Is It Time to Give Influenza Vaccine to Healthy Infants?

McIntosh, Kenneth; Lieu, Tracy A.

doi:10.1056/nejm200001273420409

Cited by 57 publications

(14 citation statements)

References 21 publications

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“…18 Since 1989 Ontario has provided yearly influenza vaccinations for persons at high risk of influenza complications (i.e., people with chronic cardiac or pulmonary disorders, those over the age of 65, residents of long-term care facilities and health services workers). The cost-effectiveness of vaccinating low-risk people remains controversial, [19][20][21][22][23][24][25][26][27][28][29][30] and although numerous studies have looked at the causes of ED utilization and overcrowding there are no data suggesting influenza causes overcrowding. [31][32][33][34][35][36] However, although universal vaccination may have little influence on ED volumes, vaccinating individuals at high risk for complications arising from influenza provides an average direct cost savings of $117 per person, in addition to reducing the number of hospitalizations and deaths.…”

Section: Discussionmentioning

confidence: 99%

Can a universal influenza immunization program reduce emergency department volume?

Groll

Henry²

2002

CJEM

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Objectives:In 2000 the Ontario Minister of Health and Long-Term Care announced a universal influenza immunization program for Ontario, Canada. The 2 objectives of this $38-million program were to decrease seasonal impact of influenza on emergency department (ED) visits and to decrease the number and severity of influenza cases. This paper examines the correlation between population influenza rates and ED visits in 5 tertiary care hospitals in Ontario over a 5-year period (1996)(1997)(1998)(1999)(2000)(2001). Methods: In this retrospective, observational study, we determined the total number of ED visits during the study period, by month, at 5 tertiary care hospitals in 3 Ontario cities Kingston, London and Ottawa). Detailed ED diagnoses were captured for Kingston, and provincial and national population-based influenza rates were obtained from Health Canada for the 5-year study period. Correlation and regression analyses were used to determine the relationship of influenza rates and ED volumes. "Influenza season" is defined in this study as November 1st to March 31st of each year. Results: There was no significant correlation between influenza rates and ED volumes, with Pearson correlation coefficients (r) of 0.22 (p = 0.72), 0.33 (p = 0.59) and 0.27 (p = 0.66) at the Kingston, London and Ottawa study sites, respectively. Data from the Kingston hospitals showed that, during influenza season, acute respiratory diagnoses accounted for only 4.4% of ED visits and influenza for only 0.34% of visits. Multiple linear regression analysis showed that the ED diagnosis of influenza was not significantly related to ED volume. During the influenza season after the universal immunization campaign, ED visits increased at all sites.

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Section: Discussionmentioning

confidence: 99%

Can a universal influenza immunization program reduce emergency department volume?

Groll

Henry²

2002

CJEM

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“…An important causal agent in asthma exacerbation is influenza, especially during epidemics [2,3]. Influenza has a major impact on children's well-being and need for medical treatment [4][5][6] and predisposes to complications such as pneumonia [7] and acute otitis media [7][8][9][10]. Annual influenza vaccination is there-* Author for correspondence.…”

Section: Introductionmentioning

confidence: 99%

Clinical effectiveness of conventional influenza vaccination in asthmatic children

et al. 2002

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SUMMARYInfluenza immunization rates among young asthmatics remain unsatisfactory due to persistent concern about the impact of influenza and the benefits of the vaccine. We assessed the effectiveness of the conventional inactivated trivalent sub-unit influenza vaccine in reducing acute respiratory disease in asthmatic children. We conducted a two-season retrospective cohort study covering the 1995-6 and 1996-7 influenza outbreaks in 22 computerized primary care practices in the Netherlands. In total, 349 patients aged between 0 and 12 years meeting clinical asthma-criteria were included ; 14 children were lost to follow-up in the second season. The occurrence of physician-diagnosed acute respiratory disease episodes including influenzalike illness, pneumonia, bronchitis, bronchiolitis, asthma exacerbation and acute otitis media in vaccinated and unvaccinated children were compared after adjustments for age, prior health care and medication use. The occurrence of acute respiratory disease in unvaccinated children was 28 % and 24 % in the 1995-6 and 1996-7 season, respectively, and was highest in children under 6 years of age (43 %). The overall pooled clinical vaccine effectiveness was 27 % (95 % confidence interval k7 to 51%, P l 0n11) after adjustments. A statistically higher vaccine protectiveness of 55 % (95 % CI 20-75 %, P l 0n01) was observed among asthmatics under 6 years of age compared with k5 % in older children (95 % CI k81 to 39 %).

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“…Recently, there has been renewed interest in the study of influenza transmission in families, especially in light of the recent debates about whether large-scale vaccination of healthy children in daycare would be beneficial to other age groups, 4,5 and whether contact prophylaxis with neuraminidase inhibitors could effectively prevent transmission. [6][7][8] However, no data are available on the quantitative evaluation of the predictors of influenza transmission in households.…”

Section: Introductionmentioning

confidence: 99%