Abstract
The United Kingdom (UK) is in the third season of introducing universal paediatric influenza vaccination with a quadrivalent live attenuated influenza vaccine (LAIV). The 2015/16 season in the UK was initially dominated by influenza A(H1N1)pdm09 and then influenza of B/Victoria lineage, not contained in that season’s adult trivalent inactivated influenza vaccine (IIV). Overall adjusted end-of-season vaccine effectiveness (VE) was 52.4% (95% confidence interval (CI): 41.0–61.6) against influenza-confirmed primary care consultation, 54.5% (95% CI: 41.6–64.5) against influenza A(H1N1)pdm09 and 54.2% (95% CI: 33.1–68.6) against influenza B. In 2–17 year-olds, adjusted VE for LAIV was 57.6% (95% CI: 25.1 to 76.0) against any influenza, 81.4% (95% CI: 39.6–94.3) against influenza B and 41.5% (95% CI: −8.5 to 68.5) against influenza A(H1N1)pdm09. These estimates demonstrate moderate to good levels of protection, particularly against influenza B in children, but relatively less against influenza A(H1N1)pdm09. Despite lineage mismatch in the trivalent IIV, adults younger than 65 years were still protected against influenza B. These results provide reassurance for the UK to continue its influenza immunisation programme planned for 2016/17.
Highlights
The United Kingdom (UK) has had a long-standing selective inactivated influenza vaccination programme targeted at individuals at higher risk of severe disease such as the elderly, those with an underlying clinical risk condition and pregnant women
The study population were patients presenting to their general practitioner (GP) during the study period with an acute influenza-like illness (ILI), who the physician consented verbally to be swabbed during the consultation
Post-infection ferret antisera were used in haemagglutination inhibition (HI) assays with turkey red blood cells to antigenically characterise influenza A(H1N1)pdm09 and influenza B virus isolates with a haemagglutination titre ≥ 40 [12]
Summary
The United Kingdom (UK) has had a long-standing selective inactivated influenza vaccination programme targeted at individuals at higher risk of severe disease such as the elderly, those with an underlying clinical risk condition and pregnant women. Children aged two to 17 years in a clinical risk group were offered LAIV, while children with a risk factor, in whom LAIV is contraindicated, were offered quadrivalent inactivated influenza vaccine (IIV). The United States Centers for Disease Control and Prevention (US CDC) recently reported the observation that LAIV did not provide protection in children against circulating influenza strains in North America in the 2015/16 season [3]. This raised a question about the effectiveness of LAIV in children in the UK
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