tetano
Editor, Senior Moderator
Clin Infect Dis
. 2023 Nov 16:ciad704.
doi: 10.1093/cid/ciad704. Online ahead of print. Vaccine Effectiveness Against Pediatric Influenza-A-Associated Urgent Care, Emergency Department, and Hospital Encounters During the 2022-2023 Season, VISION Network
Katherine Adams[SUP] 1 [/SUP], Zachary A Weber[SUP] 2 [/SUP], Duck-Hye Yang[SUP] 2 [/SUP], Nicola P Klein[SUP] 3 [/SUP], Malini B DeSilva[SUP] 4 [/SUP], Kristin Dascomb[SUP] 5 [/SUP], Stephanie A Irving[SUP] 6 [/SUP], Allison L Naleway[SUP] 6 [/SUP], Suchitra Rao[SUP] 7 [/SUP], Manjusha Gaglani[SUP] 8 9 [/SUP], Brendan Flannery[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP], Anupam B Kharbanda[SUP] 10 [/SUP], Shaun J Grannis[SUP] 11 12 [/SUP], Toan C Ong[SUP] 13 [/SUP], Peter J Embi[SUP] 14 [/SUP], Karthik Natarajan[SUP] 15 16 [/SUP], Bruce Fireman[SUP] 3 [/SUP], Ousseny Zerbo[SUP] 3 [/SUP], Kristin Goddard[SUP] 3 [/SUP], Julius Timbol[SUP] 3 [/SUP], John R Hansen[SUP] 3 [/SUP], Nancy Grisel[SUP] 5 [/SUP], Julie Arndorfer[SUP] 5 [/SUP], Sarah W Ball[SUP] 2 [/SUP], Margaret M Dunne[SUP] 2 [/SUP], Lindsey Kirshner[SUP] 2 [/SUP], Jessie R Chung[SUP] 1 [/SUP], Mark W Tenforde[SUP] 1 [/SUP]
Affiliations
Background: During the 2022-2023 influenza season, the United States experienced the highest influenza-associated pediatric hospitalization rate since 2010-2011. Influenza A/H3N2 infections were predominant.
Methods: We analyzed acute respiratory illness (ARI)-associated emergency department or urgent care (ED/UC) encounters or hospitalizations at three health systems among children and adolescents aged 6 months-17 years who had influenza molecular testing during October 2022-March 2023. We estimated influenza A vaccine effectiveness (VE) using a test-negative approach. The odds of vaccination among influenza-A-positive cases and influenza-negative controls were compared after adjusting for confounders and applying inverse-propensity-to-be-vaccinated weights. We developed overall and age-stratified VE models.
Results: Overall, 13,547 of 44,787 (30.2%) eligible ED/UC encounters and 263 of 1,862 (14.1%) hospitalizations were influenza-A-positive cases. Among ED/UC patients, 15.2% of influenza-positive versus 27.1% of influenza-negative patients were vaccinated; VE was 48% (95% confidence interval [CI], 44%-52%) overall, 53% (95% CI, 47%-58%) among children aged 6 months-4 years and 38% (95% CI, 30%-45%) among those aged 9-17 years. Among hospitalizations, 17.5% of influenza-positive versus 33.4% of influenza-negative patients were vaccinated; VE was 40% (95% CI, 6%-61%) overall, 56% (95% CI, 23%-75%) among children ages 6 months-4 years and 46% (95% CI, 2%-70%) among those 5-17 years.
Conclusions: During the 2022-2023 influenza season, vaccination reduced the risk of influenza-associated ED/UC encounters and hospitalizations by almost half (overall VE 40-48%). Influenza vaccination is a critical tool to prevent moderate-to-severe influenza illness in children and adolescents.
Keywords: influenza; pediatric; test-negative design; vaccine effectiveness.
. 2023 Nov 16:ciad704.
doi: 10.1093/cid/ciad704. Online ahead of print. Vaccine Effectiveness Against Pediatric Influenza-A-Associated Urgent Care, Emergency Department, and Hospital Encounters During the 2022-2023 Season, VISION Network
Katherine Adams[SUP] 1 [/SUP], Zachary A Weber[SUP] 2 [/SUP], Duck-Hye Yang[SUP] 2 [/SUP], Nicola P Klein[SUP] 3 [/SUP], Malini B DeSilva[SUP] 4 [/SUP], Kristin Dascomb[SUP] 5 [/SUP], Stephanie A Irving[SUP] 6 [/SUP], Allison L Naleway[SUP] 6 [/SUP], Suchitra Rao[SUP] 7 [/SUP], Manjusha Gaglani[SUP] 8 9 [/SUP], Brendan Flannery[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP], Anupam B Kharbanda[SUP] 10 [/SUP], Shaun J Grannis[SUP] 11 12 [/SUP], Toan C Ong[SUP] 13 [/SUP], Peter J Embi[SUP] 14 [/SUP], Karthik Natarajan[SUP] 15 16 [/SUP], Bruce Fireman[SUP] 3 [/SUP], Ousseny Zerbo[SUP] 3 [/SUP], Kristin Goddard[SUP] 3 [/SUP], Julius Timbol[SUP] 3 [/SUP], John R Hansen[SUP] 3 [/SUP], Nancy Grisel[SUP] 5 [/SUP], Julie Arndorfer[SUP] 5 [/SUP], Sarah W Ball[SUP] 2 [/SUP], Margaret M Dunne[SUP] 2 [/SUP], Lindsey Kirshner[SUP] 2 [/SUP], Jessie R Chung[SUP] 1 [/SUP], Mark W Tenforde[SUP] 1 [/SUP]
Affiliations
- PMID: 37972288
- DOI: 10.1093/cid/ciad704
Background: During the 2022-2023 influenza season, the United States experienced the highest influenza-associated pediatric hospitalization rate since 2010-2011. Influenza A/H3N2 infections were predominant.
Methods: We analyzed acute respiratory illness (ARI)-associated emergency department or urgent care (ED/UC) encounters or hospitalizations at three health systems among children and adolescents aged 6 months-17 years who had influenza molecular testing during October 2022-March 2023. We estimated influenza A vaccine effectiveness (VE) using a test-negative approach. The odds of vaccination among influenza-A-positive cases and influenza-negative controls were compared after adjusting for confounders and applying inverse-propensity-to-be-vaccinated weights. We developed overall and age-stratified VE models.
Results: Overall, 13,547 of 44,787 (30.2%) eligible ED/UC encounters and 263 of 1,862 (14.1%) hospitalizations were influenza-A-positive cases. Among ED/UC patients, 15.2% of influenza-positive versus 27.1% of influenza-negative patients were vaccinated; VE was 48% (95% confidence interval [CI], 44%-52%) overall, 53% (95% CI, 47%-58%) among children aged 6 months-4 years and 38% (95% CI, 30%-45%) among those aged 9-17 years. Among hospitalizations, 17.5% of influenza-positive versus 33.4% of influenza-negative patients were vaccinated; VE was 40% (95% CI, 6%-61%) overall, 56% (95% CI, 23%-75%) among children ages 6 months-4 years and 46% (95% CI, 2%-70%) among those 5-17 years.
Conclusions: During the 2022-2023 influenza season, vaccination reduced the risk of influenza-associated ED/UC encounters and hospitalizations by almost half (overall VE 40-48%). Influenza vaccination is a critical tool to prevent moderate-to-severe influenza illness in children and adolescents.
Keywords: influenza; pediatric; test-negative design; vaccine effectiveness.