Abstract
The 2014/15 influenza season was the second season of roll-out of a live attenuated influenza vaccine (LAIV) programme for healthy children in England. During this season, besides offering LAIV to all two to four year olds, several areas piloted vaccination of primary (4-11 years) and secondary (11-13 years) age children. Influenza A(H3N2) circulated, with strains genetically and antigenically distinct from the 2014/15 A(H3N2) vaccine strain, followed by a drifted B strain. We assessed the overall and indirect impact of vaccinating school age children, comparing cumulative disease incidence in targeted and non-targeted age groups in vaccine pilot to non-pilot areas. Uptake levels were 56.8% and 49.8% in primary and secondary school pilot areas respectively. In primary school age pilot areas, cumulative primary care influenza-like consultation, emergency department respiratory attendance, respiratory swab positivity, hospitalisation and excess respiratory mortality were consistently lower in targeted and non-targeted age groups, though less for adults and more severe end-points, compared with non-pilot areas. There was no significant reduction for excess all-cause mortality. Little impact was seen in secondary school age pilot only areas compared with non-pilot areas. Vaccination of healthy primary school age children resulted in population-level impact despite circulation of drifted A and B influenza strains.
Highlights
The United Kingdom (UK) started the phased introduction of a universal childhood influenza vaccination programme in the 2013/14 influenza season following the recommendation of the Joint Committee on Vaccination and Immunisation (JCVI) that all healthy children aged two to less than 17 years should be offered the newly licensed live attenuated influenza vaccine (LAIV) [1]
An estimated 196,994 primary school age children received at least one dose of influenza vaccine resulting in an overall uptake of 56.8%
Pilot areas that chose to deliver the programme through school settings achieved higher uptake than those delivered through community settings, such as pharmacies
Summary
The United Kingdom (UK) started the phased introduction of a universal childhood influenza vaccination programme in the 2013/14 influenza season following the recommendation of the Joint Committee on Vaccination and Immunisation (JCVI) that all healthy children aged two to less than 17 years should be offered the newly licensed live attenuated influenza vaccine (LAIV) [1]. The decision was informed by transmission modelling using Bayesian evidence synthesis, which predicted that vaccination of healthy children would provide direct protection to the vaccinated children themselves and by reducing infection in this group, it would decrease transmission of influenza in the general population and provide indirect protection to groups at higher risk of severe disease such as the elderly and those with underlying clinical risk factors [2]. Results suggested that vaccinating primary school age children led to populationlevel reductions for a range of influenza indicators in pilot areas compared with non-pilot areas [6]. These results, were not significant, likely due to the low intensity of virus circulation in the 2013/14 influenza season and the relatively limited number of primary school age children vaccinated
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