1887
Surveillance and outbreak report Open Access
Like 0

Abstract

The 2015/16 influenza season was the third season of the introduction of an intra-nasally administered live attenuated influenza vaccine (LAIV) for children in England. All children aged 2‒6 years were offered LAIV, and in addition, a series of geographically discrete areas piloted vaccinating school-age children 7‒11 years old. Influenza A(H1N1)pdm09 was the dominant circulating strain during 2015/16 followed by influenza B. We measured influenza vaccine uptake and the overall and indirect effect of vaccinating children of primary school -age, by comparing cumulative disease incidence in targeted and non-targeted age groups in vaccine pilot and non-pilot areas in England. Uptake of 57.9% (range: 43.6–72.0) was achieved in the five pilot areas for children aged 5‒11 years. In pilot areas, cumulative emergency department respiratory attendances, influenza-confirmed hospitalisations and intensive care unit admissions were consistently lower, albeit mostly non-significantly, in targeted and non-targeted age groups compared with non-pilot areas. Effect sizes were less for adults and more severe endpoints. Vaccination of healthy primary school-age children with LAIV at moderately high levels continues to be associated with population-level reductions in influenza-related respiratory illness. Further work to evaluate the population-level impact of the programme is required.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2018.23.25.1700496
2018-06-21
2024-03-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.25.1700496
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/23/25/eurosurv-23-25-4.html?itemId=/content/10.2807/1560-7917.ES.2018.23.25.1700496&mimeType=html&fmt=ahah

References

  1. Department of Health. Public Health England (PHE). The national flu immunisation programme 2015/16. London: PHE; 27 Mar 2015. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/526144/Annual_flu_letter_24_03_15superseded.pdf>
  2. Public Health England (PHE). Surveillance of influenza and other respiratory viruses in the United Kingdom: winter 2015 to 2016. London: PHE; May 2016. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/526405/Flu_Annual_Report_2015_2016.pdf
  3. Baguelin M, Flasche S, Camacho A, Demiris N, Miller E, Edmunds WJ. Assessing optimal target populations for influenza vaccination programmes: an evidence synthesis and modelling study. PLoS Med. 2013;10(10):e1001527.  https://doi.org/10.1371/journal.pmed.1001527  PMID: 24115913 
  4. Pebody R, Warburton F, Ellis J, Andrews N, Potts A, Cottrell S, et al. Effectiveness of seasonal influenza vaccine for adults and children in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2015/16 end-of-season results. Euro Surveill. 2016;21(38):30348.  https://doi.org/10.2807/1560-7917.ES.2016.21.38.30348  PMID: 27684603 
  5. Pebody RG, Green HK, Andrews N, Zhao H, Boddington N, Bawa Z, et al. Uptake and impact of a new live attenuated influenza vaccine programme in England: early results of a pilot in primary school-age children, 2013/14 influenza season. Euro Surveill. 2014;19(22):20823.  https://doi.org/10.2807/1560-7917.ES2014.19.22.20823  PMID: 24925457 
  6. Pebody RG, Green HK, Andrews N, Boddington NL, Zhao H, Yonova I, et al. 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. Euro Surveill. 2015;20(39):30029.  https://doi.org/10.2807/1560-7917.ES.2015.20.39.30029  PMID: 26537222 
  7. Grijalva CG, Zhu Y, Simonsen L, Mitchel E, Griffin MR. The population impact of a large school-based influenza vaccination campaign. PLoS One. 2010;5(11):e15097.  https://doi.org/10.1371/journal.pone.0015097  PMID: 21209872 
  8. King JC Jr, Cummings GE, Stoddard J, Readmond BX, Magder LS, Stong M, et al. SchoolMist Study Group. A pilot study of the effectiveness of a school-based influenza vaccination program. Pediatrics. 2005;116(6):e868-73.  https://doi.org/10.1542/peds.2005-1301  PMID: 16322144 
  9. King JC Jr, Lichenstein R, Cummings GE, Magder LS. Impact of influenza vaccination of schoolchildren on medical outcomes among all residents of Maryland. Vaccine. 2010;28(49):7737-42.  https://doi.org/10.1016/j.vaccine.2010.09.064  PMID: 20933566 
  10. Centres for Disease Control and Prevention (CDC). ACIP votes down use of LAIV for 2016-2017 flu season. Atlanta: CDC; 2016. Available from: http://www.cdc.gov/media/releases/2016/s0622-laiv-flu.html
  11. Gates P, Noakes K, Begum F, Pebody R, Salisbury D. Collection of routine national seasonal influenza vaccine coverage data from GP practices in England using a web-based collection system. Vaccine. 2009;27(48):6669-77.  https://doi.org/10.1016/j.vaccine.2009.08.094  PMID: 19747574 
  12. Bolotin S, Pebody R, White PJ, McMenamin J, Perera L, Nguyen-Van-Tam JS, et al. UK Severe Influenza Surveillance System (USISS) Steering Group. A new sentinel surveillance system for severe influenza in England shows a shift in age distribution of hospitalised cases in the post-pandemic period. PLoS One. 2012;7(1):e30279.  https://doi.org/10.1371/journal.pone.0030279  PMID: 22291929 
  13. Public Health England (PHE). Eastern Region Public Health Observatory (Erpho). Acute hospital catchment populations 2009. London: PHE; Jun 2015. Available from: http://www.erpho.org.uk/viewResource.aspx?id=21919
  14. Elliot AJ, Hughes HE, Hughes TC, Locker TE, Shannon T, Heyworth J, et al. Establishing an emergency department syndromic surveillance system to support the London 2012 Olympic and Paralympic Games. Emerg Med J. 2012;29(12):954-60.  https://doi.org/10.1136/emermed-2011-200684  PMID: 22366039 
  15. Zhao H, Green H, Lackenby A, Donati M, Ellis J, Thompson C, et al. A new laboratory-based surveillance system (Respiratory DataMart System) for influenza and other respiratory viruses in England: results and experience from 2009 to 2012. Euro Surveill. 2014;19(3):20680.  https://doi.org/10.2807/1560-7917.ES2014.19.3.20680  PMID: 24480060 
  16. Nielsen J, Mazick A, Andrews N, Detsis M, Fenech TM, Flores VM, et al. Pooling European all-cause mortality: methodology and findings for the seasons 2008/2009 to 2010/2011. Epidemiol Infect. 2013;141(9):1996-2010.  https://doi.org/10.1017/S0950268812002580  PMID: 23182146 
  17. World Health Organization (WHO). International statistical classification of diseases and related health problems - 10th revision. Geneva: WHO; 2010. Available from: www.who.int/classifications/icd/ICD10Volume2_en_2010.pdf
  18. Ellis J, Iturriza M, Allen R, Bermingham A, Brown K, Gray J, et al. Evaluation of four real-time PCR assays for detection of influenza A(H1N1)v viruses. Euro Surveill. 2009;14(22):19230.  https://doi.org/10.2807/ese.14.22.19230-en  PMID: 19497254 
  19. Ellis JS, Curran MD. Simultaneous molecular detection and confirmation of influenza AH5, with internal control. Methods Mol Biol. 2011;665:161-81.  https://doi.org/10.1007/978-1-60761-817-1_10  PMID: 21116801 
  20. Calder K, Bidwell S, Brunton C, Pink R. Evaluation of the Canterbury under-18 seasonal influenza vaccination programme. N Z Med J. 2014;127(1398):19-27. PMID: 25146858 
  21. Yin JK, Heywood AE, Georgousakis M, King C, Chiu C, Isaacs D, et al. Systematic Review and Meta-analysis of Indirect Protection Afforded by Vaccinating Children Against Seasonal Influenza: Implications for Policy. Clin Infect Dis. 2017;65(5):719-28. PMID: 28475770 
  22. Penttinen PM, Friede MH. Decreased effectiveness of the influenza A(H1N1)pdm09 strain in live attenuated influenza vaccines: an observational bias or a technical challenge? Euro Surveill. 2016;21(38):30350.  https://doi.org/10.2807/1560-7917.ES.2016.21.38.30350  PMID: 27684999 
  23. Caspard H, Mallory RM, Yu J, Ambrose CS. Live-Attenuated Influenza Vaccine Effectiveness in Children From 2009 to 2015-2016: A Systematic Review and Meta-Analysis. Open Forum Infect Dis. 2017;4(3):ofx111.  https://doi.org/10.1093/ofid/ofx111  PMID: 28852675 
/content/10.2807/1560-7917.ES.2018.23.25.1700496
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error