Masayoshi Shinjoh1, Norio Sugaya2, Yoshio Yamaguchi3, Noriko Iibuchi4, Isamu Kamimaki5, Anna Goto6, Hisato Kobayashi7, Yasuaki Kobayashi8, Meiwa Shibata9, Satoshi Tamaoka10, Yuji Nakata11, Atsushi Narabayashi12, Mitsuhiro Nishida13, Yasuhiro Hirano14, Takeshi Munenaga6, Kumiko Morita14, Keiko Mitamura15, Takao Takahashi1. 1. Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan. 2. Department of Pediatrics, Keiyu Hospital, Yokohama, Kanagawa, Japan. Electronic address: sugaya-n@za2.so-net.ne.jp. 3. Institute of Clinical Research Department of Infection & Allergy, National Hospital Organization Tochigi Medical Center, Utsunomiya, Tochigi, Japan. 4. Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan. 5. Department of Pediatrics, National Hospital Organization Saitama National Hospital, Wako, Saitama, Japan. 6. Department of Pediatrics, Ota Memorial Hospital, Ota, Gunma, Japan. 7. Department of Pediatrics, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan. 8. Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, Ashikaga, Tochigi, Japan. 9. Division of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan. 10. Department of Pediatrics, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochgi, Japan. 11. Department of Pediatrics, Nippon Kokan Hospital, Kawasaki, Kanagawa, Japan. 12. Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, Japan. 13. Department of Pediatrics, Shizuoka City Shimizu Hospital, Shizuoka, Japan. 14. Department of Pediatrics, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan. 15. Department of Pediatrics, Eiju General Hospital, Tokyo, Japan.
Abstract
OBJECTIVES: We assessed the vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children 6 months to 15 years of age during the 2016/17 season. In addition, we estimated the impact of repeated vaccination in children on VE. METHODS: Our study for VEs in preventing influenza and admission due to influenza were conducted according to a test-negative case-control design (TNCC) based on influenza rapid diagnostic test results. We also analyzed the VE by vaccine status in the current and previous seasons for the impact of repeated vaccination. RESULTS: During the 2016/17 season, the quadrivalent IIV was used in Japan. The adjusted VE in preventing influenza illness was 38% (95% CI, 29-46) against influenza A and 39% (95% CI, 18-54) against influenza B. Infants showed no significant VE. The VE in preventing hospitalization was not demonstrated. For the analysis of repeated vaccination, the vaccine was effective only when immunization occurred in the current season. The children who were immunized in two consecutive seasons were more likely to develop influenza compared to those immunized in the current season only (odds ratio, 1.58 [95% CI, 1.05-2.38], adjusted odds ratio, 1.53 [95% CI, 0.99-2.35]). However, the odds ratio of repeated vaccination was not significant when the analysis excluded those who developed influenza in the previous season. CONCLUSIONS: VE in children in the 2016/17 season was similar to values previously reported. Repeated vaccination interfered with the VE against any influenza infection in the 2016/17 season. The results of our study suggest that decreased VE by repeat vaccination phenomenon was associated with immunity by influenza infection in the previous season. However, the influenza vaccine should be recommended every season for children.
OBJECTIVES: We assessed the vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children 6 months to 15 years of age during the 2016/17 season. In addition, we estimated the impact of repeated vaccination in children on VE. METHODS: Our study for VEs in preventing influenza and admission due to influenza were conducted according to a test-negative case-control design (TNCC) based on influenza rapid diagnostic test results. We also analyzed the VE by vaccine status in the current and previous seasons for the impact of repeated vaccination. RESULTS: During the 2016/17 season, the quadrivalent IIV was used in Japan. The adjusted VE in preventing influenza illness was 38% (95% CI, 29-46) against influenza A and 39% (95% CI, 18-54) against influenza B. Infants showed no significant VE. The VE in preventing hospitalization was not demonstrated. For the analysis of repeated vaccination, the vaccine was effective only when immunization occurred in the current season. The children who were immunized in two consecutive seasons were more likely to develop influenza compared to those immunized in the current season only (odds ratio, 1.58 [95% CI, 1.05-2.38], adjusted odds ratio, 1.53 [95% CI, 0.99-2.35]). However, the odds ratio of repeated vaccination was not significant when the analysis excluded those who developed influenza in the previous season. CONCLUSIONS: VE in children in the 2016/17 season was similar to values previously reported. Repeated vaccination interfered with the VE against any influenza infection in the 2016/17 season. The results of our study suggest that decreased VE by repeat vaccination phenomenon was associated with immunity by influenza infection in the previous season. However, the influenza vaccine should be recommended every season for children.
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