Pilot study of influenza vaccine effectiveness in urban Australian children attending childcare

Yin, J. Kevin, Lahra, Monica M., Iskander, Mary, Lambert, Stephen B., Heron, Leon, Nissen, Michael D., Rost, Laura, Murphy, Jennifer, Sloots, Theo P. and Booy, Robert (2011) Pilot study of influenza vaccine effectiveness in urban Australian children attending childcare. Journal of Paediatrics and Child Health, 47 12: 857-862. doi:10.1111/j.1440-1754.2011.02098.x

Author Yin, J. Kevin
Lahra, Monica M.
Iskander, Mary
Lambert, Stephen B.
Heron, Leon
Nissen, Michael D.
Rost, Laura
Murphy, Jennifer
Sloots, Theo P.
Booy, Robert
Title Pilot study of influenza vaccine effectiveness in urban Australian children attending childcare
Journal name Journal of Paediatrics and Child Health   Check publisher's open access policy
ISSN 1034-4810
Publication date 2011-12
Sub-type Article (original research)
DOI 10.1111/j.1440-1754.2011.02098.x
Volume 47
Issue 12
Start page 857
End page 862
Total pages 6
Place of publication Oxford, England, U.K.
Publisher Wiley-Blackwell Publishing
Collection year 2012
Language eng
Formatted abstract
Background: Influenza outbreaks in the childcare setting are a significant cause of excess winter morbidity. This study explored methods of follow up and sample collection for a proposed randomised controlled trial of influenza vaccination in children attending childcare.

Methods: The study was conducted in four Sydney childcare centres during 2007. Healthy children aged 6–59 months eligible for vaccination were recruited in two centres, with another two acting as controls. Data on influenza-like illness (ILI: ≥37.8°C plus at least one respiratory symptom) occurrence were collected weekly. In those children with an ILI, parents were asked to collect nasal swabs and send via surface mail for viral polymerase chain reaction. Vaccine efficacy (VE) for ILI was estimated overall and for subgroups aged 6–23 and 24–59 months using the formula VE = 1 − relative risk (RR).

Results: Sixty-three per cent (151/238) of eligible children had parents give consent. Sixty-three children received influenza vaccine and 88 participated as controls. Of 26 specimens returned, a virus was detected in 18 (69%); none with influenza. Two symptomatic children had positive near-patient influenza tests in general practice (one a vaccine failure). The RR with 95% confidence interval in all children and those aged 6–23 months were less than one, 0.56 (0.32–1.02) and 0.46 (0.15–1.45), respectively.

This study demonstrated the feasibility and utility of parent-collected and mailed respiratory specimens for VE research in the childcare setting. Two-thirds of parent-collected swabs proved positive for at least one virus. Finding ways to reduce reluctance of parents to submit samples could improve the representativeness of samples collected and the power of the study. No evidence was found for influenza VE, but point estimates were in the direction of protection.
Keyword Children
Daycare centres
Influenza A virus
Vaccine effectiveness
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Wed, 23 Nov 2011, 14:51:24 EST by Matthew Lamb on behalf of School of Medicine