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Effectiveness of seasonal influenza vaccination of children in Senegal during a year of vaccine mismatch: a cluster-randomized trial

tetano

Editor, Senior Moderator
Clin Infect Dis. 2019 Jan 28. doi: 10.1093/cid/ciz066. [Epub ahead of print]
[h=1]Effectiveness of seasonal influenza vaccination of children in Senegal during a year of vaccine mismatch: a cluster-randomized trial.[/h] Diallo A[SUP]1[/SUP], Diop OM[SUP]2[/SUP], Diop D[SUP]1[/SUP], Niang MN[SUP]2[/SUP], Sugimoto JD[SUP]3[/SUP], Ortiz JR[SUP]4[/SUP], Faye EHA[SUP]2[/SUP], Diarra B[SUP]1[/SUP], Goudiaby D[SUP]2[/SUP], Lewis KDC[SUP]5[/SUP], Emery SL[SUP]6[/SUP], Zangeneh SZ[SUP]3[/SUP], Lafond KE[SUP]6[/SUP], Sokhna C[SUP]1[/SUP], Halloran ME[SUP]3,[/SUP][SUP]7[/SUP], Widdowson MA[SUP]6[/SUP], Neuzil KM[SUP]4[/SUP], Victor JC[SUP]5[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]Background:[/h] Population effects of influenza vaccination of children have not been extensively studied, especially in tropical developing countries. In rural Senegal, we assessed the total (primary objective) and indirect effectiveness of inactivated influenza vaccine, trivalent (IIV3).
[h=4]Methods:[/h] In this double-blind, cluster-randomized trial, villages were randomly allocated (1:1) for high-coverage vaccination of children aged 6 months through 10 years with 2008-09 northern hemisphere IIV3 or inactivated polio vaccine (IPV). Vaccinees were monitored for serious adverse events. All village residents, vaccinated and unvaccinated, were monitored for signs and symptoms of influenza illness using weekly home visits and surveillance in designated clinics. The primary outcome was all laboratory-confirmed symptomatic influenza.
[h=4]Results:[/h] Between May 23 and July 11, 2009, 20 villages were randomized, and 66.5% of age-eligible children were enrolled (3918 in IIV3 villages and 3848 in IPV villages). Follow-up continued until May 28, 2010. Four unrelated serious adverse events were identified. Among vaccinees, total effectiveness against illness caused by seasonal influenza virus (presumed all drifted A/H3N2 based on antigenic characterization data) circulating at high rates among children was 43.6% (95% CI, 18.6% to 60.9%). Indirect effectiveness against seasonal A/H3N2 was 15.4% (95% CI, -22.0% to 41.3%). Total effectiveness against illness caused by pandemic influenza virus (A/H1N1pdm09) was -52.1% (95% CI, -177.2% to 16.6%).
[h=4]Conclusions:[/h] IIV3 provided statistically significant, moderate protection to children in Senegal against circulating pre-2010 seasonal influenza strains but not against A/H1N1pdm09 not included in the vaccine. No indirect effects were measured. Further study in low resource populations is warranted.


PMID: 30689757 DOI: 10.1093/cid/ciz066
 
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