Sustained Within-season Vaccine Effectiveness Against Influenza-associated Hospitalization in Children: Evidence From the New Vaccine Surveillance Network, 2015-2016 Through 2019-2020.
Sustained Within-season Vaccine Effectiveness Against Influenza-associated Hospitalization in Children: Evidence From the New Vaccine Surveillance Network, 2015-2016 Through 2019-2020.
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季节性疫苗对儿童流感相关住院治疗的持续有效性：来自 2015-2016 年至 2019-2020 年新疫苗监测网络的证据。
DOI：
10.1093/cid/ciac577
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Klein,E
中科院分区：
文献类型：
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作者：
Sahni,LeilaC;Naioti,EricA;Olson,SamanthaM;Campbell,AngelaP;Michaels,MarianG;Williams,JohnV;Staat,MaryAllen;Schlaudecker,ElizabethP;McNeal,MonicaM;Halasa,NatashaB;Stewart,LauraS;Chappell,JamesD;Englund,JanetA;Klein,E
BackgroundAdult studies have demonstrated within season decreases in influenza vaccine effectiveness（VE）; data in children are limited.MethodsWe conducted a prospective，test-negative study of children 6 months through 17 years hospitalized with acute respiratory diseases at 7 pediatric medical centers during 2015-2016 through 2019-2020 influenza seasons.病例患者是流感分子检测阳性的儿童，其发病与流感阴性对照患者相匹配。我们通过比较流感阳性儿童与流感阴性儿童在发病前≥14天接受≥1剂流感疫苗的几率来估计VE [100% ×（1 -比值比）]。VE随时间的变化之间的疫苗接种日期和发病date.ResultsOf 8430名儿童，4653（55%）接受了≥1剂流感疫苗的多变量logistic回归估计。平均而言，每个季节有48%的人在10月份接种疫苗，85%的人在12月份接种疫苗。流感疫苗接种率病例组低于对照组（39%vs57%，P <0.001）;总VE与住院率之比为53%（95%可信区间[CI]：46，60%）。汇总5个季节的数据，自接种疫苗以来，流感相关住院的几率每月增加4.2%（-3.2%，12.2%），平均VE每月下降1.9%（n = 4000，P= 0.275）。≤8岁（n = 3084）和9-17岁（n = 916）儿童的住院率每月分别增加2.9%（95% CI：-5.4%，11.8%）和9.6%（95% CI：-7.0%，29.1%）。这些研究结果没有统计学意义。ConclusionsWe观察到最小的，没有统计学意义上的季节内下降VE。按照目前的免疫实践咨询委员会（ACIP）关于疫苗接种时间的指南接种疫苗仍然是预防儿童流感相关住院的最佳策略。
BackgroundAdult studies have demonstrated within-season declines in influenza vaccine effectiveness (VE); data in children are limited.MethodsWe conducted a prospective, test-negative study of children 6 months through 17 years hospitalized with acute respiratory illness at 7 pediatric medical centers during the 2015–2016 through 2019–2020 influenza seasons. Case-patients were children with an influenza-positive molecular test matched by illness onset to influenza-negative control-patients. We estimated VE [100% × (1 – odds ratio)] by comparing the odds of receipt of ≥1 dose of influenza vaccine ≥14 days before illness onset among influenza-positive children to influenza-negative children. Changes in VE over time between vaccination date and illness onset date were estimated using multivariable logistic regression.ResultsOf 8430 children, 4653 (55%) received ≥1 dose of influenza vaccine. On average, 48% were vaccinated through October and 85% through December each season. Influenza vaccine receipt was lower in case-patients than control-patients (39% vs 57%,P< .001); overall VE against hospitalization was 53% (95% confidence interval [CI]: 46, 60%). Pooling data across 5 seasons, the odds of influenza-associated hospitalization increased 4.2% (−3.2%, 12.2%) per month since vaccination, with an average VE decrease of 1.9% per month (n = 4000,P= .275). Odds of hospitalization increased 2.9% (95% CI: −5.4%, 11.8%) and 9.6% (95% CI: −7.0%, 29.1%) per month in children ≤8 years (n = 3084) and 9–17 years (n = 916), respectively. These findings were not statistically significant.ConclusionsWe observed minimal, not statistically significant within-season declines in VE. Vaccination following current Advisory Committee on Immunization Practices (ACIP) guidelines for timing of vaccine receipt remains the best strategy for preventing influenza-associated hospitalizations in children.