Effectiveness of the 2003-2004 influenza vaccine among children 6 months to 8 years of age, with 1 vs 2 doses
Effectiveness of the 2003-2004 influenza vaccine among children 6 months to 8 years of age, with 1 vs 2 doses
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DOI：
10.1542/peds.2005-0049
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发表时间：
2005-07-01
期刊：
影响因子：
8
通讯作者：
France, EK
中科院分区：
文献类型：
--
作者：
Ritzwoller, DP;Bridges, CB;France, EK
目标。评估1剂和2剂2003 - 2004年流感疫苗在预防6至23个月和6个月至8岁儿童接受医疗护理的流感样疾病（ILI）方面的有效性。设计和方法。使用门诊和急诊就诊记录和免疫接种记录对6个月至8岁的儿童进行回顾性队列研究。ILI和肺炎和流感（P&I）的结果是根据《国际疾病分类》第九次修订代码定义的。流感疫苗有效性（VE）计算为（1 -危险率比）× 100。共有29 726名儿童被纳入分析；6 ~ 23月龄占17.3%。到2003年11月19日流感活动高峰开始时，6个月至8岁的儿童分别有7.5%和9.9%接种了全部或部分流感疫苗。对于完全接种疫苗的6至23个月大的儿童，ILI和P&I的VE分别为25%和49%。在6至23个月大的部分接种疫苗的儿童中，没有观察到ILI或P&I率的统计学显著降低（分别为-3%和22%）。在完全接种疫苗的6个月至8岁儿童中，ILI和P&I的VE分别为23%和51%。对于部分疫苗接种，VE仅在P&I中显著（23%）。尽管流感疫苗与主要流行毒株之间的匹配不理想，但流感疫苗为完全接种疫苗的儿童提供了实质性保护，并可能为部分接种疫苗的9岁以下儿童提供了一些保护。这些发现支持即使在疫苗匹配不理想的情况下为目标儿童接种疫苗，并强调需要为以前未接种疫苗的儿童接种两剂疫苗以获得最佳保护。
Objective. To evaluate the effectiveness of 1 and 2 doses of the 2003 - 2004 influenza vaccine in preventing medically attended influenza-like illness (ILI) among children 6 to 23 months and 6 months to 8 years of age.Design and Methods. Outpatient and emergency department visits and immunization records were used to conduct a retrospective cohort study among children 6 months to 8 years of age. ILI and pneumonia and influenza (P&I) outcomes were defined on the basis of International Classification of Diseases, Ninth Revision, codes. Influenza vaccine effectiveness (VE) was calculated as (1 - hazard rate ratio) x 100.Results. A total of 29 726 children were included in the analyses; 17.3% were 6 to 23 months of age. By November 19, 2003, the start of peak influenza activity, 7.5% and 9.9% of children 6 months to 8 years were fully or partially vaccinated against influenza, respectively. For fully vaccinated children 6 to 23 months of age, VE against ILI and P&I was 25% and 49%, respectively. No statistically significant reduction in ILI or P&I rates was observed for partially vaccinated children 6 to 23 months of age (-3% and 22%, respectively). For fully vaccinated children 6 months to 8 years of age, VE against ILI and P&I was 23% and 51%, respectively. For partial vaccination, VE was significant only for P&I ( 23%).Conclusions. Despite a suboptimal match between the influenza vaccine and predominant circulating strains, influenza vaccination provided substantial protection for fully vaccinated children and possibly some protection for partially vaccinated children < 9 years of age. These findings support vaccinating targeted children even when the vaccine match is suboptimal, and they highlight the need to vaccinate previously unvaccinated children with 2 doses for optimal protection.