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Vaccine Effectiveness Against Pediatric Influenza Hospitalizations and Emergency Visits

Angela P Campbell1, Constance Ogokeh2,3, Joana Y Lively4,5

  • 1Influenza Division and app4@cdc.gov.

Pediatrics
|October 6, 2020
PubMed

Insights

The 2018-2019 influenza vaccine demonstrated significant effectiveness in children, reducing hospitalizations and emergency department visits by 40-60%. This protection was observed despite the presence of drifted influenza A(H3N2) viruses during the season.

Area of Science:

  • Pediatric infectious diseases
  • Vaccinology
  • Public health surveillance

Background:

  • The 2018-2019 influenza season in the US was characterized by the initial predominance of influenza A(H1N1)pdm09 followed by antigenically drifted influenza A(H3N2) viruses.
  • Influenza poses a significant health burden on children, necessitating ongoing evaluation of vaccine effectiveness.

Purpose of the Study:

  • To estimate the vaccine effectiveness (VE) of the seasonal influenza vaccine against laboratory-confirmed influenza-associated hospitalizations and emergency department (ED) visits in children.
  • To assess VE specifically against circulating influenza A(H1N1)pdm09 and A(H3N2) strains.

Main Methods:

  • A test-negative design was employed, enrolling children aged 6 months to 17 years with acute respiratory illness at 7 pediatric hospitals.
  • Vaccination status was determined through multiple sources, including parental report and immunization information systems.
  • Multivariable logistic regression was used to compare vaccination odds between influenza-positive and influenza-negative children.

Main Results:

  • Among 1792 inpatients, 13% tested positive for influenza (47% A(H3N2), 36% A(H1N1)pdm09).
  • Among 1944 ED children, 22% tested positive for influenza (48% A(H3N2), 35% A(H1N1)pdm09).
  • Overall VE was 41% against hospitalizations and 51% against ED visits. VE against A(H1N1)pdm09 was 47% for hospitalizations and 61% for ED visits, while VE against A(H3N2) was 41% for hospitalizations and 39% for ED visits.

Conclusions:

  • The 2018-2019 influenza vaccine provided moderate to substantial protection against influenza A-associated hospitalizations and ED visits in children.
  • Vaccine effectiveness was notable even against the drifted influenza A(H3N2) viruses, highlighting the importance of annual vaccination.
  • Findings support the continued recommendation of seasonal influenza vaccination for pediatric populations.
Abstract

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