Eisenberg Katherine W, Szilagyi Peter G, Fairbrother Gerry, Griffin Marie R, Staat Mary, Shone Laura P, Weinberg Geoffrey A, Hall Caroline B, Poehling Katherine A, Edwards Kathryn M, Lofthus Geraldine, Fisher Susan G, Bridges Carolyn B, Iwane Marika K
Department of Community and Preventive Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, New York 14642, USA.
Pediatrics. 2008 Nov;122(5):911-9. doi: 10.1542/peds.2007-3304.
The goal was to estimate the effectiveness of influenza vaccination against laboratory-confirmed influenza during the 2003-2004 and 2004-2005 influenza seasons in children 6 to 59 months of age.
We conducted a case-control study with children with medically attended, acute respiratory infections who received care in an inpatient, emergency department, or outpatient clinic setting during 2 consecutive influenza seasons. All children residing in Monroe County, New York, Davidson County, Tennessee, or Hamilton County, Ohio, were enrolled prospectively at the time of acute illness and had nasal/throat swabs tested for influenza with cultures and/or polymerase chain reaction assays. Children with laboratory-confirmed influenza were case subjects and children who tested negative for influenza were control subjects. Child vaccination records from the parent and the child's physician were used to determine and to validate influenza vaccination status. Influenza vaccine effectiveness was calculated as (1 - adjusted odds ratio) x 100.
We enrolled 288 case subjects and 744 control subjects during the 2003-2004 season and 197 case subjects and 1305 control subjects during the 2004-2005 season. Six percent and 19% of all study children were fully vaccinated according to immunization guidelines in the respective seasons. Full vaccination was associated with significantly fewer influenza-related inpatient, emergency department, or outpatient clinic visits in 2004-2005 (vaccine effectiveness: 57%) but not in 2003-2004 (vaccine effectiveness: 44%). Partial vaccination was not effective in either season.
Receipt of all recommended doses of influenza vaccine was associated with halving of laboratory-confirmed influenza-related medical visits among children 6 to 59 months of age in 1 of 2 study years, despite suboptimal matches between the vaccine and circulating influenza strains in both years.
评估2003 - 2004年和2004 - 2005年流感季节，流感疫苗接种对6至59个月大儿童确诊流感的预防效果。
我们进行了一项病例对照研究，研究对象为在连续两个流感季节中，因急性呼吸道感染在住院部、急诊科或门诊接受治疗的儿童。所有居住在纽约州门罗县、田纳西州戴维森县或俄亥俄州汉密尔顿县的儿童，在急性发病时均被前瞻性纳入研究，并通过培养和/或聚合酶链反应检测法对其鼻/咽拭子进行流感检测。确诊为流感的儿童为病例组，流感检测呈阴性的儿童为对照组。通过家长和儿童医生提供的疫苗接种记录来确定并验证流感疫苗接种情况。流感疫苗有效性的计算方法为(1 - 调整后的比值比)×100。
在2003 - 2004年流感季节，我们纳入了288例病例组和744例对照组；在2004 - 2005年流感季节，纳入了197例病例组和1305例对照组。根据免疫指南，在各自流感季节中，所有研究儿童中分别有6%和19%完成了全程疫苗接种。在2004 - 2005年，全程接种疫苗与流感相关的住院、急诊或门诊就诊显著减少相关(疫苗有效性：57%)，但在2003 - 2004年并非如此(疫苗有效性：44%)。在两个季节中，部分接种疫苗均无效。
在两个研究年份中的一年，尽管疫苗与流行的流感毒株匹配度欠佳，但对于6至59个月大的儿童，接种所有推荐剂量的流感疫苗可使实验室确诊的流感相关就诊次数减半。
