Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for influenza vaccination in children

Usonis, Vytautas; Anca, Ioana; André, Francis; Chlíbek, Roman; Ivaškevičienė, Inga; Mangarov, Atanas; Mészner, Zsófia; Prymula, Roman; Šimurka, Pavol; Tamm, Eda; Tešović, Goran

doi:10.1186/1471-2334-10-168

Cited by 40 publications

(34 citation statements)

References 48 publications

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“…Many countries’ immunisation guidelines recommend influenza vaccination of the elderly and individuals with underlying chronic medical conditions because of their increased risk of complications due to influenza [2]. However, it is often forgotten that children have the highest influenza attack rates, with annual incidence rates of up to 30% [3]. This translates into significant illness and health care resource use, particularly related to outpatient consultations and hospitalisations [4-8].…”

Section: Introductionmentioning

confidence: 99%

Burden of paediatric influenza in Western Europe: a systematic review

Antonova¹,

Rycroft²,

Ambrose³

et al. 2012

BMC Public Health

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BackgroundInfluenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden) in children in Western Europe via a systematic literature review.MethodsWe conducted a systematic literature search of PubMed, EMBASE, and the Cochrane Library (1970-April 2011) and extracted data on influenza burden in children (defined as aged ≤ 18 years) from 50 publications (13 reporting laboratory-confirmed influenza; 37 reporting influenza-like illness).ResultsChildren with laboratory-confirmed influenza experienced hospitalisations (0.3%-20%), medical visits (1.7-2.8 visits per case), antibiotic prescriptions (7%-55%), and antipyretic or other medications for symptomatic relief (76%-99%); young children and those with severe illness had the highest rates of health care use. Influenza in children also led to absenteeism from day care, school, or work for the children, their siblings, and their parents. Average (mean or median) length of absence from school or day care associated with confirmed influenza ranged from 2.8 to 12.0 days for the children, from 1.3 to 6.0 days for their siblings, and from 1.3 to 6.3 days for their parents. Influenza negatively affected health-related quality of life in children with asthma, including symptoms and activities; this negative effect was smaller in vaccinated children than in non-vaccinated children.ConclusionsInfluenza burden in children is substantial and has a significant direct impact on the ill children and an indirect impact on their siblings and parents. The identified evidence regarding the burden of influenza may help inform both influenza antiviral use in children and paediatric immunisation policies in European countries.

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Section: Introductionmentioning

confidence: 99%

Burden of paediatric influenza in Western Europe: a systematic review

Antonova¹,

Rycroft²,

Ambrose³

et al. 2012

BMC Public Health

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“…Following recognition of the substantial burden of influenza disease in the pediatric population and the importance of young children for transmission, 1 - 5 there has been a shift in focus toward universal vaccination of healthy children. In the US, seasonal influenza vaccination is recommended for all children aged 6 months to 18 years and in Canada for children aged 6–23 months, whereas vaccination of healthy children is currently recommended in only a few European countries 6 - 9 …”

Section: Introductionmentioning

confidence: 99%

A randomized controlled study to evaluate the immunogenicity of a trivalent inactivated seasonal influenza vaccine at two dosages in children 6 to 35 months of age

Pavía-Ruz

Weber²,

Lau

et al. 2013

Human Vaccines & Immunotherapeutics

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The trivalent inactivated influenza vaccine Fluarix™ is licensed in the US for adults and children from 3 years old. This randomized observer-blind study (NCT00764790) evaluated Fluarix™ at two doses; 0.25 ml (Flu-25) and 0.5 ml (Flu-50) in children aged 6–35 months. The primary objective was to demonstrate immunogenic non-inferiority vs. a control vaccine (Fluzone®; 0.25 ml). Children received Flu-25 (n = 1107), Flu-50 (n = 1106) or control vaccine (n = 1104) at Day 0 and for un-primed children, also on Day 28. Serum hemagglutination-inhibition titers were determined pre-vaccination and at Day 28 (primed) or Day 56 (un-primed). Non-inferiority was assessed by post-vaccination geometric mean titer (GMT) ratio, (upper 95% confidence interval [CI] ≤ 1.5) and difference in seroconversion rate (upper 95% CI ≤ 10%). Reactogenicity/safety was monitored. The immune response to Flu-50 met all regulatory criteria. Indicated by adjusted GMT ratios [with 95% CI], the criteria for non-inferiority of Flu-50 vs. control vaccine were reached for the B/Florida strain (1.13 [1.01–1.25]) but not for the A/Brisbane/H1N1 (1.74 [1.54–1.98]) or A/Uruguay/H3N2 (1.72 [1.57–1.89]) strains. In children aged 18–35 months similar immune responses were observed for Flu-50 and the control vaccine. Flu-50 induced a higher response than Flu-25 for all strains. Temperature (≥ 37.5°C) was reported in 6.2%, 6.4%, and 6.6% of the Flu-25, Flu-50, and control group, respectively. Reactogenicity/safety endpoints were within the same range for all vaccines. In children aged 6–35 months, immune responses with Flu-50 fulfilled regulatory criteria but did not meet the pre-defined criteria for non-inferiority vs. control. This appeared to be due to differences in immunogenicity in children aged < 18 months.

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“…The World Health Organization (WHO) has recommended annual influenza vaccination of these subjects (44). In addition, it has been recommended in a number of countries that all healthy children older than 6 months of age be vaccinated against seasonal influenza (14,41). Since universal influenza vaccines are currently unavailable, annual vaccination aims at the induction of immunity to circulating seasonal influenza viruses (A/H3N2, A/H1N1, and B viruses).…”

Section: Here We Compared the Virus-specific Cd8mentioning

confidence: 99%

Annual Vaccination against Influenza Virus Hampers Development of Virus-Specific CD8⁺T Cell Immunity in Children

Bodewes

Fraaij

Geelhoed-Mieras

et al. 2011

J Virol

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Infection with seasonal influenza A viruses induces immunity to potentially pandemic influenza A viruses of other subtypes (heterosubtypic immunity).We recently demonstrated that vaccination against seasonal influenza prevented the induction of heterosubtypic immunity against influenza A/H5N1 virus induced by infection with seasonal influenza in animal models, which correlated with the absence of virus-specific CD8 ؉ T cell responses. Annual vaccination of all healthy children against influenza has been recommended, but the impact of vaccination on the development of the virus-specific CD8؉ T cell immunity in children is currently unknown. Here we compared the virus-specific CD8؉ T cell immunity in children vaccinated annually with that in unvaccinated children. In the present study, we compared influenza A virus-specific cellular and humoral responses of unvaccinated healthy control children with those of children with cystic fibrosis (CF) who were vaccinated annually. Similar virus-specific CD4؉ T cell and antibody responses were observed, while an age-dependent increase of the virus-specific CD8 ؉ T cell response that was absent in vaccinated CF children was observed in unvaccinated healthy control children. Our results indicate that annual influenza vaccination is effective against seasonal influenza but hampers the development of virus-specific CD8 ؉ T cell responses.

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Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for influenza vaccination in children

Cited by 40 publications

References 48 publications

Burden of paediatric influenza in Western Europe: a systematic review

Burden of paediatric influenza in Western Europe: a systematic review

A randomized controlled study to evaluate the immunogenicity of a trivalent inactivated seasonal influenza vaccine at two dosages in children 6 to 35 months of age

Annual Vaccination against Influenza Virus Hampers Development of Virus-Specific CD8⁺T Cell Immunity in Children

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Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for influenza vaccination in children

Cited by 40 publications

References 48 publications

Burden of paediatric influenza in Western Europe: a systematic review

Burden of paediatric influenza in Western Europe: a systematic review

A randomized controlled study to evaluate the immunogenicity of a trivalent inactivated seasonal influenza vaccine at two dosages in children 6 to 35 months of age

Annual Vaccination against Influenza Virus Hampers Development of Virus-Specific CD8+T Cell Immunity in Children

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Annual Vaccination against Influenza Virus Hampers Development of Virus-Specific CD8⁺T Cell Immunity in Children