Effect of Age on Relative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccines Among US Medicare Beneficiaries Aged ≥65 Years

By Yun Lu, Yoganand Chillarige, Hector S Izurieta, Yuqin Wei, Wenjie Xu, Michael Lu, Heng-Ming Sung, Arnstein Lindaas, Michael Wernecke, Thomas Macurdy, Jeffrey Kelman, Richard A Forshee. Published in The Journal of Infectoius Diseases. To be published November 1, 2019.   

 

Studies have found that the high-dose influenza vaccine has a higher relative vaccine effectiveness (rve) versus standard-dose vaccines in some seasons. We evaluated the effect of age on the rve of high-dose versus standard-dose influenza vaccines among medicare beneficiaries. A 6-season retrospective cohort study from 2012 to 2018 among medicare beneficiaries aged ≥65 years was performed. Poisson regression was used to evaluate the effect of age on the rve of high-dose versus standard-dose influenza vaccines in preventing influenza-related hospitalizations.The study included >19 million vaccinated beneficiaries in a community pharmacy setting. The poisson models indicated a slightly increasing trend in rve with age in all seasons. The high-dose vaccine was more effective than standard-dose vaccines in preventing influenza-related hospital encounters (ie, influenza-related inpatient stays and emergency department visits) in the 2012–2013 (rve, 23.1%; 95% confidence interval [ci], 17.6%–28.3%), 2013–2014 (rve, 15.3%; 95% ci, 7.8%–22.3%), 2014–2015 (rve, 8.9%; 95% ci, 5.6%–12.1%), and 2016–2017 (rve, 12.6%; 95% ci, 6.3%–18.4%) seasons and was at least as effective in all other seasons. We also found that the high-dose vaccine was consistently more effective than standard-dose vaccines across all seasons for people aged ≥85 years. Similar trends were observed for influenza-related inpatient stays. The rve of high-dose versus standard-dose influenza vaccines increases with age.

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Burden of Invasive Pneumococcal Disease

By Mary Slack, Andrew Vyse, Harish Madhava, Gillian Ellsbury, Carole Czudek, Ralf-Rene Reinert, Bradford Gessner. Published in Clinical Infectious Diseases. October 15, 2019.  

 

TO THE EDITOR—We read with interest the article by Kent et al [1]. The authors note that the burden of invasive pneumococcal disease (IPD) in UK infants aged <1 year is substantial and that the incidence of IPD in this age group increased over the study period (2013–2016). Although the majority of IPD cases (369/454, 71.4%) were due to non–13-valent pneumococcal conjugate vaccine (PCV13) serotypes, disease also was caused by PCV13 (vaccine type [VT]) serotypes (85/454, 16.4%), with a limited reduction in VT IPD from 36 cases in 2013 to 28 cases in 2016. Serotype 3 was the most common VT serotype identified…

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Preference for Private Sector for Vaccination of Under-Five Children in India and Its Associated Factors: Findings from a Nationally Representative Sample

By Gokul Sarveswaran, Yuvaraj Krishnamoorthy, Manikandanesan Sakthivel, Karthiga Vijayakumar, Shanthosh Priyan, Pruthu Thekkur, Palanivel Chinnakali

Journal of Tropical Pediatrics. October 2019.

 

Understanding the factors associated with private sector preference for vaccination will help in understanding the barriers in seeking public facility and also the steps to improve public–private partnership (PPP) model. We analysed the recent National Family Health Survey-4 data (NFHS-4; 2015–16) gathered from Demographic Health Survey programme. Stratification and clustering in the sample design was accounted using svyset command. Weighted proportion of children receiving private vaccination was 10.0% (95% CI: 9.7–10.3). Children belonging to highest wealth quantile (adjusted Prevalence ratio; aPR-1.58), male child (aPR-1.07) urban area (aPR-1.11), not receiving anganwadi/Integrated Childhood Development Services (aPR-1.71) and receiving antenatal care in private sector was significantly associated with higher proportion of private vaccination. Current study showed that 1 in 10 <5 years child in India received vaccination from private health facility. Preference for private health facility was found to be influenced by higher socio-economic strata, urban area residence and seeking private health facility for antenatal and delivery services.

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Impact of H1N1 Influenza Vaccination on Child Morbidity in Guinea-Bissau

By Olga Bengård Hansen, Amabelia Rodrigues, Cesario Martins, Andreas Rieckmann, Christine Stabell Benn, Peter Aaby, Ane Bærent Fisker

Journal of Tropical Pediatrics. October 2019.

 

In addition to vaccines’ specific effects, vaccines may have non-specific effects (NSEs) altering the susceptibility to unrelated infections. Non-live vaccines have been associated with negative NSEs. In 2010, a campaign with the non-live H1N1-influenza vaccine targeted children 6–59 months in Guinea-Bissau. Bandim Health Project runs a health and demographic surveillance system site in Guinea-Bissau. Using a Cox proportional hazards model, we compared all-cause consultation rates after vs. before the campaign, stratified by participation status. Among 10 290 children eligible for the campaign, 60% had participated, 18% had not and for 22% no information was obtained. After the H1N1 campaign, the consultation rates tended to decline less for participants [HR = 0.80 (95% confidence interval, CI: 0.75; 0.85)] than for non-participants [HR = 0.68 (95% CI: 0.58; 0.79)], p = 0.06 for same effect. The decline in the vaccinated group may have been smaller than the decline in the non-vaccinated group consistent with H1N1-vaccine increasing susceptibility to unrelated infections.

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Respiratory Syncytial Virus Vaccines Are We Making Progress?

By Asuncion Mejias, Rosa Rodriguez-Fernandez, Mark E. Peeples, Octavio Ramilo. Published in The Journal of Pediatric Infectious Diseases. Published October 1, 2019.  

 

Globally, it is estimated that respiratory syncytial virus (RSV) causes 33 million new episodes of acute lower respiratory tract infection (LRTI) in children <5 years of age and ≈120,000 deaths annually. In infants, RSV represents the leading cause of hospitalization worldwide and the second commonest cause of mortality in low- and middle-income countries.1,2 RSV also causes significant disease in immunocompromised hosts and the elderly and has been associated with the development of asthma.3 The increasingly recognized burden of RSV disease has made the development of a vaccine(s) a global health priority. The World Health Organization recently released a roadmap to facilitate the development and implementation of vaccines and monoclonal antibodies (mAbs) and estimated that RSV vaccination will be available in the next 5–10 years.4 This review summarizes the strategies and challenges associated with RSV vaccine development and the vaccine candidates undergoing clinical evaluation, with a focus on those geared toward the pediatric population.

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