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The impact of new universal child influenza programs in Australia: Vaccine coverage, effectiveness and disease epidemiology in hospitalised children in 2018

Blyth, Christopher C; Cheng, Allen; Crawford, Nigel; Clark, Julia; Buttery, Jim; Marshall, Helen; Francis, Josh; McRae, Jocelynne; Kotsimbos, Tom; Kelly, Paul; Macartney, Kristine K.

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Background: New jurisdictionally-based vaccination programs were established providing free quadrivalent influenza vaccine (QIV) for preschool Australian children in 2018. This was in addition to the National Immunisation Program (NIP) funded QIV for Indigenous children and children with comorbid medical conditions. We assessed the impact of this policy change on influenza disease burden and vaccine coverage, as well as report on 2018 vaccine effectiveness in a hospital-based surveillance...[Show more]

dc.contributor.authorBlyth, Christopher C
dc.contributor.authorCheng, Allen
dc.contributor.authorCrawford, Nigel
dc.contributor.authorClark, Julia
dc.contributor.authorButtery, Jim
dc.contributor.authorMarshall, Helen
dc.contributor.authorFrancis, Josh
dc.contributor.authorMcRae, Jocelynne
dc.contributor.authorKotsimbos, Tom
dc.contributor.authorKelly, Paul
dc.contributor.authorMacartney, Kristine K.
dc.date.accessioned2022-03-01T04:11:28Z
dc.identifier.issn0264-410X
dc.identifier.urihttp://hdl.handle.net/1885/261599
dc.description.abstractBackground: New jurisdictionally-based vaccination programs were established providing free quadrivalent influenza vaccine (QIV) for preschool Australian children in 2018. This was in addition to the National Immunisation Program (NIP) funded QIV for Indigenous children and children with comorbid medical conditions. We assessed the impact of this policy change on influenza disease burden and vaccine coverage, as well as report on 2018 vaccine effectiveness in a hospital-based surveillance system. Methods: Subjects were recruited prospectively from twelve PAEDS-FluCAN sentinel hospital sites (April until October 2018). Children aged 16 years hospitalised with an acute respiratory illness (ARI) and laboratory-confirmed influenza were considered cases. Hospitalised children with ARI who tested negative for influenza were considered controls. VE estimates were calculated from the adjusted odds ratio of vaccination in cases and controls. Results: A total of 458 children were hospitalised with influenza: 31.7% were <2 years, 5.0% were Indigenous, and 40.6% had medical comorbidities predisposing to severe influenza. Influenza A was detected in 90.6% of children (A/H1N1: 38.0%; A/H3N2: 3.1%; A/unsubtyped 48.6%). The median length of stay was 2 days (IQR: 1,3) and 8.1% were admitted to ICU. Oseltamivir use was infrequent (16.6%). Two in-hospital deaths occurred (0.45%). 12.0% of influenza cases were vaccinated compared with 36.0% of test-negative controls. Vaccine effectiveness of QIV for preventing influenza hospitalisation was estimated at 78.8% (95%CI: 66.9; 86.4). Conclusions: Compared with 2017 (n = 1268 cases), a significant reduction in severe influenza was observed in Australian children, possibly contributed to by improved vaccine coverage and high vaccine effectiveness. Despite introduction of jurisdictionally-funded preschool programs and NIP-funded vaccine for children with risk factors for severe disease, improved coverage is required to ensure adequate protection against paediatric influenza morbidity and mortality.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherElsevier
dc.rights© 2020 Elsevier Ltd.
dc.sourceVaccine
dc.subjectInfluenza
dc.subjectHospitalization
dc.subjectVaccination
dc.subjectChildren
dc.subjectVaccine effectiveness
dc.titleThe impact of new universal child influenza programs in Australia: Vaccine coverage, effectiveness and disease epidemiology in hospitalised children in 2018
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume38
dc.date.issued2020
local.identifier.absfor111711 - Health Information Systems (incl. Surveillance)
local.identifier.ariespublicationa383154xPUB13083
local.publisher.urlhttps://www.elsevier.com/en-au
local.type.statusPublished Version
local.contributor.affiliationBlyth, Christopher C, University of Western Australia
local.contributor.affiliationCheng, Allen, Alfred Hospital
local.contributor.affiliationCrawford, Nigel, Royal Children's Hospital
local.contributor.affiliationClark, Julia, Queensland Children's Hospital
local.contributor.affiliationButtery, Jim, Monash University
local.contributor.affiliationMarshall, Helen, University of Adelaide
local.contributor.affiliationFrancis, Josh, Royal Darwin Hospital
local.contributor.affiliationMcRae, Jocelynne, University of Sydney
local.contributor.affiliationKotsimbos, Tom, Monash University
local.contributor.affiliationKelly, Paul, College of Health and Medicine, ANU
local.contributor.affiliationMacartney, Kristine K., University of Sydney
local.description.embargo2099-12-31
local.bibliographicCitation.issue13
local.bibliographicCitation.startpage2779
local.bibliographicCitation.lastpage2787
local.identifier.doi10.1016/j.vaccine.2020.02.031
local.identifier.absseo920501 - Child Health
dc.date.updated2020-12-20T07:20:12Z
CollectionsANU Research Publications

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