Seasonal influenza prevention and control in Taiwan—Strategies revisited

Su, Chia‐Ping; Tsou, Tsung-Pei; Chen, Chang-Hsun; Lin, Tzou–Yien; Chang, Shan-Chwen

doi:10.1016/j.jfma.2018.12.022

Cited by 22 publications

(24 citation statements)

References 16 publications

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“…The vaccine coverage among the Taiwanese population has gradually increased from less than 10% in 2001 to 26% in the 2016-2017 season (Meyer et al, 2018). In the 2017-18 season, the TIV coverage for elderly !65 years old, school-aged children/adolescent 7-18 years old and children 0.5-6 years old are 49%, 76% and 58%, respectively (Su et al, 2019). After the vaccine-mismatched influenza B outbreak in 2011-2012, there has been debate about whether quadrivalent vaccine should be used to offer better protection for the population.…”

Section: Discussionmentioning

confidence: 99%

“…Free vaccines are offered to a list of prioritized groups including pre-and school age children, pregnant women, adults over 50 years of age, people living with chronic illness, healthcare workers, etc. (Su et al, 2019). From 2002 to 2012, a lineagemismatch occurred between the vaccine and circulating influenza B virus strains in five of the 10 influenza seasons (Lo et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Comparative epidemiology of influenza B by lineage in intensive care unit-admitted patients with complications: A nationwide study in Taiwan, 2013–2017

Chen

Liu

et al. 2019

International Journal of Infectious Diseases

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Background: We describe the relative proportions and epidemiological features of influenza B/Victoria and B/Yamagata, using data from nationwide surveillance systems. Methods: We collected respiratory samples from outpatients with influenza-like illness (ILI) and intensive care unit (ICU)-admitted patients with complications (pulmonary or neurological complications, myocarditis/pericarditis or invasive bacterial infection) for virus isolation and lineage typing. Demographics, epidemiological features, and vaccination history from ICU-admitted patients with complications were analyzed. Results: From July 2013-June 2017, 21% of 11517 influenza isolates were influenza B. B/Victoria was the predominant circulating strain in 2013-2014, accounted for 56% of all influenza B positive samples and B/ Yamagata was predominant in 2014-2017 (82%, 69%, and 85%, respectively). Among all typed viruses, the proportion of B/Yamagata was higher among specimens from ICU-admitted patients with complications (77%, 154/199) than from ILI outpatients (66%, 276/418, p < 0.005). Compared to B/Victoria, B/Yamagata infected ICU-admitted patients with complications were older, median age (71 vs. 59 years, p < 0.05), had longer durations of hospitalization (15 vs. 7.5 days, p < 0.05) and ICU stays (8.5 vs. 5.5 days, p < 0.05). Conclusions: Two lineages of influenza B viruses co-circulate annually in Taiwan. Among ICU-admitted patients with complications, B/Yamagata causes more severe illness than B/Victoria.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative epidemiology of influenza B by lineage in intensive care unit-admitted patients with complications: A nationwide study in Taiwan, 2013–2017

Chen

Liu

et al. 2019

International Journal of Infectious Diseases

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“…Influenza remains a public health concern in Asia, and particularly in Taiwan [1]. The Taiwan Centers for Diseases Control (TCDC) and Infectious Disease Control Advisory Committee have multiple health strategies for seasonal influenza prevention in addition to the national influenza vaccination campaign for controlling the risk of influenza transmission among vulnerable groups and reducing influenza-associated mortality and hospitalization [1]. The influenza season in Taiwan usually begins in December and peaks in January or February of the following year [2].…”

Section: Introductionmentioning

confidence: 99%

“…The influenza season in Taiwan usually begins in December and peaks in January or February of the following year [2]. Annual government-funded influenza vaccination campaigns aim to reduce the transmission of influenza and the associated mortality and morbidity [1][2][3]. Initially, Taiwan government-funded vaccines were only offered to adults ≥65 years [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Annual government-funded influenza vaccination campaigns aim to reduce the transmission of influenza and the associated mortality and morbidity [1][2][3]. Initially, Taiwan government-funded vaccines were only offered to adults ≥65 years [1][2][3][4][5]. Subsequently, people at high risk of developing serious complications and key spreaders, approximately 25% of the Taiwanese population, are vaccinated free of charge [1,2,4,5] However, individuals with a disability are not included in the current priority groups [6].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Influenza Vaccination on Mortality and Risk of Hospitalization in Elderly Individuals with and without Disabilities: A Nationwide, Population-Based Cohort Study

et al. 2020

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Purpose: The effects of influenza vaccines are unclear for elderly individuals with disabilities. We use a population-based cohort study to estimate the effects of influenza vaccines in elderly individuals with and without disabilities. Methods: Data were taken from the National Health Insurance Research Database and Disabled Population Profile of Taiwan. A total of 2,741,403 adults aged 65 or older were identified and 394,490 were people with a disability. These two groups were further divided into those who had or had not received an influenza vaccine. Generalized estimating equations (GEE) were used to compare the relative risks (RRs) of death and hospitalization across the four groups. Results: 30.78% elderly individuals without a disability and 34.59% elderly individuals with a disability had vaccinated for influenza. Compared to the unvaccinated elderly without a disability, the vaccinated elderly without a disability had significantly lower risks in all-cause mortality (RR = 0.64) and hospitalization for any of the influenza-related diseases (RR = 0.91). Both the unvaccinated and vaccinated elderly with a disability had significantly higher risks in all-cause mortality (RR = 1.81 and 1.18, respectively) and hospitalization for any of the influenza-related diseases (RR = 1.73 and 1.59, respectively). Conclusions: The elderly with a disability had higher risks in mortality and hospitalization than those without a disability; however, receiving influenza vaccinations could still generate more protection to the disabled elderly.

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Association of Influenza Vaccination With Risk of Bell Palsy Among Older Adults in Taiwan

Wei

Wang

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceAnnual administration of the influenza vaccine (fluVc) is currently the most effective method of preventing the influenza virus in older adults. However, half of adults older than 65 years remain unvaccinated in Taiwan, possibly because of concern about adverse events, such as Bell palsy (BP). Currently, studies on the association between fluVc and risk of BP are inconsistent.ObjectiveTo determine whether the incidence of BP increases following fluVc in older adults.Design, Setting, and ParticipantsA self-controlled case series study design was used. Days 1 through 7, days 8 through 14, days 15 through 30, and days 31 through 60 following fluVc were identified as risk intervals, and days 61 through 180 were considered the control interval. A total of 4367 vaccinated individuals aged 65 years or older who developed BP within 6 months following fluVc were enrolled. Population-based retrospective claims data were obtained between 2010 and 2017; data were analyzed from April 2022 through September 2022.ExposureGovernment-funded seasonal fluVc.Main Outcomes and MeasuresThe outcome of interest was BP onset in risk intervals compared with control intervals. Three or more consecutive diagnoses of BP within 60 days following fluVc were used as the definition of a patient with BP. Poisson regression was used to analyze the incidence rate ratio (IRR) of risk intervals compared with control intervals.ResultsIn total, 13 261 521 patients who received the fluVc were extracted from the National Health Insurance Research Database in Taiwan from January 1, 2010, to December 31, 2017. Of those, 7 581 205 patients older than 65 years old met the inclusion criteria. The number of patients with BP diagnosed within 6 months following fluVc enrolled for risk analysis was 4367 (mean [SD] age, 74.19 [5.97] years; 2349 [53.79%] female patients). The incidence rate of BP among all observed fluVc older adults was 57.87 per 100 000 person-years. The IRRs for BP on days 1 through 7, days 8 through 14, and days 15 through 30 were 4.18 (95% CI, 3.82-4.59), 2.73 (95% CI, 2.45-3.05), and 1.67 (95% CI, 1.52-1.84), respectively. However, there was no increase during days 31 through 60 (IRR, 1.06; 95% CI, 0.97-1.16). The postvaccination risk of BP was consistent across all subgroups stratified by sex, age group, and baseline conditions.Conclusions and RelevanceThe present self-controlled case series indicated that the risk of BP in individuals older than 65 years increased within the first month, especially within the first week, following fluVc. But overall, the adverse event rate of BP was low, and considering the morbidity and mortality of influenza infection, the benefits of fluVc still outweigh the risks.

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Seasonal influenza prevention and control in Taiwan—Strategies revisited

Cited by 22 publications

References 16 publications

Comparative epidemiology of influenza B by lineage in intensive care unit-admitted patients with complications: A nationwide study in Taiwan, 2013–2017

Comparative epidemiology of influenza B by lineage in intensive care unit-admitted patients with complications: A nationwide study in Taiwan, 2013–2017

Effect of Influenza Vaccination on Mortality and Risk of Hospitalization in Elderly Individuals with and without Disabilities: A Nationwide, Population-Based Cohort Study

Association of Influenza Vaccination With Risk of Bell Palsy Among Older Adults in Taiwan

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