Vaccine Effectiveness Against Pediatric Influenza-A-Associated Urgent Care, Emergency Department, and Hospital Encounters During the 2022-2023 Season: VISION Network

被引：4

作者：

Adams, Katherine ^{[1
]}

Weber, Zachary A. ^{[2
]}

Yang, Duck-Hye ^{[2
]}

Klein, Nicola P. ^{[3
]}

Desilva, Malini B. ^{[4
]}

Dascomb, Kristin ^{[5
]}

Irving, Stephanie A. ^{[6
]}

Naleway, Allison L. ^{[6
]}

Rao, Suchitra ^{[7
]}

Gaglani, Manjusha ^{[8
,9
,10
]}

Flannery, Brendan ^{[1
]}

Garg, Shikha ^{[1
]}

Kharbanda, Anupam B. ^{[11
]}

Grannis, Shaun J. ^{[12
,13
]}

Ong, Toan C. ^{[14
]}

Embi, Peter J. ^{[15
]}

Natarajan, Karthik ^{[16
,17
]}

Fireman, Bruce ^{[3
]}

Zerbo, Ousseny ^{[3
]}

Goddard, Kristin ^{[3
]}

Timbol, Julius ^{[3
]}

Hansen, John R. ^{[3
]}

Grisel, Nancy ^{[5
]}

Arndorfer, Julie ^{[5
]}

Ball, Sarah W. ^{[2
]}

Dunne, Margaret M. ^{[2
]}

Kirshner, Lindsey ^{[2
]}

Chung, Jessie R. ^{[1
]}

Tenforde, Mark W. ^{[1
,18
]}

机构：

[1] CDCP, Influenza Div, Atlanta, GA USA

[2] Westat Corp, Dept Clin Res, Rockville, MD USA

[3] Kaiser Permanente Vaccine Study Ctr, Kaiser Permanente Northern Calif Div Res, Oakland, CA USA

[4] HealthPartners Inst, Dept Res, Minneapolis, MN USA

[5] Intermt Healthcare, Div Infect Dis & Clin Epidemiol, Salt Lake City, UT USA

[6] Kaiser Permanente Ctr Hlth Res, Dept Sci Programs, Portland, OR USA

[7] Univ Colorado, Dept Pediat, Anschutz Med Campus, Aurora, CO USA

[8] Baylor Scott & White Hlth, Dept Pediat, Sect Pediat Infect Dis, Temple, TX USA

[9] Baylor Coll Med, Temple, TX USA

[10] Texas A&M Univ Coll Med, Dept Med Educ, Temple, TX USA

[11] Childrens Minnesota, Dept Emergency Med, Minneapolis, MN USA

[12] Regenstrief Inst Hlth Care, Ctr Biomed Informat, Indianapolis, IN USA

[13] Indiana Univ, Sch Med, Indianapolis, IN USA

[14] Univ Colorado, Dept Biomed Informat, Anschutz Med Campus, Aurora, CO USA

[15] Vanderbilt Univ, Med Ctr, Dept Biomed Informat, Nashville, TN USA

[16] Columbia Univ, Irving Med Ctr, Dept Biomed Informat, New York, NY USA

[17] New York Presbyterian Hosp, Med Informat Serv, New York, NY USA

[18] CDCP, Influenza Div, 1600 Clifton Rd,Mailstop H24-7, Atlanta, GA 30329 USA

来源：

CLINICAL INFECTIOUS DISEASES | 2024年 / 78卷 / 03期

关键词：

influenza; pediatric; vaccine effectiveness; test-negative design; IMMUNIZATION PRACTICES; ADVISORY-COMMITTEE; UNITED-STATES; CHILDREN; ILLNESS; RECOMMENDATIONS; ABSENTEEISM; PREVENTION;

D O I：

10.1093/cid/ciad704

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

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 3 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 1862 (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. Among pediatric acute respiratory illness-associated encounters during the 2022-2023 influenza season, vaccine effectiveness was 48% (95% confidence interval [CI], 44-52%) against emergency department/urgent care encounters and 40% (95% CI, 6-61%) against hospitalization. Graphical Abstract https://tidbitapp.io/tidbits/vaccine-effectiveness-against-pediatric-influenza-a-associated-urgent-care-emergency-department-andhospital-encounters-during-the-2022-2023-season-vision-network-15078ac6-f6db-43ce-9668-9524fa92cce0/

引用

页码：746 / 755

页数：10

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