Abstract
Although widely recommended, influenza vaccination of children is part of the national vaccination programme only in few countries. In addition to Canada and the United States (US), in Europe Finland and the United Kingdom have introduced live attenuated influenza vaccine (LAIV) for healthy children in their programmes. On 22 June 2016, the US Advisory Committee on Immunizations Practices, voted against further use of LAIV due to no observed vaccine effectiveness (VE) over three consecutive influenza seasons (2013/14 to 2015/16). We summarise the results of a nationwide, register-based cohort study (N=55,258 of whom 8,086 received LAIV and 4,297 TIV); all outcome (laboratory-confirmed influenza), exposure (vaccination) and confounding variable data were retrieved from four computerised national health registers, which were linked via a unique personal identity code assigned to all permanent Finnish residents regardless of nationality. Our study provides evidence of moderate effectiveness against any laboratory-confirmed influenza of the quadrivalent LAIV vaccine (VE: 51%; 95% confidence interval (CI): 28–66%) as well as the inactivated trivalent vaccine (VE: 61%; 95% CI: 31–78%) among two-year-olds during the influenza season 2015/16 in Finland. Based on these data, Finland will continue using LAIV for young children in its National Immunisation Programme this coming influenza season.
Highlights
Influenza causes mild to severe symptoms among one in three young children
Since 2007, influenza vaccine has been given free of charge to all children aged 6 to 35 months as part of the National Vaccination Programme of Finland (NVP) [3], following a formal cost effectiveness analysis [4] requested by the National Immunization Technical Advisory Group and favourable decision by the government
For young healthy children and those above three but under nine years of age with medical risk conditions, the recommended schedule has included two doses for those vaccinated for the first time ever and one dose if they were already vaccinated during previous seasons
Summary
Influenza causes mild to severe symptoms among one in three young children. Vaccination is considered the best available intervention to prevent influenza in children and its spread from children to other age groups reducing the disease burden in the entire population [1]. Many European countries recommend to vaccinate the elderly, medical risk groups and healthcare workers but only nine countries recommend vaccination of healthy children, i.e. Austria, Estonia, Finland, Latvia, Malta, Poland, Slovakia, Slovenia, and the United Kingdom (UK) [2]. For young healthy children and those above three but under nine years of age with medical risk conditions, the recommended schedule has included two doses for those vaccinated for the first time ever and one dose if they were already vaccinated during previous seasons. Different types of influenza vaccines have been available for large scale use since early 1970s. The live attenuated influenza vaccine (LAIV) was developed already in the 1960s but it has been available for large scale use in the United States (US) since 2003 (FluMist) and in Europe since 2011 (Fluenz). Prior to season 2015/2016, in Europe, only the UK had introduced LAIV for healthy children in their programme
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