Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children

Samantha M. Olson; Margaret M. Newhams; Natasha B. Halasa; Leora R. Feldstein; Tanya Novak; Scott L. Weiss; Bria M. Coates; Jennifer E. Schuster; Adam J. Schwarz; Aline B. Maddux; Mark W. Hall; Ryan A. Nofziger; Heidi R. Flori; Shira J. Gertz; Michele Kong; Ronald C. Sanders; Katherine Irby; Janet R. Hume; Melissa L. Cullimore; Steven L. Shein; Neal J. Thomas; Laura S. Stewart; John R. Barnes; Manish M. Patel; Adrienne G. Randolph; Kong Michele; Meghan Murdock; Ronald C. Sanders; Glenda Hefley; Adam J. Schwarz; Cathy Flores; Ofelia Vargas-Shiraishi; Aline B. Maddux; Peter M. Mourani; Kevin A. Van; Bria M. Coates; Avani Shukla; Jairo Chavez; Adrienne G. Randolph; Margaret M. Newhams; Sabrina R. Chen; Emily Jung; Heidi R. Flori; Mary K. Dahmer; Chaandini Jayachandran; Janet R. Hume; Lexie Goertzen; Brittany Faanes; Jennifer E. Schuster; Megan C. Bledsoe; Shannon E. Clark; Melissa L. Cullimore; Rachel L. Wellman; Shira J. Gertz; Ryan A. Nofziger; Nicole Twinem; Steven L. Shein; Amanda N. Lansell; Rajashri Rasal; Mark W. Hall; Maggie Flowers; Lisa Steele; Jenny L. Bush; Ryan H. Burnett; Neal J. Thomas; Debra Spear; Natasha B. Halasa; Laura S. Stewart; Tricia L. Lynch; Samantha M. Olson; Manish M. Patel; Leora R. Feldstein; John R. Barnes; Shoshona Le; Juliana DaSilva; Lisa Keong; Thomas Stark; Garten Kondor Rebecca; Wu Michael

doi:10.1093/cid/ciab931

Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children

Samantha M. Olson, Margaret M. Newhams, Natasha B. Halasa, Leora R. Feldstein, Tanya Novak, Scott L. Weiss, Bria M. Coates, Jennifer E. Schuster, Adam J. Schwarz, Aline B. Maddux, Mark W. Hall, Ryan A. Nofziger, Heidi R. Flori, Shira J. Gertz, Michele Kong, Ronald C. Sanders, Katherine Irby, Janet R. Hume, Melissa L. Cullimore, Steven L. SheinNeal J. Thomas, Laura S. Stewart, John R. Barnes, Manish M. Patel, Adrienne G. Randolph, Kong Michele, Meghan Murdock, Ronald C. Sanders, Glenda Hefley, Adam J. Schwarz, Cathy Flores, Ofelia Vargas-Shiraishi, Aline B. Maddux, Peter M. Mourani, Kevin A. Van, Bria M. Coates, Avani Shukla, Jairo Chavez, Adrienne G. Randolph, Margaret M. Newhams, Sabrina R. Chen, Emily Jung, Heidi R. Flori, Mary K. Dahmer, Chaandini Jayachandran, Janet R. Hume, Lexie Goertzen, Brittany Faanes, Jennifer E. Schuster, Megan C. Bledsoe, Shannon E. Clark, Melissa L. Cullimore, Rachel L. Wellman, Shira J. Gertz, Ryan A. Nofziger, Nicole Twinem, Steven L. Shein, Amanda N. Lansell, Rajashri Rasal, Mark W. Hall, Maggie Flowers, Lisa Steele, Jenny L. Bush, Ryan H. Burnett, Neal J. Thomas, Debra Spear, Natasha B. Halasa, Laura S. Stewart, Tricia L. Lynch, Samantha M. Olson, Manish M. Patel, Leora R. Feldstein, John R. Barnes, Shoshona Le, Juliana DaSilva, Lisa Keong, Thomas Stark, Garten Kondor Rebecca, Wu Michael

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29 Scopus citations

Abstract

Background: Predominance of 2 antigenically drifted influenza viruses during the 2019-2020 season offered an opportunity to assess vaccine effectiveness against life-threatening pediatric influenza disease from vaccine-mismatched viruses in the United States. Methods: We enrolled children aged <18 years admitted to the intensive care unit with acute respiratory infection across 17 hospitals. Respiratory specimens were tested using reverse-transcription polymerase chain reaction for influenza viruses and sequenced. Using a test-negative design, we estimated vaccine effectiveness comparing odds of vaccination in test-positive case patients vs test-negative controls, stratifying by age, virus type, and severity. Life-threating influenza included death or invasive mechanical ventilation, vasopressors, cardiopulmonary resuscitation, dialysis, or extracorporeal membrane oxygenation. Results: We enrolled 159 critically ill influenza case-patients (70% ≤8 years; 51% A/H1N1pdm09 and 25% B-Victoria viruses) and 132 controls (69% were aged ≤8 years). Among 56 sequenced A/H1N1pdm09 viruses, 29 (52%) were vaccine-mismatched (A/H1N1pdm09/5A+156K) and 23 (41%) were vaccine-matched (A/H1N1pdm09/5A+187A,189E). Among sequenced B-lineage viruses, majority (30 of 31) were vaccine-mismatched. Effectiveness against critical influenza was 63% (95% confidence interval [CI], 38% to 78%) and similar by age. Effectiveness was 75% (95% CI, 49% to 88%) against life-threatening influenza vs 57% (95% CI, 24% to 76%) against non-life-threating influenza. Effectiveness was 78% (95% CI, 41% to 92%) against matched A(H1N1)pdm09 viruses, 47% (95% CI,-21% to 77%) against mismatched A(H1N1)pdm09 viruses, and 75% (95% CI, 37% to 90%) against mismatched B-Victoria viruses. Conclusions: During a season when vaccine-mismatched influenza viruses predominated, vaccination was associated with a reduced risk of critical and life-threatening influenza illness in children.

Original language	English (US)
Pages (from-to)	230-238
Number of pages	9
Journal	Clinical Infectious Diseases
Volume	75
Issue number	2
DOIs	https://doi.org/10.1093/cid/ciab931
State	Published - Jul 15 2022

All Science Journal Classification (ASJC) codes

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/cid/ciab931

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Olson, S. M., Newhams, M. M., Halasa, N. B., Feldstein, L. R., Novak, T., Weiss, S. L., Coates, B. M., Schuster, J. E., Schwarz, A. J., Maddux, A. B., Hall, M. W., Nofziger, R. A., Flori, H. R., Gertz, S. J., Kong, M., Sanders, R. C., Irby, K., Hume, J. R., Cullimore, M. L., ... Michael, W. (2022). Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children. Clinical Infectious Diseases, 75(2), 230-238. https://doi.org/10.1093/cid/ciab931

@article{7a7e022cc9a64373a38c1a311d91273c,

title = "Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children",

abstract = "Background: Predominance of 2 antigenically drifted influenza viruses during the 2019-2020 season offered an opportunity to assess vaccine effectiveness against life-threatening pediatric influenza disease from vaccine-mismatched viruses in the United States. Methods: We enrolled children aged <18 years admitted to the intensive care unit with acute respiratory infection across 17 hospitals. Respiratory specimens were tested using reverse-transcription polymerase chain reaction for influenza viruses and sequenced. Using a test-negative design, we estimated vaccine effectiveness comparing odds of vaccination in test-positive case patients vs test-negative controls, stratifying by age, virus type, and severity. Life-threating influenza included death or invasive mechanical ventilation, vasopressors, cardiopulmonary resuscitation, dialysis, or extracorporeal membrane oxygenation. Results: We enrolled 159 critically ill influenza case-patients (70% ≤8 years; 51% A/H1N1pdm09 and 25% B-Victoria viruses) and 132 controls (69% were aged ≤8 years). Among 56 sequenced A/H1N1pdm09 viruses, 29 (52%) were vaccine-mismatched (A/H1N1pdm09/5A+156K) and 23 (41%) were vaccine-matched (A/H1N1pdm09/5A+187A,189E). Among sequenced B-lineage viruses, majority (30 of 31) were vaccine-mismatched. Effectiveness against critical influenza was 63% (95% confidence interval [CI], 38% to 78%) and similar by age. Effectiveness was 75% (95% CI, 49% to 88%) against life-threatening influenza vs 57% (95% CI, 24% to 76%) against non-life-threating influenza. Effectiveness was 78% (95% CI, 41% to 92%) against matched A(H1N1)pdm09 viruses, 47% (95% CI,-21% to 77%) against mismatched A(H1N1)pdm09 viruses, and 75% (95% CI, 37% to 90%) against mismatched B-Victoria viruses. Conclusions: During a season when vaccine-mismatched influenza viruses predominated, vaccination was associated with a reduced risk of critical and life-threatening influenza illness in children.",

author = "Olson, {Samantha M.} and Newhams, {Margaret M.} and Halasa, {Natasha B.} and Feldstein, {Leora R.} and Tanya Novak and Weiss, {Scott L.} and Coates, {Bria M.} and Schuster, {Jennifer E.} and Schwarz, {Adam J.} and Maddux, {Aline B.} and Hall, {Mark W.} and Nofziger, {Ryan A.} and Flori, {Heidi R.} and Gertz, {Shira J.} and Michele Kong and Sanders, {Ronald C.} and Katherine Irby and Hume, {Janet R.} and Cullimore, {Melissa L.} and Shein, {Steven L.} and Thomas, {Neal J.} and Stewart, {Laura S.} and Barnes, {John R.} and Patel, {Manish M.} and Randolph, {Adrienne G.} and Kong Michele and Meghan Murdock and Sanders, {Ronald C.} and Glenda Hefley and Schwarz, {Adam J.} and Cathy Flores and Ofelia Vargas-Shiraishi and Maddux, {Aline B.} and Mourani, {Peter M.} and Van, {Kevin A.} and Coates, {Bria M.} and Avani Shukla and Jairo Chavez and Randolph, {Adrienne G.} and Newhams, {Margaret M.} and Chen, {Sabrina R.} and Emily Jung and Flori, {Heidi R.} and Dahmer, {Mary K.} and Chaandini Jayachandran and Hume, {Janet R.} and Lexie Goertzen and Brittany Faanes and Schuster, {Jennifer E.} and Bledsoe, {Megan C.} and Clark, {Shannon E.} and Cullimore, {Melissa L.} and Wellman, {Rachel L.} and Gertz, {Shira J.} and Nofziger, {Ryan A.} and Nicole Twinem and Shein, {Steven L.} and Lansell, {Amanda N.} and Rajashri Rasal and Hall, {Mark W.} and Maggie Flowers and Lisa Steele and Bush, {Jenny L.} and Burnett, {Ryan H.} and Thomas, {Neal J.} and Debra Spear and Halasa, {Natasha B.} and Stewart, {Laura S.} and Lynch, {Tricia L.} and Olson, {Samantha M.} and Patel, {Manish M.} and Feldstein, {Leora R.} and Barnes, {John R.} and Shoshona Le and Juliana DaSilva and Lisa Keong and Thomas Stark and Rebecca, {Garten Kondor} and Wu Michael",

note = "Publisher Copyright: {\textcopyright} 2022 Published by Oxford University Press for the Infectious Diseases Society of America.",

year = "2022",

month = jul,

day = "15",

doi = "10.1093/cid/ciab931",

language = "English (US)",

volume = "75",

pages = "230--238",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "2",

}

Olson, SM, Newhams, MM, Halasa, NB, Feldstein, LR, Novak, T, Weiss, SL, Coates, BM, Schuster, JE, Schwarz, AJ, Maddux, AB, Hall, MW, Nofziger, RA, Flori, HR, Gertz, SJ, Kong, M, Sanders, RC, Irby, K, Hume, JR, Cullimore, ML, Shein, SL, Thomas, NJ, Stewart, LS, Barnes, JR, Patel, MM, Randolph, AG, Michele, K, Murdock, M, Sanders, RC, Hefley, G, Schwarz, AJ, Flores, C, Vargas-Shiraishi, O, Maddux, AB, Mourani, PM, Van, KA, Coates, BM, Shukla, A, Chavez, J, Randolph, AG, Newhams, MM, Chen, SR, Jung, E, Flori, HR, Dahmer, MK, Jayachandran, C, Hume, JR, Goertzen, L, Faanes, B, Schuster, JE, Bledsoe, MC, Clark, SE, Cullimore, ML, Wellman, RL, Gertz, SJ, Nofziger, RA, Twinem, N, Shein, SL, Lansell, AN, Rasal, R, Hall, MW, Flowers, M, Steele, L, Bush, JL, Burnett, RH, Thomas, NJ, Spear, D, Halasa, NB, Stewart, LS, Lynch, TL, Olson, SM, Patel, MM, Feldstein, LR, Barnes, JR, Le, S, DaSilva, J, Keong, L, Stark, T, Rebecca, GK & Michael, W 2022, 'Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children', Clinical Infectious Diseases, vol. 75, no. 2, pp. 230-238. https://doi.org/10.1093/cid/ciab931

TY - JOUR

T1 - Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children

AU - Olson, Samantha M.

AU - Newhams, Margaret M.

AU - Halasa, Natasha B.

AU - Feldstein, Leora R.

AU - Novak, Tanya

AU - Weiss, Scott L.

AU - Coates, Bria M.

AU - Schuster, Jennifer E.

AU - Schwarz, Adam J.

AU - Maddux, Aline B.

AU - Hall, Mark W.

AU - Nofziger, Ryan A.

AU - Flori, Heidi R.

AU - Gertz, Shira J.

AU - Kong, Michele

AU - Sanders, Ronald C.

AU - Irby, Katherine

AU - Hume, Janet R.

AU - Cullimore, Melissa L.

AU - Shein, Steven L.

AU - Thomas, Neal J.

AU - Stewart, Laura S.

AU - Barnes, John R.

AU - Patel, Manish M.

AU - Randolph, Adrienne G.

AU - Michele, Kong

AU - Murdock, Meghan

AU - Sanders, Ronald C.

AU - Hefley, Glenda

AU - Schwarz, Adam J.

AU - Flores, Cathy

AU - Vargas-Shiraishi, Ofelia

AU - Maddux, Aline B.

AU - Mourani, Peter M.

AU - Van, Kevin A.

AU - Coates, Bria M.

AU - Shukla, Avani

AU - Chavez, Jairo

AU - Randolph, Adrienne G.

AU - Newhams, Margaret M.

AU - Chen, Sabrina R.

AU - Jung, Emily

AU - Flori, Heidi R.

AU - Dahmer, Mary K.

AU - Jayachandran, Chaandini

AU - Hume, Janet R.

AU - Goertzen, Lexie

AU - Faanes, Brittany

AU - Schuster, Jennifer E.

AU - Bledsoe, Megan C.

AU - Clark, Shannon E.

AU - Cullimore, Melissa L.

AU - Wellman, Rachel L.

AU - Gertz, Shira J.

AU - Nofziger, Ryan A.

AU - Twinem, Nicole

AU - Shein, Steven L.

AU - Lansell, Amanda N.

AU - Rasal, Rajashri

AU - Hall, Mark W.

AU - Flowers, Maggie

AU - Steele, Lisa

AU - Bush, Jenny L.

AU - Burnett, Ryan H.

AU - Thomas, Neal J.

AU - Spear, Debra

AU - Halasa, Natasha B.

AU - Stewart, Laura S.

AU - Lynch, Tricia L.

AU - Olson, Samantha M.

AU - Patel, Manish M.

AU - Feldstein, Leora R.

AU - Barnes, John R.

AU - Le, Shoshona

AU - DaSilva, Juliana

AU - Keong, Lisa

AU - Stark, Thomas

AU - Rebecca, Garten Kondor

AU - Michael, Wu

PY - 2022/7/15

Y1 - 2022/7/15

N2 - Background: Predominance of 2 antigenically drifted influenza viruses during the 2019-2020 season offered an opportunity to assess vaccine effectiveness against life-threatening pediatric influenza disease from vaccine-mismatched viruses in the United States. Methods: We enrolled children aged <18 years admitted to the intensive care unit with acute respiratory infection across 17 hospitals. Respiratory specimens were tested using reverse-transcription polymerase chain reaction for influenza viruses and sequenced. Using a test-negative design, we estimated vaccine effectiveness comparing odds of vaccination in test-positive case patients vs test-negative controls, stratifying by age, virus type, and severity. Life-threating influenza included death or invasive mechanical ventilation, vasopressors, cardiopulmonary resuscitation, dialysis, or extracorporeal membrane oxygenation. Results: We enrolled 159 critically ill influenza case-patients (70% ≤8 years; 51% A/H1N1pdm09 and 25% B-Victoria viruses) and 132 controls (69% were aged ≤8 years). Among 56 sequenced A/H1N1pdm09 viruses, 29 (52%) were vaccine-mismatched (A/H1N1pdm09/5A+156K) and 23 (41%) were vaccine-matched (A/H1N1pdm09/5A+187A,189E). Among sequenced B-lineage viruses, majority (30 of 31) were vaccine-mismatched. Effectiveness against critical influenza was 63% (95% confidence interval [CI], 38% to 78%) and similar by age. Effectiveness was 75% (95% CI, 49% to 88%) against life-threatening influenza vs 57% (95% CI, 24% to 76%) against non-life-threating influenza. Effectiveness was 78% (95% CI, 41% to 92%) against matched A(H1N1)pdm09 viruses, 47% (95% CI,-21% to 77%) against mismatched A(H1N1)pdm09 viruses, and 75% (95% CI, 37% to 90%) against mismatched B-Victoria viruses. Conclusions: During a season when vaccine-mismatched influenza viruses predominated, vaccination was associated with a reduced risk of critical and life-threatening influenza illness in children.

AB - Background: Predominance of 2 antigenically drifted influenza viruses during the 2019-2020 season offered an opportunity to assess vaccine effectiveness against life-threatening pediatric influenza disease from vaccine-mismatched viruses in the United States. Methods: We enrolled children aged <18 years admitted to the intensive care unit with acute respiratory infection across 17 hospitals. Respiratory specimens were tested using reverse-transcription polymerase chain reaction for influenza viruses and sequenced. Using a test-negative design, we estimated vaccine effectiveness comparing odds of vaccination in test-positive case patients vs test-negative controls, stratifying by age, virus type, and severity. Life-threating influenza included death or invasive mechanical ventilation, vasopressors, cardiopulmonary resuscitation, dialysis, or extracorporeal membrane oxygenation. Results: We enrolled 159 critically ill influenza case-patients (70% ≤8 years; 51% A/H1N1pdm09 and 25% B-Victoria viruses) and 132 controls (69% were aged ≤8 years). Among 56 sequenced A/H1N1pdm09 viruses, 29 (52%) were vaccine-mismatched (A/H1N1pdm09/5A+156K) and 23 (41%) were vaccine-matched (A/H1N1pdm09/5A+187A,189E). Among sequenced B-lineage viruses, majority (30 of 31) were vaccine-mismatched. Effectiveness against critical influenza was 63% (95% confidence interval [CI], 38% to 78%) and similar by age. Effectiveness was 75% (95% CI, 49% to 88%) against life-threatening influenza vs 57% (95% CI, 24% to 76%) against non-life-threating influenza. Effectiveness was 78% (95% CI, 41% to 92%) against matched A(H1N1)pdm09 viruses, 47% (95% CI,-21% to 77%) against mismatched A(H1N1)pdm09 viruses, and 75% (95% CI, 37% to 90%) against mismatched B-Victoria viruses. Conclusions: During a season when vaccine-mismatched influenza viruses predominated, vaccination was associated with a reduced risk of critical and life-threatening influenza illness in children.

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U2 - 10.1093/cid/ciab931

DO - 10.1093/cid/ciab931

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AN - SCOPUS:85131325474

SN - 1058-4838

VL - 75

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EP - 238

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 2

ER -

Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children

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