Prevention of vaccine-matched and mismatched influenza in children aged 6–35 months: a multinational randomised trial across five influenza seasons

Abstract

GlaxoSmithKline Biologicals SA.

The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience

“…Unfortunately, we did not have vaccination data for most of our paients and the majority of available data was for pediatric patients. It is important to recall that although influenza vaccines were thought to be mostly effective for children 2 years and older, recent data showed high vaccine efficacy reaching 60% in infants as young as 6 months [36,[40][41][42][43][44].…”

“…Moderate to severe influenza disease was defined as (1) fever > 39 degree Celsius (39°C), and/or (2) physician-verified shortness of breath, pulmonary congestion, pneumonia, bronchiolitis, bronchitis, wheezing, croup, or acute otitis media, and/or (3) physician-diagnosed serious extrapulmonary complication of influenza, including myositis, encephalitis, seizure, and/or myocarditis [36].…”

Retrospective study of the use of an influenza disease two-tiered classification system to characterize clinical severity in US children

“…In particular, the ≥6 to <36 months and ≥3 to <9 years age groupings were included to be consistent with previous phase 3 efficacy studies that used the same novel M-S influenza disease classification. 5,6 We did not include race/ethnicity, influenza type, and presence of RSV co-infection in our models due to insufficient variation when stratified by outcome. Pearson's Chi-squared test (or Fisher's Exact Test) was used to determine whether there was a significant difference between mild versus M-S cases for each of the outcomes.…”

“…In this study, we used a novel influenza severity definition that has been utilized in other (non-US) clinical and observational studies [5][6][7][8] to characterize whether US children classified retrospectively as having moderate-to-severe influenza disease had an increased likelihood of utilizing healthcare, including having antibiotics or antivirals prescribed. Overall, this study found that children identified as having moderate-to-severe disease had an increased likelihood of being prescribed antibiotics, having ED visits, and subsequent outpatient visits when compared with children with mild disease.…”

“…5 Another phase 3 multinational trial similarly found QIV efficacy to be higher against M-S disease (63%) versus any severity (50%) in children aged 6-35 months. 6 A prospective cohort study in Finland found that children aged <13 years with M-S influenza had significantly longer durations of fever, were more likely to receive any antibiotic treatment, and in post hoc analysis, were the only cases with any emergency department (ED) visits or hospitalizations. 7 Another prospective cohort study in Germany reported that M-S influenza was associated with more healthcare utilization among children aged 1 to 5 years.…”