2018-2019 季急诊儿童流感疫苗有效性：韩国流感国家免疫计划首次将学龄儿童纳入其中。

Influenza Vaccine Effectiveness in Children at the Emergency Department during the 2018-2019 Season: the First Season School-aged Children Were Included in the Korean Influenza National Immunization Program.

机构信息

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University of Medicine, Yongin, Korea.

出版信息

J Korean Med Sci. 2021 Mar 15;36(10):e71. doi: 10.3346/jkms.2021.36.e71.

DOI:10.3346/jkms.2021.36.e71

PMID:33724738

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7961871/

Abstract

BACKGROUND

For the 2018-2019 season, the national influenza immunization program expanded to cover children aged from 6 months to 12 years in Korea. This study aimed to analyze vaccine effectiveness (VE) against influenza in children visiting the pediatric emergency room at a tertiary hospital during the 2018-2019 season.

METHODS

Patients tested for influenza antigens from October 1st 2018 to May 31st 2019 at the pediatric emergency room of Samsung Medical Center were included. Patients' influenza antigen test results, influenza vaccination history, and underlying medical conditions were reviewed retrospectively. VE was estimated from the test-negative design study.

RESULTS

Among the 2,901 visits with influenza test results 1,692 visits of 1,417 patients were included for analysis. Among these 1,417 patients, 285 (20.1%) were positive (influenza A, n = 211, 74.0%; influenza B, n = 74, 26.0%). The VE in all patients was 36.4% (95% confidence interval [CI], 13.9 to 53.1). The VE for influenza A was 37.6% (95% CI, 12.6 to 55.5) and VE for influenza B was 24.0% (?38.5 to 58.3). The VE in the age group 6 months to 12 years was significant with a value of 35.6% (95% CI, 10.5 to 53.7); it was not statistically significant in the age group 13 to 18 years. In a multivariate logistic regression model, patients who received an influenza vaccination were less likely to get influenza infection (OR, 0.6; 95% CI, 0.4 to 0.8; = 0.001), with significant confounding factors such as age group 13 to 18 years (OR, 0.5; 95% CI, 0.3 to 0.8; = 0.003) and underlying hematology-oncology disease (OR, 0.3; 95% CI, 0.1 to 0.6; = 0.002).

CONCLUSION

We report moderate effectiveness of influenza vaccination in previously healthy children aged from 6 months to 12 years in the 2018-2019 season.

摘要

背景

2018-2019 年流感季节，韩国国家流感免疫计划扩大至覆盖 6 个月至 12 岁儿童。本研究旨在分析 2018-2019 年在一家三级医院儿科急诊就诊的儿童中流感疫苗的有效性（VE）。

方法

我们纳入了 2018 年 10 月 1 日至 2019 年 5 月 31 日在三星医疗中心儿科急诊进行流感抗原检测的患者。回顾性分析患者的流感抗原检测结果、流感疫苗接种史和基础疾病情况。使用阴性对照设计研究估计 VE。

结果

在有流感检测结果的 2901 次就诊中，有 1692 次就诊（1417 名患者）纳入分析。在这 1417 名患者中，有 285 名（20.1%）检测结果为阳性（甲型流感，n=211，74.0%；乙型流感，n=74，26.0%）。所有患者的 VE 为 36.4%（95%置信区间[CI]，13.9 至 53.1）。甲型流感的 VE 为 37.6%（95% CI，12.6 至 55.5），乙型流感的 VE 为 24.0%（95% CI，-38.5 至 58.3）。6 个月至 12 岁年龄组的 VE 有统计学意义，为 35.6%（95% CI，10.5 至 53.7）；13 至 18 岁年龄组的 VE 无统计学意义。在多变量逻辑回归模型中，接种流感疫苗的患者感染流感的可能性较低（比值比，0.6；95%置信区间，0.4 至 0.8；=0.001），存在明显的混杂因素，如 13 至 18 岁年龄组（比值比，0.5；95%置信区间，0.3 至 0.8；=0.003）和基础血液肿瘤疾病（比值比，0.3；95%置信区间，0.1 至 0.6；=0.002）。