Identifying pediatric age groups for influenza vaccination using a real-time regional surveillance system
Identifying pediatric age groups for influenza vaccination using a real-time regional surveillance system
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DOI：
10.1093/aje/kwi257
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发表时间：
2005-10-01
影响因子：
5
通讯作者：
Mandl, KD
中科院分区：
文献类型：
--
作者：
Brownstein, JS;Kleinman, KP;Mandl, KD
越来越多的证据表明，学童普遍接种疫苗可以减少流感的传播。作者试图确定儿科人群中最早患流感且与人群死亡率关系最密切的目标年龄组。在马萨诸塞州的六个医疗机构（包括三级医院和社区医院的门诊护理点和急诊室），使用实时症状监测系统对呼吸系统疾病患者的就诊情况进行了监测。 2000年1月1日至2004年9月30日期间的访问被分为不同年龄组的亚人群。通过时间序列分析和回归模型，根据新英格兰的肺炎和流感死亡率来衡量每个亚群的及时性和预测。研究结果表明，患者年龄显着影响及时性 (p = 0.026)，其中儿科年龄组首先到达 (p < 0.001)； 3-4 岁的儿童始终是最早的（p = 0.0058）。年龄也会影响死亡率的预测程度 (p = 0.036)，与所有其他患者相比，5 岁以下儿童的疾病与死亡率的相关性最强 (p < 0.001)。研究结果为目前目标年龄（6-23 个月）以上儿童接种疫苗的策略提供了越来越多的支持，并特别表明为学龄前儿童接种疫苗可能有价值。
Evidence is accumulating that universal vaccination of schoolchildren would reduce the transmission of influenza. The authors sought to identify target age groups within the pediatric population that develop influenza the earliest and are most strongly linked with mortality in the population. Patient visits for respiratory illness were monitored, using real-time syndromic surveillance systems, in six Massachusetts health-care settings, including ambulatory care sites and emergency departments at tertiary-care and community hospitals. Visits from January 1, 2000, to September 30, 2004, were segmented into age group subpopulations. Timeliness and prediction of each subpopulation were measured against pneumonia and influenza mortality in New England with time-series analyses and regression models. Study results show that patient age significantly influences timeliness (p = 0.026), with pediatric age groups arriving first (p < 0.001); children aged 3-4 years are consistently the earliest (p = 0.0058). Age also influences the degree of prediction of mortality (p = 0.036), with illness among children under age 5 years, compared with all other patients, most strongly associated with mortality (p < 0.001). Study findings add to a growing body of support for a strategy to vaccinate children older than the currently targeted age of 6-23 months and specifically suggest that there may be value in vaccinating preschool-age children.