1
|
Orrico-Sánchez A, Valls-Arévalo Á, Garcés-Sánchez M, Álvarez Aldeán J, Ortiz de Lejarazu Leonardo R. Efficacy and effectiveness of influenza vaccination in healthy children. A review of current evidence. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:396-406. [PMID: 36681572 DOI: 10.1016/j.eimce.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/08/2022] [Indexed: 01/21/2023]
Abstract
Influenza is common in healthy children and adolescents and is associated with a high rate of hospitalization in this group, especially for those <5 years. Although the WHO has recommended vaccination in children under 5 years of age since 2012, it is really implemented in few countries today. The aim of this paper was to review the available evidence on the efficacy/effectiveness of influenza vaccination in healthy children <18 years of age through a non-systematic search of studies conducted between 2010 and 2020. Despite the high variability in results due to differences in design, vaccine type and season included in the 41 selected studies, statistically significant studies show efficacy values for the influenza vaccine of between 25.6% and 74.2%, and effectiveness from 26% to 78.8%. Although a systematic review would be necessary to corroborate the evidence, this review suggests that paediatric vaccination is generally an effective measure for preventing influenza in healthy children in line with international organisms' recommendations.
Collapse
Affiliation(s)
- Alejandro Orrico-Sánchez
- Área de Investigación en vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO) - Salud Pública, Valencia, Spain
| | | | | | | | | |
Collapse
|
2
|
Shinjoh M, Furuichi M, Kobayashi H, Yamaguchi Y, Maeda N, Yaginuma M, Kobayashi K, Nogayama T, Chiga M, Oshima M, Kuramochi Y, Yamada G, Narabayashi A, Ookawara I, Nishida M, Tsunematsu K, Kamimaki I, Shimoyamada M, Yoshida M, Shibata A, Nakata Y, Taguchi N, Mitamura K, Takahashi T. Trends in effectiveness of inactivated influenza vaccine in children by age groups in seven seasons immediately before the COVID-19 era. Vaccine 2022; 40:3018-3026. [PMID: 35450780 PMCID: PMC8995322 DOI: 10.1016/j.vaccine.2022.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND We have reported the vaccine effectiveness of inactivated influenza vaccine in children aged 6 months to 15 years between the 2013/14 and 2018/19 seasons. Younger (6-11 months) and older (6-15 years old) children tended to have lower vaccine effectiveness. The purpose of this study is to investigate whether the recent vaccine can be recommended to all age groups. METHODS The overall adjusted vaccine effectiveness was assessed from the 2013/14 until the 2020/21 season using a test-negative case-control design based on rapid influenza diagnostic test results. Vaccine effectiveness was calculated by influenza type and by age group (6-11 months, 1-2, 3-5, 6-12, and 13-15 years old) with adjustments including influenza seasons. RESULTS A total of 29,400 children (9347, 4435, and 15,618 for influenza A and B, and test-negatives, respectively) were enrolled. The overall vaccine effectiveness against influenza A, A(H1N1)pdm09, and B was significant (44% [95% confidence interval (CI), 41-47], 63% [95 %CI, 51-72], and 37% [95 %CI, 32-42], respectively). The vaccine was significantly effective against influenza A and B, except among children 6 to 11 months against influenza B. The age group with the highest vaccine effectiveness was 1 to 2 years old with both influenza A and B (60% [95 %CI, 55-65] and 52% [95 %CI, 41-61], respectively). Analysis for the 2020/21 season was not performed because no cases were reported. CONCLUSIONS This is the first report showing influenza vaccine effectiveness by age group in children for several seasons, including immediately before the coronavirus disease (COVID-19) era. The fact that significant vaccine effectiveness was observed in nearly every age group and every season shows that the recent vaccine can still be recommended to children for the upcoming influenza seasons, during and after the COVID-19 era.
Collapse
Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Hisato Kobayashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, Department of Infection and Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomaturi, Utsunomiya-City, Tochigi 320-8580, Japan.
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Ken Kobayashi
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama 221-0855, Kanagawa, Japan.
| | - Taisuke Nogayama
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Michiko Chiga
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Mio Oshima
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Yuu Kuramochi
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Ohshimacho, Ota City, Gunma 273-8585, Japan.
| | - Go Yamada
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan; Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, 8-2 Outemachi, Aoi-ku, Shizuoka 420-0853, Japan.
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka-shi, Shizuoka 424-8636, Japan.
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0061, Japan.
| | - Isamu Kamimaki
- Department of Pediatrics, National Hospital Organization, Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan.
| | - Motoko Shimoyamada
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-0911, Japan.
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-chou, Sano-city, Tochigi 327-8511, Japan.
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843, Japan.
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1Koukan-Dori, Kawasaki, Kanagawa 210-0852, Japan.
| | - Nobuhiko Taguchi
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8581, Japan.
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| |
Collapse
|
3
|
Efficacy and effectiveness of influenza vaccination in healthy children. A review of current evidence. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
4
|
Lv H, Pan X, Liang H, Wang Y, Hu Y. Analysis of the adverse events following immunization with inactivated quadrivalent influenza vaccine from 2018 to 2020 in Zhejiang province, with a comparison to trivalent influenza vaccine. Hum Vaccin Immunother 2021; 17:4617-4622. [PMID: 34491888 DOI: 10.1080/21645515.2021.1964310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To summarize reports to the national adverse event following immunization surveillance system (NAEFISS) following inactivated quadrivalent influenza vaccine (QIV) in Zhejiang province from 2018 to 2020. METHODS We analyzed adverse events following immunization (AEFI) reports following QIV, with a comparison, with the AEFI reports following inactivated trivalent influenza vaccine (TIV). Reporting rates of AEFI were calculated by age, severity of AEFI, categories of AEFI, and reaction categories. The data mining algorithm used in this study was reporting odds ratio (ROR). A value of ROR‑1.96SE >1 (standard error [SE]) was considered as positive signal. These reporting rates between vaccine types were compared through chi-square tests. RESULTS NAEFISS received 514 AEFI reports following QIV and 536 reports following TIV, with a reporting rate of 13.66/100,000 100,000 doses/100,000 doses (χ2 = 7.11, P> .05). Of the 514 reports following QIV, 410 were vaccine product-related reactions and 51 were severe AEFI. Fever/redness/induration was the most frequent clinical diagnosis of the QIV AEFI, with a reporting rate of 12.42/100,000 doses in the age group of 3-17 years, and 12.44/100,000 doses in the age group of ≥18 years. The positive signal of QIV AEFI was observed for the allergic rash and asthma/wheezing. CONCLUSION The present analysis did not identify any new/unexpected safety concerns. We suggested that NAEFISS continue to monitor the safety of QIV.
Collapse
Affiliation(s)
- Huakun Lv
- Institute Of Immunization And Prevention, Zhejiang Center For Disease Control And Prevention, Hangzhou, Zhejiang, China
| | - Xuejiao Pan
- Institute Of Immunization And Prevention, Zhejiang Center For Disease Control And Prevention, Hangzhou, Zhejiang, China
| | - Hui Liang
- Institute Of Immunization And Prevention, Zhejiang Center For Disease Control And Prevention, Hangzhou, Zhejiang, China
| | - Ying Wang
- Institute Of Immunization And Prevention, Zhejiang Center For Disease Control And Prevention, Hangzhou, Zhejiang, China
| | - Yu Hu
- Institute Of Immunization And Prevention, Zhejiang Center For Disease Control And Prevention, Hangzhou, Zhejiang, China
| |
Collapse
|
5
|
BOCCALINI SARA, PARIANI ELENA, CALABRÒ GIOVANNAELISA, DE WAURE CHIARA, PANATTO DONATELLA, AMICIZIA DANIELA, LAI PIEROLUIGI, RIZZO CATERINA, AMODIO EMANUELE, VITALE FRANCESCO, CASUCCIO ALESSANDRA, DI PIETRO MARIALUISA, GALLI CRISTINA, BUBBA LAURA, PELLEGRINELLI LAURA, VILLANI LEONARDO, D’AMBROSIO FLORIANA, CAMINITI MARTA, LORENZINI ELISA, FIORETTI PAOLA, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, CANTOVA ELISA, PARENTE FLAVIO, TRENTO GIACOMO, SOTTILE SARA, PUGLIESE ANDREA, BIAMONTE MASSIMILIANOALBERTO, GIORGETTI DUCCIO, MENICACCI MARCO, D’ANNA ANTONIO, AMMOSCATO CLAUDIA, LA GATTA EMANUELE, BECHINI ANGELA, BONANNI PAOLO. [Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra ®]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E118. [PMID: 34909481 PMCID: PMC8639053 DOI: 10.15167/2421-4248/jpmh2021.62.2s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - ELENA PARIANI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
| | - GIOVANNA ELISA CALABRÒ
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), spin off dell’Università Cattolica del Sacro Cuore, Roma, Italia
| | - CHIARA DE WAURE
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - DONATELLA PANATTO
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - DANIELA AMICIZIA
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - PIERO LUIGI LAI
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - CATERINA RIZZO
- Area Funzionale Percorsi Clinici ed Epidemiologia, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italia
| | - EMANUELE AMODIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - FRANCESCO VITALE
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - ALESSANDRA CASUCCIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - MARIA LUISA DI PIETRO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - CRISTINA GALLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA BUBBA
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA PELLEGRINELLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LEONARDO VILLANI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - FLORIANA D’AMBROSIO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - MARTA CAMINITI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - ELISA LORENZINI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - PAOLA FIORETTI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - ELISA CANTOVA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - FLAVIO PARENTE
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - GIACOMO TRENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - SARA SOTTILE
- Università degli Studi di Trento, Trento, Italia
| | | | | | - DUCCIO GIORGETTI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - MARCO MENICACCI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - ANTONIO D’ANNA
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - CLAUDIA AMMOSCATO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - EMANUELE LA GATTA
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| |
Collapse
|
6
|
Huh K, Jung J, Hong J, Kim M, Ahn JG, Kim JH, Kang JM. Impact of Nonpharmaceutical Interventions on the Incidence of Respiratory Infections During the Coronavirus Disease 2019 (COVID-19) Outbreak in Korea: A Nationwide Surveillance Study. Clin Infect Dis 2021; 72:e184-e191. [PMID: 33150393 PMCID: PMC7665442 DOI: 10.1093/cid/ciaa1682] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/28/2020] [Indexed: 12/22/2022] Open
Abstract
Background Many countries have implemented non-pharmaceutical interventions (NPIs) to slow the spread of coronavirus disease 2019 (COVID-19). We aimed to determine whether NPIs led to the decline in the incidences of respiratory infections. Methods We conducted a retrospective, ecological study using a nationwide notifiable diseases database and a respiratory virus sample surveillance collected from January 2016 through July 2020 in the Republic of Korea. Intervention period was defined as February–July 2020, when the government implemented NPIs nationwide. Observed incidences in the intervention period were compared to the predicted incidences by autoregressive integrated moving average model and the 4-year mean cumulative incidences (CuIs) in the same months of the pre-intervention period. Results Five infectious diseases met the inclusion criteria: chickenpox, mumps, invasive pneumococcal disease, scarlet fever, and pertussis. The incidences of chickenpox and mumps during the intervention period were significantly lower than the prediction model. The CuIs of chickenpox and mumps were 36.4% (95% CI, 23.9–76.3) and 63.4% (95% CI, 48.0–93.3) of the predicted values. Subgroup analysis showed that the decrease in the incidence was universal for chickenpox, while mumps showed a marginal reduction among those aged <18 years, but not in adults. The incidence of respiratory viruses was significantly lower than both the predicted incidence (19.5%; 95% CI, 11.8–55.4%) and the 4-year mean CuIs in the pre-intervention period (24.5%; P<0.001). Conclusions The implementation of NPIs was associated with a significant reduction in the incidences of several respiratory infections in Korea.
Collapse
Affiliation(s)
- Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jinwook Hong
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - MinYoung Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Gyun Ahn
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Gyeonggi-do, Korea
| | - Ji-Man Kang
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.,Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Kawahara Y, Nishiura H. Exploring Influenza Vaccine Uptake and Its Determinants among University Students: A Cross-Sectional Study. Vaccines (Basel) 2020; 8:vaccines8010052. [PMID: 32013015 PMCID: PMC7158679 DOI: 10.3390/vaccines8010052] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/25/2022] Open
Abstract
While vaccination is the only established option to prevent a susceptible host from influenza, we have yet to clarify the decision-making mechanisms of vaccine uptake among Japanese university and college students. We aimed to explore vaccination coverage and the related demographic, sociocultural, and socioeconomic factors among university students. We performed a cross-sectional survey involving 604 students at Hokkaido University. Participants were asked if they received influenza vaccination in advance of the 2018/19 season, and subsequently, their demographic and sociocultural/socioeconomic characteristics were surveyed. We also explored the mechanisms underlying students’ vaccination decisions. Vaccination coverage was estimated at 27.3% (95% confidence interval: 23.7–30.9). Freshmen (p < 0.0001) were significantly associated with choosing vaccination, and their odds ratio of vaccination was 11.3 (95% confidence interval: 6.2–20.7) times greater than students in other years. Among students other than freshmen, students belonging to medicine- and healthcare-related faculties were vaccinated three times more frequently than other students, and the coverage in students from Hokkaido was twice as large as that for students from other prefectures. Moreover, extracurricular activity was a positive predictor of vaccination. Although the coverage was as small as 27.3% among university students, freshmen in Japan have high vaccination coverage, which we believe is associated with the entrance examination during high influenza activity. In addition to exposing students to proper education regarding their risk self-assessment, consciousness raising via appropriate understanding of influenza and its severity and offering vaccination at university health centers at a reasonable cost may promote vaccine acceptance.
Collapse
Affiliation(s)
- Yukako Kawahara
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan;
- Hokkaido University Health Center, Kita 16 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-0816, Japan
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan;
- Correspondence: ; Tel.: +81-11-706-5066
| |
Collapse
|
8
|
Kimiya T, Shinjoh M, Anzo M, Takahashi H, Sekiguchi S, Sugaya N, Takahashi T. Effectiveness of inactivated quadrivalent influenza vaccine in the 2015/2016 season as assessed in both a test-negative case-control study design and a traditional case-control study design. Eur J Pediatr 2018; 177:1009-1017. [PMID: 29680993 DOI: 10.1007/s00431-018-3145-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/09/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
Abstract
UNLABELLED Both traditional case-control studies (TCCSs) and test-negative case-control studies (TNCCSs) are commonly used to assess influenza vaccine effectiveness (VE). To compensate for the fact that observational studies are susceptible to bias, we combined both methods to assess VE in one geographical area during the 2015/2016 season, when influenza A (H1N1)pdm was dominant. Our TNCCS covered 331 children aged 6 months to 15 years who visited our hospital with fever, including 182 with influenza, and our TCCS covered 812 pediatric outpatients aged 6 months to 15 years, including 214 with influenza. Influenza infection and vaccination history were reviewed, and VE was calculated as (1 - odds ratio) × 100. In the TNCCS, VE against influenza A was 68% (95% CI 47-81) overall, and 70% (48-83) for those given two doses; against influenza B, VE was 37% (- 12-64) overall and 49% (2-74) for two doses. In the TCCS, VE against influenza A was 44% (15-63) overall and 44% (13-64) for two doses, and VE against influenza B was 24% (- 19-52) overall and 41% (3-64) for two doses. CONCLUSION Both studies confirmed significant VE against influenza A, significant two-dose VE against influenza B, and better two-dose VE than one-dose VE. What is Known: • Influenza vaccine effectiveness (VE) varies from year to year. • Observational studies are conventionally used for VE assessment. However, they are inherently susceptible to bias and confounding. What is New: • This is the first report of influenza VE assessment using more than one observational study and performed in a specific area during the same season. • VE estimates obtained in our traditional case-control study were lower than those in our test-negative case-control study, but both studies found significant VE against influenza.
Collapse
Affiliation(s)
- Takahisa Kimiya
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan.
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Makoto Anzo
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan
| | - Hiroki Takahashi
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan
| | - Shinichiro Sekiguchi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|
9
|
Perceived concern about the new strain of the influenza and obtaining the vaccine in China, Japan and South Korea. J Infect Public Health 2017; 10:251-257. [DOI: 10.1016/j.jiph.2016.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/21/2016] [Accepted: 06/24/2016] [Indexed: 11/24/2022] Open
|
10
|
Vaccine strategies: Optimising outcomes. Vaccine 2016; 34:6691-6699. [PMID: 27887796 DOI: 10.1016/j.vaccine.2016.10.078] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/12/2016] [Accepted: 10/31/2016] [Indexed: 11/22/2022]
Abstract
Successful immunisation programmes generally result from high vaccine effectiveness and adequate uptake of vaccines. In the development of new vaccination strategies, the structure and strength of the local healthcare system is a key consideration. In high income countries, existing infrastructures are usually used, while in less developed countries, the capacity for introducing new vaccines may need to be strengthened, particularly for vaccines administered beyond early childhood, such as the measles or human papillomavirus (HPV) vaccine. Reliable immunisation service funding is another important factor and low income countries often need external supplementary sources of finance. Many regions also obtain support in generating an evidence base for vaccination via initiatives created by organisations including World Health Organization (WHO), the Pan American Health Organization (PAHO), the Agence de Médecine Préventive and the Sabin Vaccine Institute. Strong monitoring and surveillance mechanisms are also required. An example is the efficient and low-cost approaches for measuring the impact of the hepatitis B control initiative and evaluating achievement of goals that have been established in the WHO Western Pacific region. A review of implementation strategies reveals differing degrees of success. For example, in the Americas, PAHO advanced a measles-mumps-rubella vaccine strategy, targeting different population groups in mass, catch-up and follow-up vaccination campaigns. This has had much success but coverage data from some parts of the region suggest that children are still not receiving all appropriate vaccines, highlighting problems with local service infrastructures. Stark differences in coverage levels are also observed among high income countries, as is the case with HPV vaccine implementation in the USA versus the UK and Australia, reflecting differences in delivery settings. Experience and research have shown which vaccine strategies work well and the factors that encourage success, which often include strong support from government and healthcare organisations, as well as tailored, culturally-appropriate local approaches to optimise outcomes.
Collapse
|
11
|
Matsuoka T, Sato T, Akita T, Yanagida J, Ohge H, Kuwabara M, Tanaka J. High Vaccination Coverage among Children during Influenza A(H1N1)pdm09 as a Potential Factor of Herd Immunity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13101017. [PMID: 27763532 PMCID: PMC5086756 DOI: 10.3390/ijerph13101017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/24/2022]
Abstract
The objective of this study was to identify factors related to the expansion of infection and prevention of influenza A(H1N1)pdm09. A retrospective non-randomized cohort study (from June 2009 to May 2010) on influenza A(H1N1)pdm09 was conducted in a sample of residents from Hiroshima Prefecture, Japan. The cumulative incidence of the influenza A(H1N1)pdm09 and the pandemic vaccine effectiveness (VE) were estimated. The response rate was 53.5% (178,669/333,892). Overall, the odds ratio of non-vaccinated group to vaccinated group for cumulative incidence of influenza A(H1N1)pdm09 was 2.18 (95% confidence interval (CI): 2.13–2.23) and the VE was 43.9% (CI: 42.8–44.9). The expansion of infection, indicating the power of transmission from infected person to susceptible person, was high in the 7–15 years age groups in each area. In conclusion, results from this survey suggested that schoolchildren-based vaccination rate participates in determining the level of herd immunity to influenza and children might be the drivers of influenza transmission. For future pandemic preparedness, vaccination of schoolchildren may help to prevent disease transmission during influenza outbreak.
Collapse
Affiliation(s)
- Toshihiko Matsuoka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
| | - Tomoki Sato
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
| | - Jiturou Yanagida
- Hiroshima City Funairi Citizens Hospital, Hiroshima 730-0844, Japan.
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima 734-8551, Japan.
| | - Masao Kuwabara
- Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima 734-0007, Japan.
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
| |
Collapse
|
12
|
Panapasa JA, Cox RJ, Mohn KGI, Aqrawi LA, Brokstad KA. The expression of B & T cell activation markers in children's tonsils following live attenuated influenza vaccine. Hum Vaccin Immunother 2016; 11:1663-72. [PMID: 26148331 PMCID: PMC4514187 DOI: 10.1080/21645515.2015.1032486] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Live attenuated influenza vaccines (LAIV) can prevent influenza illness and death in children. The absence of known correlates of protection induced by LAIV requires human studies of underlying mechanisms of vaccine-induced immunity, to further elucidate the immunological processes occurring. In this study, children scheduled for elective tonsillectomy were enrolled in a clinical trial to evaluate the immune response to LAIV, in order to compare T and B cell gene expression profiles. Twenty-three children (aged 3-17 years) were divided into 4 groups; unvaccinated controls, or vaccinated intranasally with LAIV at days 3-4, 6-7, and 12-15 before tonsillectomy. Total RNA extraction was performed on tonsillar tissue and high RNA quality was assured. The samples were then analyzed using a validated RT2 Profiler PCR Array containing 84 gene-specific primers involved in B and T cell activation, proliferation, differentiation, regulation and polarization. The gene expression after LAIV vaccination was subsequently compared to the controls. We observed that at d 3-4 post vaccination, 6 genes were down-regulated, namely APC, CD3G, FASLG, IL7, CD8A and TLR1. Meanwhile at 6-7 days post vaccination, 9 genes were significantly up-regulated, including RIPK2, TGFB1, MICB, SOCS1, IL2RA, MS4A1, PTPRC, IL2 and IL8. By days 12-15 the genes RIPK2, IL4, IL12B and TLR2 were overexpressed. RIPK2 was upregulated at all 3 time points. Our data suggests an overall proliferation, differentiation and regulation of B and T cells in the tonsils following LAIV, where the majority of genes were up-regulated at days 6-7 and normalized by days 12-15. These findings may provide a first step into defining future biomarkers or correlates of protection after LAIV immunization.
Collapse
Affiliation(s)
- Jack A Panapasa
- a Broegelmann Research Laboratory; Department of Clinical Sciences; University of Bergen ; Bergen , Norway
| | | | | | | | | |
Collapse
|
13
|
Shinjoh M, Sugaya N, Yamaguchi Y, Tomidokoro Y, Sekiguchi S, Mitamura K, Fujino M, Shiro H, Komiyama O, Taguchi N, Nakata Y, Yoshida N, Narabayashi A, Myokai M, Sato M, Furuichi M, Baba H, Fujita H, Sato A, Ookawara I, Tsunematsu K, Yoshida M, Kono M, Tanaka F, Kawakami C, Kimiya T, Takahashi T, Iwata S. Effectiveness of Trivalent Inactivated Influenza Vaccine in Children Estimated by a Test-Negative Case-Control Design Study Based on Influenza Rapid Diagnostic Test Results. PLoS One 2015; 10:e0136539. [PMID: 26317334 PMCID: PMC4552891 DOI: 10.1371/journal.pone.0136539] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 08/05/2015] [Indexed: 01/20/2023] Open
Abstract
We assessed vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza in children 6 months to 15 years of age in 22 hospitals in Japan during the 2013-14 season. Our study was conducted according to a test-negative case-control design based on influenza rapid diagnostic test (IRDT) results. Outpatients who came to our clinics with a fever of 38 °C or over and had undergone an IRDT were enrolled in this study. Patients with positive IRDT results were recorded as cases, and patients with negative results were recorded as controls. Between November 2013 and March 2014, a total of 4727 pediatric patients (6 months to 15 years of age) were enrolled: 876 were positive for influenza A, 66 for A(H1N1)pdm09 and in the other 810 the subtype was unknown; 1405 were positive for influenza B; and 2445 were negative for influenza. Overall VE was 46% (95% confidence interval [CI], 39-52). Adjusted VE against influenza A, influenza A(H1N1)pdm09, and influenza B was 63% (95% CI, 56-69), 77% (95% CI, 59-87), and 26% (95% CI, 14-36), respectively. Influenza vaccine was not effective against either influenza A or influenza B in infants 6 to 11 months of age. Two doses of influenza vaccine provided better protection against influenza A infection than a single dose did. VE against hospitalization influenza A infection was 76%. Influenza vaccine was effective against influenza A, especially against influenza A(H1N1)pdm09, but was much less effective against influenza B.
Collapse
Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Norio Sugaya
- Department of Paediatrics, Keiyu Hospital, Yokohama, Kanagawa, Japan
| | - Yoshio Yamaguchi
- Department of Clinical Research, National Hospital Organization, Utsunomiya, Tochigi Medical Center, Tochigi, Japan
| | - Yuka Tomidokoro
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, Toshima-ku, Tokyo, Japan
| | - Shinichiro Sekiguchi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, Taito-ku, Tokyo, Japan
| | - Motoko Fujino
- Department of Pediatrics, Saiseikai Central Hospital, Minato-ku, Tokyo, Japan
| | - Hiroyuki Shiro
- Department of Pediatrics, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Osamu Komiyama
- Department of Pediatrics, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Nobuhiko Taguchi
- Department of Paediatrics, Keiyu Hospital, Yokohama, Kanagawa, Japan
| | - Yuji Nakata
- Department of Pediatrics, Nippon Kokan Hospital, Kawasaki, Kanagawa, Japan
| | - Naoko Yoshida
- Department of Pediatrics, Kyosai Tachikawa Hospital, Tachikawa, Tokyo, Japan
| | - Atsushi Narabayashi
- Department of Paediatrics, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Michiko Myokai
- Department of Pediatrics, Shizuoka City Shimizu Hospital, Shizuoka, Shizuoka, Japan
| | - Masanori Sato
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan
| | - Munehiro Furuichi
- Department of Pediatrics, Saitama City Hospital, Saitama, Saitama, Japan
| | - Hiroaki Baba
- Department of Pediatrics, Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital, Ota, Gunma, Japan
| | - Hisayo Fujita
- Department of Pediatrics, Hiratsuka Kyosai Hospital, Hiratsuka, Kanagawa, Japan
| | - Akihiro Sato
- Department of Pediatrics, Yokohama Municipal Citizen's hospital, Yokohama, Kanagawa, Japan
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, Shizuoka, Shizuoka, Japan
| | | | - Makoto Yoshida
- Department of Pediatrics, Sano Kousei General Hospital, Sano, Tochigi, Japan
| | - Mio Kono
- Department of Pediatrics, National Hospital Organization Saitama National Hospital, Wako, Saitama, Japan
| | - Fumie Tanaka
- Department of Pediatrics, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan
| | | | - Takahisa Kimiya
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, Toshima-ku, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Satoshi Iwata
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Infectious Diseases, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | | |
Collapse
|
14
|
Factors associated with seasonal influenza vaccine uptake among children in Japan. BMC Infect Dis 2015; 15:72. [PMID: 25886607 PMCID: PMC4335773 DOI: 10.1186/s12879-015-0821-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/10/2015] [Indexed: 11/25/2022] Open
Abstract
Background Seasonal influenza vaccine was once part of the routine immunization schedule that is routinely offered to all children in Japan, but it is now excluded from the schedule. This study aimed to investigate factors influential to parents’ decision to have their children receive seasonal influenza vaccine, as well as types of seasonal influenza vaccine information that is given to parents. Methods We conducted a cross-sectional online survey of 555 participants who have at least one child younger than 13 years of age. Respondents were asked to categorize the history of influenza vaccination of their youngest child as either ‘annual’ , ‘sometimes’ , or ‘never’. Participants were also asked about potentially influential factors in their decision to have their children receive a seasonal influenza vaccine. Results A total of 75% of respondents answered that their youngest child had received a seasonal influenza vaccine, and 57% of respondents answered that their child receives the vaccine every year. The higher income group was more likely than the lowest income group to have a history of influenza vaccine uptake. A recommendation from a pediatrician or school/nursery to have their child vaccinated was also positively associated with a history of influenza vaccine uptake. The most common reason for a pediatrician’s recommendation was ‘it leads to milder symptoms if infected’. Conclusions The main finding of the study is a significant association between household income and influenza vaccination of the youngest child in the household. We also found that cost could be a barrier to vaccinating children in low income households and that information from pediatricians and schools/nurseries could motivate parents to have their children vaccinated.
Collapse
|
15
|
Sugaya N. A review of the indirect protection of younger children and the elderly through a mass influenza vaccination program in Japan. Expert Rev Vaccines 2014; 13:1563-70. [PMID: 25138431 DOI: 10.1586/14760584.2014.951036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the past, Japan's strategy for controlling influenza was to vaccinate schoolchildren based on the theory that this could reduce influenza epidemics in the community, and a special program to vaccinate schoolchildren against influenza was begun in 1962. However, the program was discontinued in 1994 because of lack of evidence that it had limited the spread of influenza in the community. In 2001, it was reported that a clear decrease in excess mortality had coincided with the timing of the schoolchild vaccination program. This decrease could have potentially occurred because elderly people were protected by herd immunity generated by the program. Moreover, the program protected the younger siblings of schoolchildren against influenza-associated encephalopathy. Finally, the program was effective in reducing the number of class cancellations and absenteeism from school. During the period when the program was in effect, Japanese schoolchildren served as a barrier against influenza in the community.
Collapse
Affiliation(s)
- Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, Yokohama, Japan
| |
Collapse
|
16
|
Shono A, Kondo M. Parents' preferences for seasonal influenza vaccine for their children in Japan. Vaccine 2014; 32:5071-6. [PMID: 25063570 DOI: 10.1016/j.vaccine.2014.07.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 06/06/2014] [Accepted: 07/08/2014] [Indexed: 11/18/2022]
Abstract
In Japan, trivalent inactivated influenza vaccine is the only approved influenza vaccine. It is typically administrated by hypodermic injection, and children under 13 years of age are recommended to be vaccinated two times during each winter season. Live-attenuated influenza vaccine (LAIV) is administered by a thimerosal-free nasal spray. If LAIV is approved in the future in Japan, parents will have an alternative type of influenza vaccine for their children. This study investigated parents' preference for the type of seasonal influenza vaccine for their children if alternatives are available. The marginal willingness to pay for vaccine benefits was also evaluated. We conducted a discrete choice experiment, a quantitative approach that is often used in healthcare studies, in January 2013. Respondents were recruited from a registered online survey panel, and parents with at least one child under 13 years of age were offered questionnaires. This study showed that for seasonal influenza vaccines for their children, parents are more likely to value safety, including thimerosal-free vaccines and those with a lower risk of adverse events, instead of avoiding the momentary pain from an injection. If LAIV is released in Japan, the fact that it is thimerosal-free could be an advantage. However, for parents to choose LAIV, they would need to accept the slightly higher risk of minor adverse events from LAIV.
Collapse
Affiliation(s)
- Aiko Shono
- Department of Public Health and Epidemiology, Faculty of Pharmaceutical Sciences, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan.
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058577, Japan.
| |
Collapse
|
17
|
A review of the evidence to support influenza vaccine introduction in countries and areas of WHO's Western Pacific Region. PLoS One 2013; 8:e70003. [PMID: 23875015 PMCID: PMC3713047 DOI: 10.1371/journal.pone.0070003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 06/17/2013] [Indexed: 11/24/2022] Open
Abstract
Background Immunization against influenza is considered an essential public health intervention to control both seasonal epidemics and pandemic influenza. According to the World Health Organization (WHO), there are five key policy and three key programmatic issues that decision-makers should consider before introducing a vaccine. These are (a) public health priority, (b) disease burden, (c) efficacy, quality and safety of the vaccine, (d) other inventions, (e) economic and financial issues, (f) vaccine presentation, (g) supply availability and (h) programmatic strength. We analyzed the body of evidence currently available on these eight issues in the WHO Western Pacific Region. Methodology/Principal Findings Studies indexed in PubMed and published in English between 1 January 2000 and 31 December 2010 from the 37 countries and areas of the Western Pacific Region were screened for keywords pertaining to the five policy and three programmatic issues. Studies were grouped according to country income level and vaccine target group. There were 133 articles that met the selection criteria, with most (90%) coming from high-income countries. Disease burden (n = 34), vaccine efficacy, quality and safety (n = 27) and public health priority (n = 27) were most frequently addressed by studies conducted in the Region. Many studies assessed influenza vaccine policy and programmatic issues in the general population (42%), in the elderly (24%) and in children (17%). Few studies (2%) addressed the eight issues relating to pregnant women. Conclusions/Significance The evidence for vaccine introduction in countries and areas in this Region remains limited, particularly in low- and middle-income countries that do not currently have influenza vaccination programmes. Surveillance activities and specialized studies can be used to assess the eight issues including disease burden among vaccine target groups and the cost-effectiveness of influenza vaccine. Multi-country studies should be considered to maximize resource utilization for cross-cutting issues such as vaccine presentation and other inventions.
Collapse
|
18
|
Acute Viral Infections of the Central Nervous System in Immunocompetent Adults: Diagnosis and Management. Drugs 2013; 73:131-58. [DOI: 10.1007/s40265-013-0007-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
19
|
Towers S, Feng Z. Social contact patterns and control strategies for influenza in the elderly. Math Biosci 2012; 240:241-9. [PMID: 22877728 DOI: 10.1016/j.mbs.2012.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 07/20/2012] [Accepted: 07/21/2012] [Indexed: 10/28/2022]
Abstract
Despite dramatic increases in influenza vaccination coverage in the elderly population over the past 30 years, influenza mortality rates have remained static in this age group. Children are believed to be the primary spreaders of diseases such as influenza due to their high degree of inter-contact in school settings, and several studies have examined control of influenza in the entire population, including the elderly, via targeted vaccination of school children. However, such vaccination programs are expensive, and fraught with difficulties of public perception of what may be seen as an unnecessary vaccination against a disease that is normally mild in the children themselves. In the study presented here, we examine the control of influenza in the elderly using simple social distancing measures during an influenza epidemic. The recent work of Glasser et al. characterizes daily contact interactions within the population in terms of preferential mixing between age group peers, co-workers, and parents and children. We expand upon this to include interactions between grandparents and grandchildren, and fit the parameters of this formulation to the recently published social contact survey data of Mossong et al. Using this formulation, we then model an influenza epidemic with an age-structured deterministic disease model and examine how reduction in contacts between grandchildren and grandparents affects the spread of influenza to the elderly. We find that over 50% of all influenza infections in the elderly are caused by direct contact with an infected child, and we determine that social distancing between grandparents and grandchildren is remarkably effective, and is capable of reducing influenza attack rates in the elderly by up to 60%.
Collapse
Affiliation(s)
- S Towers
- Department of Mathematics, Purdue University, West Lafayette, IN 47907, USA.
| | | |
Collapse
|
20
|
Kawashima H, Morichi S, Okumara A, Nakagawa S, Morishima T. Treatment of pandemic influenza A (H1N1) 2009-associated encephalopathy in children. ACTA ACUST UNITED AC 2012; 44:941-7. [DOI: 10.3109/00365548.2012.700769] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
21
|
Lang PO, Aspinall R. Immunosenescence and herd immunity: with an ever-increasing aging population do we need to rethink vaccine schedules? Expert Rev Vaccines 2012; 11:167-76. [PMID: 22309666 DOI: 10.1586/erv.11.187] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Vaccination is a powerful public health tool that has been of tremendous benefit in protecting vulnerable populations from specific infections. Moreover, in addition to the direct benefits to vaccinated individuals, the indirect effects of protection at the community level have also been demonstrated and termed 'herd immunity'. The predicted demographic shift in the population landscape towards an ever-increasing aging population and the evidence suggesting that older individuals produce less-than-optimal vaccine responses have raised the question of rethinking vaccine schedules. This article provides evidence that even if herd immunity might be an option to indirectly protect the aging and aged adult population, the highest priorities for the near future must be to understand how vaccine responses in older individuals can be improved, to break down the public, cultural, societal and political barriers to vaccination and to counter the antivaccination movement that inhibits the worldwide spread of lifelong immunization programs.
Collapse
Affiliation(s)
- Pierre Olivier Lang
- Department of Internal Medicine, Rehabilitation & Geriatrics, Medical School & University Hospitals of Geneva, Hospital of Trois-Chêne, Chemin du Pont-Bochet 3, CH-1226 Thônex-Geneva, Geneva, Switzerland.
| | | |
Collapse
|
22
|
Lang PO, Samaras D, Samaras N, Govind S, Aspinall R. Influenza vaccination in the face of immune exhaustion: is herd immunity effective for protecting the elderly? INFLUENZA RESEARCH AND TREATMENT 2012; 2011:419216. [PMID: 23074656 PMCID: PMC3447292 DOI: 10.1155/2011/419216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 12/22/2011] [Indexed: 12/22/2022]
Abstract
At the start of the 21st century, seasonal influenza virus infection is still a major public health concern across the world. The recent body of evidence confirms that trivalent inactivated influenza vaccines (TIVs) are not optimal within the population who account for approximately 90% of all influenza-related death: elderly and chronically ill individuals regardless of age. With the ever increasing aging of the world population and the recent fears of any pandemic influenza rife, great efforts and resources have been dedicated to developing more immunogenic vaccines and strategies for enhancing protection in these higher-risk groups. This paper describes the mechanisms that shape immune response at the extreme ages of life and how they have been taken into account to design more effective immunization strategies for these vulnerable populations. Furthermore, consideration will be given to how herd immunity may provide an effective strategy in preventing the burden of seasonal influenza infection within the aged population.
Collapse
Affiliation(s)
- Pierre Olivier Lang
- Department of Internal Medicine, Rehabilitation and Geriatrics, Medical school and University Hospitals of Geneva, CH-1226 Thônex-Geneva, Switzerland
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
| | - Dimitrios Samaras
- Nutrition Unit, Medical school and University Hospitals of Geneva, CH-1205 Geneva, Switzerland
| | - Nikolaos Samaras
- Department of Internal Medicine, Rehabilitation and Geriatrics, Medical school and University Hospitals of Geneva, CH-1226 Thônex-Geneva, Switzerland
| | - Sheila Govind
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
| | - Richard Aspinall
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield MK43 0AL, UK
| |
Collapse
|
23
|
Charu V, Viboud C, Simonsen L, Sturm-Ramirez K, Shinjoh M, Chowell G, Miller M, Sugaya N. Influenza-related mortality trends in Japanese and American seniors: evidence for the indirect mortality benefits of vaccinating schoolchildren. PLoS One 2011; 6:e26282. [PMID: 22087226 PMCID: PMC3210121 DOI: 10.1371/journal.pone.0026282] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 09/23/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The historical Japanese influenza vaccination program targeted at schoolchildren provides a unique opportunity to evaluate the indirect benefits of vaccinating high-transmitter groups to mitigate disease burden among seniors. Here we characterize the indirect mortality benefits of vaccinating schoolchildren based on data from Japan and the US. METHODS We compared age-specific influenza-related excess mortality rates in Japanese seniors aged ≥65 years during the schoolchildren vaccination program (1978-1994) and after the program was discontinued (1995-2006). Indirect vaccine benefits were adjusted for demographic changes, socioeconomics and dominant influenza subtype; US mortality data were used as a control. RESULTS We estimate that the schoolchildren vaccination program conferred a 36% adjusted mortality reduction among Japanese seniors (95%CI: 17-51%), corresponding to ∼1,000 senior deaths averted by vaccination annually (95%CI: 400-1,800). In contrast, influenza-related mortality did not change among US seniors, despite increasing vaccine coverage in this population. CONCLUSIONS The Japanese schoolchildren vaccination program was associated with substantial indirect mortality benefits in seniors.
Collapse
Affiliation(s)
- Vivek Charu
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Kawai S, Nanri S, Ban E, Inokuchi M, Tanaka T, Tokumura M, Kimura K, Sugaya N. Influenza Vaccination of Schoolchildren and Influenza Outbreaks in a School. Clin Infect Dis 2011; 53:130-6. [DOI: 10.1093/cid/cir336] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Lang PO, Govind S, Michel JP, Aspinall R, Mitchell WA. Immunosenescence: Implications for vaccination programmes in adults. Maturitas 2011; 68:322-30. [PMID: 21316879 DOI: 10.1016/j.maturitas.2011.01.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 01/17/2011] [Indexed: 01/10/2023]
Affiliation(s)
- Pierre Olivier Lang
- Department of Internal Medicine, Rehabilitation and Geriatrics, Medical School and University Hospitals of Geneva, Geneva, Switzerland.
| | | | | | | | | |
Collapse
|
26
|
Cohen SA, Chui KKH, Naumova EN. Influenza vaccination in young children reduces influenza-associated hospitalizations in older adults, 2002-2006. J Am Geriatr Soc 2011; 59:327-32. [PMID: 21275932 DOI: 10.1111/j.1532-5415.2010.03271.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess how influenza vaccination coverage in children is related to pneumonia and influenza (P&I) in older adults and whether sociodemographic factors modify these associations. DESIGN Approximately 5 million hospitalization records from the Centers for Medicare and Medicaid Services for four influenza years (2002-2006) were abstracted. A single-year age distribution of rates of P&I hospitalization was estimated according to state for each influenza season; an exponential acceleration in the P&I rates with age was observed for each influenza season. State- and season-specific P&I rate accelerations were regressed against the percentage of vaccinated children, older adults, or both using mixed effects models. SETTING U.S. population, 2002 to 2006. PARTICIPANTS U.S. population aged 65 and older. MEASUREMENTS State-level influenza annual vaccination coverage data in children and older adults were obtained from the National Immunization Survey and the Behavioral Risk Factor Surveillance System, respectively. RESULTS Child influenza vaccination coverage was negatively associated with age acceleration in P&I, whereas influenza vaccination in the older adults themselves was not significantly associated with P&I in older adults. CONCLUSION Vaccination of children against influenza may induce herd immunity against influenza for older adults and has the potential to be more beneficial to older adults than the existing policy of preventing influenza by vaccinating older adults themselves.
Collapse
Affiliation(s)
- Steven A Cohen
- Initiative for the Forecasting and Modeling of Infectious Disease, Tufts University, Boston, Massachusetts, USA.
| | | | | |
Collapse
|
27
|
Cohen SA, Ahmed S, Klassen AC, Agree EM, Louis TA, Naumova EN. Childhood Hib vaccination and pneumonia and influenza burden in US seniors. Vaccine 2010; 28:4462-9. [PMID: 20457288 DOI: 10.1016/j.vaccine.2010.04.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 04/02/2010] [Accepted: 04/14/2010] [Indexed: 10/19/2022]
Abstract
This analysis examines the potential for the elderly to receive indirect protection from pneumonia and influenza (P&I) from vaccination of children. Using data from the Centers for Medicare and Medicaid Services, the National Immunization Survey, and the Behavioral Risk Factor Surveillance System, mixed-effects models were used to assess associations between vaccination coverage and P&I on the state level overall and by urbanicity and income. As vaccination coverage in children increased, the state-level P&I rates in seniors decreased (beta=-0.040, -0.074 to 0.006), where beta represents the expected change in the logged age-associated rate of disease increase for a one-percentage point increase in vaccination coverage. Increasing vaccination coverage in the elderly was associated with an increase in P&I rates (beta=0.045, 0.011-0.077) in seniors. The degree of association was more prominent in urban and high income areas. The consistent associations between influenza in the elderly and vaccination coverage in children suggest that routine vaccination of children may impart some indirect protection to the elderly.
Collapse
Affiliation(s)
- Steven A Cohen
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. steven
| | | | | | | | | | | |
Collapse
|
28
|
School-based influenza vaccine delivery, vaccination rates, and healthcare use in the context of a universal influenza immunization program: an ecological study. Vaccine 2010; 28:2722-9. [PMID: 20109594 DOI: 10.1016/j.vaccine.2010.01.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 12/24/2009] [Accepted: 01/13/2010] [Indexed: 11/22/2022]
Abstract
Influenza vaccines are universally funded in Ontario, Canada. Some public health units (PHUs) vaccinate children in schools. We examined the impact of school-based delivery on vaccination rates and healthcare use of the entire population over seven influenza seasons (2000-2007) using population-based survey and health administrative data. School-based vaccination was associated with higher vaccination rates in school-age children only. Doctors' office visits were lower for PHUs with school-based vaccination for children aged 12-19 but not for other age groups. Emergency department use and hospitalizations were similar between the two groups. In the context of universal influenza vaccination, school-based delivery is associated with higher vaccination rates and modest reductions in healthcare use in school-age children.
Collapse
|
29
|
Talbot HK, Poehling KA, Williams JV, Zhu Y, Chen Q, McNabb P, Edwards KM, Griffin MR. Influenza in older adults: impact of vaccination of school children. Vaccine 2009; 27:1923-7. [PMID: 19368772 DOI: 10.1016/j.vaccine.2009.01.108] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 01/20/2009] [Accepted: 01/22/2009] [Indexed: 10/21/2022]
Abstract
The extent to which immunizing school children reduce the burden of influenza in adults is controversial. We enrolled a systematic sample of adults > or = 50 years hospitalized with respiratory symptoms in two counties, one with and one without a school-based immunization program. We tested all subjects for influenza by polymerase chain reaction. Hospitalizations per 1000 adults aged > or = 50 years were 1.28 (95% CI 0.59, 2.04) in the intervention county and 1.53 (95% CI 0.71, 2.34) in the control county. These rates did not differ significantly except in the subgroup aged 50 -- 64 years where rates in the intervention county were significantly lower.
Collapse
Affiliation(s)
- H Keipp Talbot
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Demography and Life Histories of Sympatric Patas Monkeys, Erythrocebus patas, and Vervets, Cercopithecus aethiops, in Laikipia, Kenya. INT J PRIMATOL 2009; 30:103-124. [PMID: 20976285 PMCID: PMC2949556 DOI: 10.1007/s10764-009-9332-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 09/13/2008] [Indexed: 11/24/2022]
Abstract
Mortality patterns are thought to be strong selective forces on life history traits, with high adult mortality and low immature mortality favoring early and rapid reproduction. Patas monkeys (Erythrocebus patas) have the highest potential rates of population increase for their body size of any haplorhine primate because they reproduce both earlier and more often. We report here 10 yr of comparative demographic data on a population of patas monkeys and a sympatric population of vervet monkeys (Cercopithecus aethiops), a closely related species differing in aspects of social system, ecology, and life history. The data reveal that 1) adult female patas monkeys have significantly higher mortality than adult female vervets; 2) infant mortality in patas monkeys is relatively low compared to the norm for mammals because it is not significantly different from that of adult female patas monkeys; and 3) infant mortality is significantly higher than adult female mortality in vervets. For both species, much of the mortality could be attributed to predation. An epidemic illness was also a major contributor to the mortality of adult female patas monkeys whereas chronic exposure to pathogens in a cold and damp microenvironment may have contributed to the mortality of infant vervets. Both populations experienced large fluctuations during the study period. Our results support the prediction from demographic models of life history evolution that high adult mortality relative to immature mortality selects for early maturation.
Collapse
|
31
|
Affiliation(s)
- Kam-Lun Hon
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| | | |
Collapse
|
32
|
Abstract
In 1976, influenza mass vaccination among schoolchildren was started under the Preventive Vaccination Law, which was intended to control epidemics in the community. However, in the late 1980s, questions about this policy and vaccine efficacy arose, and a campaign against vaccination began. In 1994, influenza was excluded from the target diseases list in the Preventive Vaccination Law, without considering the immunization policy with respect to the common indications in high-risk groups. In 2001, the Law was again amended, specifying target groups, such as the elderly aged 65 or over, for influenza vaccination. In the 2005--2006 season, vaccine coverage among the elderly reached 52%. This shows that the need for vaccination has gradually become understood. However, the anti-vaccination campaign, which claims that the influenza vaccine has no efficacy, is still active. Vaccine efficacy studies that were not properly conducted are also being reported. In 2002, the Ministry of Health, Labor, and Welfare organized a research group on vaccine efficacy consisting of epidemiologists. The present symposium, as part of the 9th Annual Meeting of the Japanese Society for Vaccinology in 2005, was planned to further introduce epidemiological concepts useful in studying influenza vaccine efficacy.
Collapse
Affiliation(s)
- Yoshio Hirota
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Osaka 545-8585, Japan.
| | | |
Collapse
|
33
|
Corbeel L. Should healthy children be vaccinated against influenza? Comments about this query. Eur J Pediatr 2007; 166:629-31. [PMID: 17008996 DOI: 10.1007/s00431-006-0285-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Accepted: 06/20/2006] [Indexed: 10/24/2022]
|
34
|
Gooskens J, Kuiken T, Claas EC, Harinck HI, Thijssen JC, Baelde HJ, Kroes AC. Severe influenza resembling hemorrhagic shock and encephalopathy syndrome. J Clin Virol 2007; 39:136-40. [PMID: 17499546 DOI: 10.1016/j.jcv.2007.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Revised: 03/23/2007] [Accepted: 03/26/2007] [Indexed: 10/23/2022]
Abstract
Influenza-associated encephalopathy is a clinically diverse syndrome and severe cases are not well documented outside Japan. Clinical, pathological and molecular aspects are described of two fatal cases presenting during 2004 and 2005 winter seasons in The Netherlands. Results showed that severe influenza can resemble hemorrhagic shock and encephalopathy syndrome, and proper testing for influenza virus should be considered in similar cases. The failure to detect viral replication in non-pulmonary organs including the brain would support the pathogenesis of this syndrome is based on proinflammatory cytokine responses.
Collapse
Affiliation(s)
- J Gooskens
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
35
|
Ploin D, Gillet Y, Morfin F, Fouilhoux A, Billaud G, Liberas S, Denis A, Thouvenot D, Fritzell B, Lina B, Floret D. Influenza burden in febrile infants and young children in a pediatric emergency department. Pediatr Infect Dis J 2007; 26:142-7. [PMID: 17259877 DOI: 10.1097/01.inf.0000253062.41648.60] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In France, epidemiologic data in children in ambulatory settings are scarce. We aimed to measure the burden of influenza in young children. METHODS Febrile children younger than 36 months were consecutively recruited in a pediatric emergency department during the 2002 epidemic peak. Virology analysis and follow-up were systematic. RESULTS During calendar weeks 3 to 6, 2002, 575 children were recruited; 49% were positive: A/H3N2 in 44% and B in 5%. Prevalence rate was 57% in 12- to 35-month-old children and 39% in infants younger than 12 months. The main clinical pictures were nonrespiratory in one third of them. One of 8 patients had a complication. One of 10 patients was hospitalized, and the estimated specific hospitalization rate for the study period was 237 of 100,000 in the general population among infants younger than 12 months. Forty-two percent of children (n = 110) were prescribed antibiotics and at least 34% of them were inappropriate (n = 89). Median length of disease was 8 days, and 25% of the children had not fully recovered by day 11. Only one child had been previously vaccinated of 65 with chronic conditions. Both epidemic strains were covered by the vaccine. CONCLUSIONS Health outcomes showed that influenza disease burden in young French children is similar to that observed in North America. An active vaccination strategy would have strongly reduced the burden of influenza and lowered antibiotic use. Continuous efforts are needed to reach requirements of our influenza vaccination policy.
Collapse
Affiliation(s)
- Dominique Ploin
- Département d'Information Médicale des Hospices Civils de Lyon, Lyon, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Abstract
PURPOSE OF REVIEW Pandemic influenza is inevitable, will have significant impact on the population and will challenge healthcare delivery. Planning for an influenza pandemic will improve the ability of healthcare facilities to respond successfully. RECENT FINDINGS Planning activities involve determining the role of the facility during an influenza pandemic, estimating resources necessary to fulfil this role and developing the infrastructure, material and human resources surge capacity necessary to meet the estimated needs. Plans to perform surveillance for potentially contagious individuals, handle clinical specimens, increase social distancing during a pandemic and the development of personal preparedness plans may be beneficial. SUMMARY The goal of this review is to provide a framework for healthcare facility pandemic influenza planning.
Collapse
Affiliation(s)
- Richard A Martinello
- Department of Internal Medicine, Yale University School of Medicine, Connecticut, USA.
| |
Collapse
|
37
|
Abstract
PURPOSE OF REVIEW To assess new information from peer-reviewed publications in 2005 regarding emerging respiratory viral threats. RECENT FINDINGS The expanding epizootic of avian A/H5N1 influenza and increasing number of human cases heighten concern regarding the threat of pandemic influenza. Studies of the 1918 pandemic virus have shown the potential for direct interspecies transmission from an avian host. In the absence of an effective vaccine, antiviral agents could provide an important response measure. Inadequate supplies and potential antiviral resistance are limiting factors. Seasonal influenza heavily affects infants and young children, who also serve to foster transmission at the community level, findings that indicate the need for broader immunization strategies in pediatric populations. Like avian influenza, the severe acute respiratory syndrome coronavirus was a zoonotic infection, perhaps derived from related coronaviruses in bats. Molecular diagnostic techniques have led to the recent identification of several new coronaviruses and a respiratory parvovirus. It has also helped to define the impact of previously described ones such as human metapneumovirus and rhinoviruses, which account for the majority of asthma exacerbations and frequent lower respiratory tract illnesses. SUMMARY Progress has been made in development of possible specific interventions for influenza and possibly severe acute respiratory syndrome coronavirus, but effective antivirals and vaccines for most other respiratory viruses are currently lacking.
Collapse
Affiliation(s)
- Frederick G Hayden
- Department of Internal Medicine, University of Virginia School of Medicine, Box 800473, Charlottesville, VA 22908, USA.
| |
Collapse
|