Abstract
The 2015/16 influenza season was the third season of the introduction of an intra-nasally administered live attenuated influenza vaccine (LAIV) for children in England. All children aged 2‒6 years were offered LAIV, and in addition, a series of geographically discrete areas piloted vaccinating school-age children 7‒11 years old. Influenza A(H1N1)pdm09 was the dominant circulating strain during 2015/16 followed by influenza B. We measured influenza vaccine uptake and the overall and indirect effect of vaccinating children of primary school -age, by comparing cumulative disease incidence in targeted and non-targeted age groups in vaccine pilot and non-pilot areas in England. Uptake of 57.9% (range: 43.6-72.0) was achieved in the five pilot areas for children aged 5‒11 years. In pilot areas, cumulative emergency department respiratory attendances, influenza-confirmed hospitalisations and intensive care unit admissions were consistently lower, albeit mostly non-significantly, in targeted and non-targeted age groups compared with non-pilot areas. Effect sizes were less for adults and more severe endpoints. Vaccination of healthy primary school-age children with LAIV at moderately high levels continues to be associated with population-level reductions in influenza-related respiratory illness. Further work to evaluate the population-level impact of the programme is required.
Highlights
During the 2015/16 influenza season, England and the rest of the United Kingdom (UK) was in the third season of a new childhood influenza vaccination programme targeting healthy children with a recently licensed intra-nasally administered live attenuated influenza vaccine (LAIV)
Cumulative disease incidence rates per 100,000 population were calculated for the Royal College of General Practitioners (RCGP), UK Severe Influenza Surveillance System (USISS) sentinel and USISS mandatory schemes, by summing the number of weekly disease episodes over the average weekly population at risk based on the GP registered or hospital catchment population respectively
An estimated 162,013 primary school-age children in pilot areas received at least one dose of influenza vaccine resulting in an overall uptake of 57.9%
Summary
During the 2015/16 influenza season, England and the rest of the United Kingdom (UK) was in the third season of a new childhood influenza vaccination programme targeting healthy children with a recently licensed intra-nasally administered live attenuated influenza vaccine (LAIV). The programme aims to offer annual influenza vaccination to all children 2–16 years of age to both directly protect them, and, by reducing their rate of infection, indirectly protect others in the community – those who may be at higher risk of severe disease following influenza [1]. In this third season, the LAIV programme was extended from offering the vaccine to all healthy children 2–4 years of age to all children in school years 1 and 2, i.e. children 5 and 6 years of age across England. The first 2 years of the LAIV programme provided encouraging evidence, albeit often not statistically significant, showing that vaccinating children of primary school age was associated with reductions in incidence for a range of influenza disease indicators in both targeted (7,653/13,460)
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