Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017: Results from the PAEDS-FluCAN Collaboration

Christopher C. Blyth, Kristine K. Macartney, Jocelynne McRae, Julia E. Clark, Helen S. Marshall, Jim Buttery, Joshua R. Francis, Tom Kotsimbos, Paul M. Kelly, Allen C. Cheng, on behalf of the Paediatric Active Enhanced Disease Surveillance (PAEDS) and Influenza Complications Alert Network (FluCAN) Collaboration

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background In 2017, Australia experienced record influenza notifications. Two surveillance programs combined to summarize the epidemiology of hospitalized influenza in children and report on vaccine effectiveness (VE) in the context of a limited nationally funded vaccination program. Methods Subjects were prospectively recruited (April-October 2017). Case patients were children aged ≤16 years admitted to 11 hospitals with an acute respiratory illness and laboratory-confirmed influenza. Controls were hospitalized with acute respiratory illness and tested negative for influenza. VE estimates were calculated using the test-negative design. Results A total of 1268 children were hospitalized with influenza: 31.5% were <2 years old, 8.3% were indigenous, and 45.1% had comorbid conditions predisposing to severe influenza. Influenza B was detected in 34.1% with influenza A/H1N1 and A/H3N2 detected in 47.2% and 52.8% of subtyped influenza A specimens. The median length of stay was 3 days (interquartile range, 1-5), 14.5% were admitted to the intensive care unit, and 15.9% received oseltamivir. Four in-hospital deaths occurred (0.3%): one was considered influenza associated. Only 17.1% of test-negative-controls were vaccinated. The VE of inactivated quadrivalent influenza vaccine for preventing hospitalized influenza was estimated at 30.3% (95% confidence interval, 2.6%-50.2%). Conclusions Significant influenza-associated morbidity was observed in 2017 in Australia. Most hospitalized children had no comorbid conditions. Vaccine coverage and antiviral use was inadequate. Influenza vaccine was protective in 2017, yet VE was lower than previous seasons. Multiple Australian states have introduced funded preschool vaccination programs in 2018. Additional efforts to promote vaccination and monitor effectiveness are required.

Original languageEnglish
Pages (from-to)940-948
Number of pages9
JournalClinical Infectious Diseases
Volume68
Issue number6
DOIs
Publication statusPublished - 5 Mar 2019

Keywords

  • children
  • hospitalization
  • influenza
  • vaccination
  • vaccine effectiveness

Cite this

Blyth, C. C., Macartney, K. K., McRae, J., Clark, J. E., Marshall, H. S., Buttery, J., ... on behalf of the Paediatric Active Enhanced Disease Surveillance (PAEDS) and Influenza Complications Alert Network (FluCAN) Collaboration (2019). Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017: Results from the PAEDS-FluCAN Collaboration. Clinical Infectious Diseases, 68(6), 940-948. https://doi.org/10.1093/cid/ciy597
Blyth, Christopher C. ; Macartney, Kristine K. ; McRae, Jocelynne ; Clark, Julia E. ; Marshall, Helen S. ; Buttery, Jim ; Francis, Joshua R. ; Kotsimbos, Tom ; Kelly, Paul M. ; Cheng, Allen C. ; on behalf of the Paediatric Active Enhanced Disease Surveillance (PAEDS) and Influenza Complications Alert Network (FluCAN) Collaboration. / Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017 : Results from the PAEDS-FluCAN Collaboration. In: Clinical Infectious Diseases. 2019 ; Vol. 68, No. 6. pp. 940-948.
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title = "Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017: Results from the PAEDS-FluCAN Collaboration",
abstract = "Background In 2017, Australia experienced record influenza notifications. Two surveillance programs combined to summarize the epidemiology of hospitalized influenza in children and report on vaccine effectiveness (VE) in the context of a limited nationally funded vaccination program. Methods Subjects were prospectively recruited (April-October 2017). Case patients were children aged ≤16 years admitted to 11 hospitals with an acute respiratory illness and laboratory-confirmed influenza. Controls were hospitalized with acute respiratory illness and tested negative for influenza. VE estimates were calculated using the test-negative design. Results A total of 1268 children were hospitalized with influenza: 31.5{\%} were <2 years old, 8.3{\%} were indigenous, and 45.1{\%} had comorbid conditions predisposing to severe influenza. Influenza B was detected in 34.1{\%} with influenza A/H1N1 and A/H3N2 detected in 47.2{\%} and 52.8{\%} of subtyped influenza A specimens. The median length of stay was 3 days (interquartile range, 1-5), 14.5{\%} were admitted to the intensive care unit, and 15.9{\%} received oseltamivir. Four in-hospital deaths occurred (0.3{\%}): one was considered influenza associated. Only 17.1{\%} of test-negative-controls were vaccinated. The VE of inactivated quadrivalent influenza vaccine for preventing hospitalized influenza was estimated at 30.3{\%} (95{\%} confidence interval, 2.6{\%}-50.2{\%}). Conclusions Significant influenza-associated morbidity was observed in 2017 in Australia. Most hospitalized children had no comorbid conditions. Vaccine coverage and antiviral use was inadequate. Influenza vaccine was protective in 2017, yet VE was lower than previous seasons. Multiple Australian states have introduced funded preschool vaccination programs in 2018. Additional efforts to promote vaccination and monitor effectiveness are required.",
keywords = "children, hospitalization, influenza, vaccination, vaccine effectiveness",
author = "Blyth, {Christopher C.} and Macartney, {Kristine K.} and Jocelynne McRae and Clark, {Julia E.} and Marshall, {Helen S.} and Jim Buttery and Francis, {Joshua R.} and Tom Kotsimbos and Kelly, {Paul M.} and Cheng, {Allen C.} and {on behalf of the Paediatric Active Enhanced Disease Surveillance (PAEDS) and Influenza Complications Alert Network (FluCAN) Collaboration}",
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Blyth, CC, Macartney, KK, McRae, J, Clark, JE, Marshall, HS, Buttery, J, Francis, JR, Kotsimbos, T, Kelly, PM, Cheng, AC & on behalf of the Paediatric Active Enhanced Disease Surveillance (PAEDS) and Influenza Complications Alert Network (FluCAN) Collaboration 2019, 'Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017: Results from the PAEDS-FluCAN Collaboration' Clinical Infectious Diseases, vol. 68, no. 6, pp. 940-948. https://doi.org/10.1093/cid/ciy597

Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017 : Results from the PAEDS-FluCAN Collaboration. / Blyth, Christopher C.; Macartney, Kristine K.; McRae, Jocelynne; Clark, Julia E.; Marshall, Helen S.; Buttery, Jim; Francis, Joshua R.; Kotsimbos, Tom; Kelly, Paul M.; Cheng, Allen C.; on behalf of the Paediatric Active Enhanced Disease Surveillance (PAEDS) and Influenza Complications Alert Network (FluCAN) Collaboration.

In: Clinical Infectious Diseases, Vol. 68, No. 6, 05.03.2019, p. 940-948.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Influenza Epidemiology, Vaccine Coverage and Vaccine Effectiveness in Children Admitted to Sentinel Australian Hospitals in 2017

T2 - Results from the PAEDS-FluCAN Collaboration

AU - Blyth, Christopher C.

AU - Macartney, Kristine K.

AU - McRae, Jocelynne

AU - Clark, Julia E.

AU - Marshall, Helen S.

AU - Buttery, Jim

AU - Francis, Joshua R.

AU - Kotsimbos, Tom

AU - Kelly, Paul M.

AU - Cheng, Allen C.

AU - on behalf of the Paediatric Active Enhanced Disease Surveillance (PAEDS) and Influenza Complications Alert Network (FluCAN) Collaboration

PY - 2019/3/5

Y1 - 2019/3/5

N2 - Background In 2017, Australia experienced record influenza notifications. Two surveillance programs combined to summarize the epidemiology of hospitalized influenza in children and report on vaccine effectiveness (VE) in the context of a limited nationally funded vaccination program. Methods Subjects were prospectively recruited (April-October 2017). Case patients were children aged ≤16 years admitted to 11 hospitals with an acute respiratory illness and laboratory-confirmed influenza. Controls were hospitalized with acute respiratory illness and tested negative for influenza. VE estimates were calculated using the test-negative design. Results A total of 1268 children were hospitalized with influenza: 31.5% were <2 years old, 8.3% were indigenous, and 45.1% had comorbid conditions predisposing to severe influenza. Influenza B was detected in 34.1% with influenza A/H1N1 and A/H3N2 detected in 47.2% and 52.8% of subtyped influenza A specimens. The median length of stay was 3 days (interquartile range, 1-5), 14.5% were admitted to the intensive care unit, and 15.9% received oseltamivir. Four in-hospital deaths occurred (0.3%): one was considered influenza associated. Only 17.1% of test-negative-controls were vaccinated. The VE of inactivated quadrivalent influenza vaccine for preventing hospitalized influenza was estimated at 30.3% (95% confidence interval, 2.6%-50.2%). Conclusions Significant influenza-associated morbidity was observed in 2017 in Australia. Most hospitalized children had no comorbid conditions. Vaccine coverage and antiviral use was inadequate. Influenza vaccine was protective in 2017, yet VE was lower than previous seasons. Multiple Australian states have introduced funded preschool vaccination programs in 2018. Additional efforts to promote vaccination and monitor effectiveness are required.

AB - Background In 2017, Australia experienced record influenza notifications. Two surveillance programs combined to summarize the epidemiology of hospitalized influenza in children and report on vaccine effectiveness (VE) in the context of a limited nationally funded vaccination program. Methods Subjects were prospectively recruited (April-October 2017). Case patients were children aged ≤16 years admitted to 11 hospitals with an acute respiratory illness and laboratory-confirmed influenza. Controls were hospitalized with acute respiratory illness and tested negative for influenza. VE estimates were calculated using the test-negative design. Results A total of 1268 children were hospitalized with influenza: 31.5% were <2 years old, 8.3% were indigenous, and 45.1% had comorbid conditions predisposing to severe influenza. Influenza B was detected in 34.1% with influenza A/H1N1 and A/H3N2 detected in 47.2% and 52.8% of subtyped influenza A specimens. The median length of stay was 3 days (interquartile range, 1-5), 14.5% were admitted to the intensive care unit, and 15.9% received oseltamivir. Four in-hospital deaths occurred (0.3%): one was considered influenza associated. Only 17.1% of test-negative-controls were vaccinated. The VE of inactivated quadrivalent influenza vaccine for preventing hospitalized influenza was estimated at 30.3% (95% confidence interval, 2.6%-50.2%). Conclusions Significant influenza-associated morbidity was observed in 2017 in Australia. Most hospitalized children had no comorbid conditions. Vaccine coverage and antiviral use was inadequate. Influenza vaccine was protective in 2017, yet VE was lower than previous seasons. Multiple Australian states have introduced funded preschool vaccination programs in 2018. Additional efforts to promote vaccination and monitor effectiveness are required.

KW - children

KW - hospitalization

KW - influenza

KW - vaccination

KW - vaccine effectiveness

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U2 - 10.1093/cid/ciy597

DO - 10.1093/cid/ciy597

M3 - Article

VL - 68

SP - 940

EP - 948

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 6

ER -