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Multicenter Study
. 2020 Nov;146(5):e20201368.
doi: 10.1542/peds.2020-1368. Epub 2020 Oct 5.

Vaccine Effectiveness Against Pediatric Influenza Hospitalizations and Emergency Visits

Angela P Campbell  1 , Constance Ogokeh  2   3 , Joana Y Lively  4   5 , Mary A Staat  6 , Rangaraj Selvarangan  7   8 , Natasha B Halasa  9 , Janet A Englund  10   11 , Julie A Boom  12   13 , Geoffrey A Weinberg  14 , John V Williams  15 , Monica McNeal  6 , Christopher J Harrison  15 , Laura S Stewart  9 , Eileen J Klein  10   11 , Leila C Sahni  12   13 , Peter G Szilagyi  14   16 , Marian G Michaels  15 , Robert W Hickey  15 , Mary E Moffat  17 , Barbara A Pahud  15 , Jennifer E Schuster  15 , Gina M Weddle  15 , Brian Rha  4 , Alicia M Fry  2 , Manish Patel  2
Affiliations
Multicenter Study

Vaccine Effectiveness Against Pediatric Influenza Hospitalizations and Emergency Visits

Angela P Campbell et al. Pediatrics. 2020 Nov.

Abstract

Background: Influenza A(H1N1)pdm09 viruses initially predominated during the US 2018-2019 season, with antigenically drifted influenza A(H3N2) viruses peaking later. We estimated vaccine effectiveness (VE) against laboratory-confirmed influenza-associated hospitalizations and emergency department (ED) visits among children in the New Vaccine Surveillance Network.

Methods: We tested children 6 months to 17 years with acute respiratory illness for influenza using molecular assays at 7 pediatric hospitals (ED patients <5 years at 3 sites). Vaccination status sources were parental report, state immunization information systems and/or provider records for inpatients, and parental report alone for ED patients. We estimated VE using a test-negative design, comparing odds of vaccination among children testing positive versus negative for influenza using multivariable logistic regression.

Results: Of 1792 inpatients, 226 (13%) were influenza-positive: 47% for influenza A(H3N2), 36% for A(H1N1)pdm09, 9% for A (not subtyped), and 7% for B viruses. Among 1944 ED children, 420 (22%) were influenza-positive: 48% for A(H3N2), 35% for A(H1N1)pdm09, 11% for A (not subtyped), and 5% for B viruses. VE was 41% (95% confidence interval [CI], 20% to 56%) against any influenza-related hospitalizations, 41% (95% CI, 11% to 61%) for A(H3N2), and 47% (95% CI, 16% to 67%) for A(H1N1)pdm09. VE was 51% (95% CI, 38% to 62%) against any influenza-related ED visits, 39% (95% CI, 15% to 56%) against A(H3N2), and 61% (95% CI, 44% to 73%) against A(H1N1)pdm09.

Conclusions: The 2018-2019 influenza vaccine reduced pediatric influenza A-associated hospitalizations and ED visits by 40% to 60%, despite circulation of a drifted A(H3N2) clade.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Other than those provided under “Financial Disclosure,” the authors have indicated they have no potential conflicts of interest to disclose.

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