Abstract
England has recently started a new paediatric influenza vaccine programme using a live-attenuated influenza vaccine (LAIV). There is uncertainty over how well the vaccine protects against more severe end-points. A test-negative case-control study was used to estimate vaccine effectiveness (VE) in vaccine-eligible children aged 2-16 years of age in preventing laboratory-confirmed influenza hospitalisation in England in the 2015-2016 season using a national sentinel laboratory surveillance system. Logistic regression was used to estimate the VE with adjustment for sex, risk-group, age group, region, ethnicity, deprivation and month of sample collection. A total of 977 individuals were included in the study (348 cases and 629 controls). The overall adjusted VE for all study ages and vaccine types was 33.4% (95% confidence interval (CI) 2.3-54.6) after adjusting for age group, sex, index of multiple deprivation, ethnicity, region, sample month and risk group. Risk group was shown to be an important confounder. The adjusted VE for all influenza types for the live-attenuated vaccine was 41.9% (95% CI 7.3-63.6) and 28.8% (95% CI -31.1 to 61.3) for the inactivated vaccine. The study provides evidence of the effectiveness of influenza vaccination in preventing hospitalisation due to laboratory-confirmed influenza in children in 2015-2016 and continues to support the rollout of the LAIV childhood programme.
Highlights
In 2013, the United Kingdom (UK) started the introduction of a paediatric influenza vaccination programme following recommendations of the Joint Committee on Vaccination and Immunisation (JCVI) in 2012 [1]
This study found evidence that the live-attenuated influenza vaccine (LAIV) was effective in preventing laboratory-confirmed influenza hospitalisation in children 2–6 years of age in England in 2015–2016 [9]
Suspect cases are tested for influenza, respiratory syncytial virus, rhinovirus, parainfluenza 1–4 and human metapneumovirus using reverse transcription real-time polymerase chain reaction, and adenovirus using realtime PCR on respiratory samples by 14 laboratories located across England [10]
Summary
In 2013, the United Kingdom (UK) started the introduction of a paediatric influenza vaccination programme following recommendations of the Joint Committee on Vaccination and Immunisation (JCVI) in 2012 [1] The aim of this programme is to offer annual influenza vaccination to all children 2–11 years of age to both directly protect them, and by reducing their rate of infection, indirectly protect others in the community who may be at higher risk of severe disease following infection [1]. Once it has been extended to include all 2–11 years olds the programme will be paused and evaluated Through this programme, healthy children are offered a single dose live-attenuated influenza vaccine (LAIV) which is administered intranasally. The live-attenuated vaccine was recommended compared with the injectable, inactivated vaccine due to apparent higher effectiveness in children, potential to provide cross-protection against poorly vaccine-virus matched strains, higher acceptability amongst children, their parents and carers and possible longer-term immunological advantages [2]
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