Evaluation of the influenza vaccine effectiveness among children aged 6 to 72 months based on the test-negative case control study design

Shuying LUO; Junli ZHU; Meizhai LYU; Yunqing HU; Hang CHENG; Guangming ZHANG; Gaoshang CHEN; Xiaohong WU

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Evaluation of the influenza vaccine effectiveness among children aged 6 to 72 months based on the test-negative case control study design

VernacularTitle: 基于实验室检测结果病例-对照研究评价6~72月龄儿童流感疫苗效果
Author: Shuying LUO ¹ ; Junli ZHU ² ; Meizhai LYU ³ ; Yunqing HU ³ ; Hang CHENG ¹ ; Guangming ZHANG ² ; Gaoshang CHEN ² ; Xiaohong WU ²
Author Information

1. Department of Immunization Program, Yiwu Municipal Center for Disease Control and Prevention, Yiwu 322000, China
2. Division of Infectious Disease Prevention and Control, Jinhua Municipal Center for Disease Control and Prevention, Jinhua 321002, China
3. Division of Infectious Disease Prevention and Control, Yongkang Municipal Center for Disease Control and Prevention, Jinhua 321300, China
Publication Type:Journal Article
Keywords: Influenza vaccines; Case-control studies; Vaccine effectiveness
From: Chinese Journal of Preventive Medicine 2019;53(6):576-580
CountryChina
Language:Chinese
Abstract: Objective:To assess the effectiveness of seasonal influenza vaccine among children aged 6 to 72 months.
Methods:The test-negative case control study was conducted based on available surveillance data which was from China Influenza Surveillance Information system (CSIS). From October 2016 to April 2017 and from October 2017 to April 2018,1 161 cases aged 6-72 months with influenza-like illness in Yongkang and Yiwu city, were selected as the study subjects, and the cases with influenza test-positive were selected as the case group (403 cases). Test-negative subjects were selected as control group (758 cases). The etiology and immunization data of the subjects were obtained from CSIS and Immune Information and Management System (IIMS) respectively. Vaccine effectiveness was estimated using multivariate logistic regression model,and the mixed effects of non-randomized control in TNCC study were equalized by using the propensity score (PS) method in the statistical analysis.
Results:The age of the subjects was (2.44±1.60) years,and there were 681 boys (58.66%). The age of case group was (2.62±1.58) years, and there were 246 boys (61.04%). The case group was including of 237 cases (58.81%) of influenza A (H3N2), 92 cases (22.83%) of influenza A (H1N1) pmd09, 62 cases (15.38%) of influenza B(Victoria) lineage, 11 cases (2.73%) of influenza B (Yamagata) lineage and one case (0.25%) co-infection of influenza [A(H₃N₂)+B (Victoria)]. The mean age of the control group was (2.35±1.61) years,and there were 435 boys (57.39%). Overall vaccine effectiveness (VE) against all type influenza for two seasons combined was 58% (95%CI: 31%-74%). An analysis by age groups showed 68% (95%CI:41%-82%) of the VE estimate among children aged 36-72 months while it was 28%(95%CI:-80%-71%)of the VE estimate among children aged 6-35 months. The VE estimate value was 54% (95%CI:16%-75%) against all type influenza and 65% (95%CI:24%-83%) against influenza A (H₃N₂) during the 2016-2017 season. During the 2017-2018 season, the VE estimate value was 69% (95%CI:18%-88%) against all type influenza.
Conclusion:Influenza vaccine is effective in preventing influenza virus infection during the flu season,especially the effect among children aged 36-72 months is higher compared to that among children aged 6-35 months.