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Background Recent studies have shown that some vaccines have beneficial effects that could not be explained solely by the prevention of their respective targeted disease(s). Methods We used the MarketScan® United States (US) Commercial Claims Databases from 2005–2014 to assess the risk of hospital admission for non-targeted infectious diseases (NTI) in children from 16 through 24 months according to the last vaccine type (live and/or inactivated). We included children continuously enrolled within a month of birth through 15 months who received at least three doses of Diphtheria-Tetanus-acellular Pertussis vaccine by end of 15 months of age. We used Cox regression to estimate hazard ratios (HRs), stratifying by birthdate to control for age, year and seasonality, and adjusting for sex, chronic diseases, prior hospitalizations, number of outpatient visits, region of residence, urban/rural area of domicile, prematurity, low birth weight, and mother’s age. Results 311,663 children were included. In adjusted analyses, risk of hospitalization for non-targeted infections from ages 16 through 24 months was reduced for those who received live vaccine alone compared with inactivated alone or concurrent live and inactivated vaccines (HR 0.50, 95% CI 0.43, 0.57 and HR 0.78, 95% CI 0.67, 0.91, respectively), and for those who received live and inactivated vaccines concurrently compared with inactivated only (HR 0.64, 95% CI 0.58, 0.70). Conclusions We found lower risk of non-targeted infectious disease hospitalizations from 16 through 24 months among US children whose last vaccine received was live compared with inactivated vaccine, as well as concurrent receipt compared with inactivated vaccine.

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RPs have low immunization rates and significant gaps in knowledge regarding influenza immunization. These problems should be addressed during their training by education on the importance, effectiveness, and safety of influenza vaccine for them and their patients.

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