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Assessing direct and indirect effects of pediatric influenza vaccination in Germany by individual-based simulations
Ruprecht Schmidt-Ott1, Daniel Molnar1, Anastassia Anastassopoulou2
1GSK, Wavre, Belgium.
Insights
Increasing childhood influenza vaccination significantly reduces infections in children, young adults, and the elderly. Vaccinating 60% of children could prevent over a third of all influenza cases annually in Germany.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Modeling
Background:
- Children are disproportionately affected by influenza and are key transmitters.
- Influenza vaccination in children can protect vulnerable populations like the elderly.
Purpose of the Study:
- To simulate the impact of increased pediatric influenza vaccination coverage on infection incidence in Germany.
- To quantify the reduction in influenza cases across different age groups.
Main Methods:
- Utilized the individual-based simulation tool 4Flu to model influenza transmission.
- Simulated four influenza strains in 100,000 individuals representing German demographics and contact patterns.
- Compared scenarios of increased pediatric vaccination coverage (10-60%) against a baseline over a 20-year period.
Main Results:
- Annual pediatric vaccination coverage of 10-60% prevented 6.3-50.5% of infections in children and 2.9-28.9% in the elderly.
- Overall, 34.1% of total influenza infections could be prevented with 60% pediatric vaccination coverage.
- Fewer vaccinations were needed to prevent an infection in the general population compared to solely in children.
Conclusions:
- Enhanced pediatric influenza vaccination is a highly effective strategy for reducing disease burden in children.
- Increased childhood vaccination provides substantial indirect protection to other age groups, including the elderly.
- This strategy offers a significant public health benefit for the entire population by lowering overall influenza incidence.
Abstract:
Children have a high burden of influenza and play a central role in spreading influenza. Routinely vaccinating children against influenza may, thus, not only reduce their disease burden, but also that of the general population, including the elderly who frequently suffer severe complications. Using the published individual-based tool 4Flu, we simulated how pediatric vaccination would change infection incidence in Germany. Transmission of four influenza strains was simulated in 100,000 individuals with German demography and contact structure. After initialization with the recorded trivalent influenza vaccination coverage for 20 years (1997-2016), all vaccinations were switched to quadrivalent influenza vaccine (QIV). Scenarios where vaccination coverage of children (0.5-17-year-old) was increased from the current value (4.3%) to a maximum of 10-60% were compared to baseline with unchanged coverage, averaging results of 1,000 pairs of simulations over a 20-year evaluation period (2017-2036). Pediatric vaccination coverage of 10-60% annually prevented 218-1,732 (6.3-50.5%) infections in children, 204-1,961 (2.9-28.2%) in young adults and 95-868 (3.1-28.9%) in the elderly in a population of 100,000 inhabitants; overall, 34.1% of infections in the total population (3.7 million infections per year in Germany) can be prevented if 60% of all children are vaccinated annually. 4.4-4.6 vaccinations were needed to prevent one infection among children; 1.7-1.8 were needed to prevent one in the population. Enhanced pediatric vaccination prevents many infections in children and even more in young adults and the elderly.
