Estimating influenza vaccine effectiveness using routine surveillance data among children aged 6–59 months for five consecutive influenza seasons

Abstract

We aimed to estimate the pooled vaccine effectiveness (VE) in children over five winters through data linkage of two existing surveillance systems. Five test-negative case-control studies were conducted from November to February during the 2004/2005 to 2008/2009 seasons. Sentinel physicians from the Viral Surveillance Network enrolled children aged 6-59 months with influenza-like illness to collect throat swabs. Through linking with a nationwide vaccination registry, we measured the VE with a logistic regression model adjusting for age, gender, and week of symptom onset. Both fixed-effects and random-effects models were used in the meta-analysis. Four thousand four hundred and ninety-four subjects were included. The proportion of influenza test-positive subjects across the five seasons was 11.5% (132/1151), 7.2% (41/572), 23.9% (189/791), 6.6% (75/1135), and 11.2% (95/845), respectively. The pooled VE was 62% (95% confidence interval (CI) 48-83%) in both meta-analysis models. By age category, VE was 51% (95% CI 23-68%) for those aged 6-23 months and 75% (95% CI 60-84%) for those aged 24-59 months. Influenza vaccination provided measurable protection against laboratory-confirmed influenza among children aged 6-59 months despite variations in the vaccine match during the 2004/2005 to 2008/2009 influenza seasons in Taiwan.