Uptake and impact of vaccinating school age children against influenza during a season with circulation of drifted influenza A and B strains, England, 2014/15
Uptake and impact of vaccinating school age children against influenza during a season with circulation of drifted influenza A and B strains, England, 2014/15
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DOI：
10.2807/1560-7917.es.2015.20.39.30029
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发表时间：
2015-10-01
期刊：
影响因子：
19
通讯作者：
Zambon, M.
中科院分区：
文献类型：
--
作者：
Pebody, R. G.;Green, H. K.;Zambon, M.
2014/15流感季节是英格兰为健康儿童推出减毒流感活疫苗(LAIV)计划的第二个季节。在这个季节，除了向所有2至4岁的儿童提供LAIV外，几个地区还试点了初级(4-11岁)和次级(11-13岁)儿童的疫苗接种。甲型H3N2型流感流行，其毒株在基因和抗原性上与2014/15年甲型H3N2疫苗毒株不同，随后是一种漂移的B型毒株。我们评估了接种学龄儿童疫苗的总体和间接影响，比较了疫苗试点地区和非试点地区目标年龄组和非目标年龄组的累积发病率。小学和中学试点地区的吸烟率分别为56.8%和49.8%。在小学年龄试点地区，与非试点地区相比，目标和非目标年龄组的初级保健流感样咨询、急诊科呼吸系统就诊、呼吸道拭子阳性、住院治疗和过度呼吸道死亡率一直较低，尽管成年人较少，终点更严重。超额全因死亡率没有显著下降。与非试点地区相比，仅在中学适龄试点地区看到的影响很小。尽管甲型和乙型流感病毒株漂移传播，但健康的小学适龄儿童接种疫苗仍产生了人口层面的影响。
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.