2022-2023 季节中疫苗对儿科流感相关紧急护理、急诊和住院的有效性：VISION 网络。

Vaccine Effectiveness Against Pediatric Influenza-A-Associated Urgent Care, Emergency Department, and Hospital Encounters During the 2022-2023 Season: VISION Network.

机构信息

Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Department of Clinical Research, Westat, Rockville, Maryland, USA.

出版信息

Clin Infect Dis. 2024 Mar 20;78(3):746-755. doi: 10.1093/cid/ciad704.

DOI:10.1093/cid/ciad704

PMID:37972288

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10954409/

Abstract

BACKGROUND

During the 2022-2023 influenza season, the United States experienced the highest influenza-associated pediatric hospitalization rate since 2010-2011. Influenza A/H3N2 infections were predominant.

METHODS

We analyzed acute respiratory illness (ARI)-associated emergency department or urgent care (ED/UC) encounters or hospitalizations at 3 health systems among children and adolescents aged 6 months-17 years who had influenza molecular testing during October 2022-March 2023. We estimated influenza A vaccine effectiveness (VE) using a test-negative approach. The odds of vaccination among influenza-A-positive cases and influenza-negative controls were compared after adjusting for confounders and applying inverse-propensity-to-be-vaccinated weights. We developed overall and age-stratified VE models.

RESULTS

Overall, 13 547 of 44 787 (30.2%) eligible ED/UC encounters and 263 of 1862 (14.1%) hospitalizations were influenza-A-positive cases. Among ED/UC patients, 15.2% of influenza-positive versus 27.1% of influenza-negative patients were vaccinated; VE was 48% (95% confidence interval [CI], 44-52%) overall, 53% (95% CI, 47-58%) among children aged 6 months-4 years, and 38% (95% CI, 30-45%) among those aged 9-17 years. Among hospitalizations, 17.5% of influenza-positive versus 33.4% of influenza-negative patients were vaccinated; VE was 40% (95% CI, 6-61%) overall, 56% (95% CI, 23-75%) among children ages 6 months-4 years, and 46% (95% CI, 2-70%) among those 5-17 years.

CONCLUSIONS

During the 2022-2023 influenza season, vaccination reduced the risk of influenza-associated ED/UC encounters and hospitalizations by almost half (overall VE, 40-48%). Influenza vaccination is a critical tool to prevent moderate-to-severe influenza illness in children and adolescents.

摘要

背景

在 2022-2023 年流感季节，美国经历了自 2010-2011 年以来儿童因流感住院率最高的一次。甲型流感 A/H3N2 感染占主导地位。

方法

我们分析了三家医疗系统在 2022 年 10 月至 2023 年 3 月期间接受过流感分子检测的 6 个月至 17 岁儿童和青少年因急性呼吸道疾病（ARI）就诊于急诊或紧急护理（ED/UC）或住院的病例。我们使用了阴性检测方法来估计甲型流感疫苗的有效性（VE）。对流感 A 阳性病例和流感阴性对照病例在调整混杂因素并应用反向倾向于接种疫苗的权重后，比较了接种疫苗的可能性。我们建立了总体和年龄分层 VE 模型。

结果

总体而言，在符合条件的 44787 例 ED/UC 就诊者中，有 13547 例（30.2%）和 1862 例住院者中，有 263 例（14.1%）为甲型流感 A 阳性病例。在 ED/UC 患者中，15.2%的流感阳性患者与 27.1%的流感阴性患者接种了疫苗；总体 VE 为 48%（95%置信区间[CI]，44-52%），6 个月至 4 岁儿童的 VE 为 53%（95% CI，47-58%），9 至 17 岁儿童的 VE 为 38%（95% CI，30-45%）。在住院患者中，17.5%的流感阳性患者与 33.4%的流感阴性患者接种了疫苗；总体 VE 为 40%（95% CI，6-61%），6 个月至 4 岁儿童的 VE 为 56%（95% CI，23-75%），5-17 岁儿童的 VE 为 46%（95% CI，2-70%）。