1. Estimated influenza vaccine effectiveness (VE) was 65% against laboratory-confirmed influenza-associated deaths among children.
2. Vaccine effectiveness was lower at 51% for children with underlying medication conditions, though the protection remained significant.
Evidence Rating Level: 2 (Good)
Study Rundown: Data on influenza-associated deaths in children indicate that most deaths occur in unvaccinated children. The purpose of this study was to assess the effectiveness of vaccination in preventing pediatric influenza-associated deaths. Results demonstrated that influenza vaccination was associated with reduced risk of laboratory-confirmed influenza-associated pediatric death. Estimated influenza VE was 65% against laboratory-confirmed influenza-associated deaths among children. Though protection was still significant, VE was lower, at 51%, in children with underlying conditions. Limitations of this study include parental report of influenza vaccination status and a study population of only privately-insured children. These findings highlight the importance of adhering to the current recommendations for annual influenza vaccines for all children ≥ 6 months of age.
In-Depth [case-cohort study]: Cases were identified as deaths in the United States aged < 18 years with laboratory-confirmed influenza virus infection reported to the Influenza-Associated Pediatric Mortality Surveillance System. Children were considered vaccinated if records indicated receipt of ≥1 doses of the current seasonal influenza vaccine ≥14 days before onset of illness. Presence of underlying medical conditions was documented and included: asthma, chronic lung disease, neurologic or neurodevelopmental disorders, heart disease (including congenital heart disease), blood disorders, endocrine disorders, metabolic disorders, kidney disorders, liver disorders, immunosuppression, and pregnancy. Analysis of the data indicated 358 influenza-associated pediatrics deaths during 4 influenza seasons from July 1, 2010 through June 30, 2014. Of the 291 children with known vaccination status, 75 (26%) children were considered vaccinated. Black non-Hispanic children who died had significantly lower vaccination rates compared with white non-Hispanic children who died (P<0.05). Estimated VE against pediatric death was 65% (95% CI, 54% to 74%) in children without high risk conditions, and 51% (95% CI, 31% to 67%) among children with high-risk medical conditions.
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