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Vaccination reduced risk of pediatric influenza-related death by 65%
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Influenza vaccination reduces the risk of lab-confirmed influenza-associated pediatric death by 65% among healthy children and 51% among children with high-risk medical conditions; however, among recorded pediatric deaths from influenza, only one in four children had been vaccinated.
“Since 2004, when influenza-associated deaths among children aged younger than 18 years became nationally notifiable, reported numbers of deaths have ranged from 37 in the 2011-2012 season to 358 during the 2009 pandemic” Brendan Flannery, PhD, from the Influenza Division at the CDC, and colleagues wrote. “Surveillance for pediatric deaths has contributed to identification of groups at high risk of influenza-related mortality, such as children with neurologic conditions, and undocumented fatal illness among children with and without underlying high-risk medical conditions.”
To analyze the effects of vaccination against influenza-related pediatric deaths, researchers conducted a case-cohort analysis that examined the relation between vaccination uptake in lab-confirmed influenza-related pediatric deaths. Vaccination coverage was estimated among children in the U.S., and case investigation established case vaccination and high-risk status. Data regarding vaccination coverage were collected from national surveys or national insurance claims.
Flannery and colleagues identified 348 lab-confirmed influenza-associated deaths among children aged 6 months to 17 years between July 2010 and June 2014. Of these cases in which vaccination was confirmed (291), 26% were vaccinated before the onset of influenza, and average vaccination coverage was 48%.
High-risk children encompassed 153 deaths in this cohort; however, only 31% were vaccinated. The effectiveness of influenza vaccination in these children was lessened when compared with those without high-risk conditions (51% vs. 65%).
“Despite high prevalence — 53% — of underlying conditions that increase risk of severe influenza-related complications, only one in four children who died with laboratory-confirmed influenza had been vaccinated,” Flannery and colleagues wrote. “These results reinforce the need to increase influenza vaccination coverage, especially among children at increased risk of influenza-related complications and death.” — by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Pedro A. Piedra, MD
National recommendation for universal influenza immunization of children 6 months of age and older was first made in 2009 by the Advisory Committee on Immunization Practices of the CDC. This year (2016-17 flu season) over 149 million vaccine doses were distributed with the majority issued by first of December. Immunization coverage of children early in the season was low, approaching 37% as reported by the CDC, which is far below the Healthy People 2020 target of 70%.
Why are we falling short of immunizing our children against the serious and sometimes lethal consequences of influenza? Influenza vaccine is not a perfect vaccine, but it is safe and has good levels of protection in most years. The study by Flannery et al demonstrates that over a 4-year period influenza vaccination reduced influenza-associated pediatric deaths by 65% in all children, and reduced by 51% among children with high-risk conditions. Sadly, most of the children who died from influenza were unvaccinated. Surely, as advocates of children, we can do a better job in vaccinating early and vaccinating more against influenza.
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