pediatric death.
- Increased influenza vaccination coverage among children and adolescents has the potential to prevent fatalities.
Background And Objectives:
Surveillance for laboratory-confirmed influenza-associated pediatric deaths since 2004 has shown that most deaths occur in unvaccinated children. We assessed whether influenza vaccination reduced the risk of influenza-associated death in children and adolescents.
Methods:
We conducted a case-cohort analysis comparing vaccination uptake among laboratory-confirmed influenza-associated pediatric deaths with estimated vaccination coverage among pediatric cohorts in the United States. Case vaccination and high-risk status were determined by case investigation. Influenza vaccination coverage estimates were obtained from national survey data or a national insurance claims database. We estimated odds ratios from logistic regression comparing odds of vaccination among cases with odds of vaccination in comparison cohorts. We used Bayesian methods to compute 95% credible intervals (CIs) for vaccine effectiveness (VE), calculated as (1 - odds ratio) × 100.
Results:
From July 2010 through June 2014, 358 laboratory-confirmed influenza-associated pediatric deaths were reported among children aged 6 months through 17 years. Vaccination status was determined for 291 deaths; 75 (26%) received vaccine before illness onset. Average vaccination coverage in survey cohorts was 48%. Overall VE against death was 65% (95% CI, 54% to 74%). Among 153 deaths in children with underlying high-risk medical conditions, 47 (31%) were vaccinated. VE among children with high-risk conditions was 51% (95% CI, 31% to 67%), compared with 65% (95% CI, 47% to 78%) among children without high-risk conditions.
Conclusions:
Influenza vaccination was associated with reduced risk of laboratory-confirmed influenza-associated pediatric death. Increasing influenza vaccination could prevent influenza-associated deaths among children and adolescents.
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