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Clinical effectiveness of conventional influenza vaccination in asthmatic children

Published online by Cambridge University Press:  25 April 2002

A. J. SMITS ,
E. HAK ,
W. A. B. STALMAN ,
G. A. VAN ESSEN ,
A. W. HOES  and
Th. J. M. VERHEIJ
A. J. SMITS
Affiliation:
University Medical Center Utrecht, Julius Center for General Practice and Patient Oriented Research, Location Stratenum, P.O. Box 85060, 3508 AB Utrecht, the Netherlands.
E. HAK
Affiliation:
University Medical Center Utrecht, Julius Center for General Practice and Patient Oriented Research, Location Stratenum, P.O. Box 85060, 3508 AB Utrecht, the Netherlands.
W. A. B. STALMAN
Affiliation:
University Medical Center Utrecht, Julius Center for General Practice and Patient Oriented Research, Location Stratenum, P.O. Box 85060, 3508 AB Utrecht, the Netherlands.
G. A. VAN ESSEN
Affiliation:
University Medical Center Utrecht, Julius Center for General Practice and Patient Oriented Research, Location Stratenum, P.O. Box 85060, 3508 AB Utrecht, the Netherlands.
A. W. HOES
Affiliation:
University Medical Center Utrecht, Julius Center for General Practice and Patient Oriented Research, Location Stratenum, P.O. Box 85060, 3508 AB Utrecht, the Netherlands.
Th. J. M. VERHEIJ
Affiliation:
University Medical Center Utrecht, Julius Center for General Practice and Patient Oriented Research, Location Stratenum, P.O. Box 85060, 3508 AB Utrecht, the Netherlands.
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Abstract

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Influenza immunization rates among young asthmatics remain unsatisfactory due to persistent concern about the impact of influenza and the benefits of the vaccine. We assessed the effectiveness of the conventional inactivated trivalent sub-unit influenza vaccine in reducing acute respiratory disease in asthmatic children. We conducted a two-season retrospective cohort study covering the 1995–6 and 1996–7 influenza outbreaks in 22 computerized primary care practices in the Netherlands. In total, 349 patients aged between 0 and 12 years meeting clinical asthma-criteria were included; 14 children were lost to follow-up in the second season. The occurrence of physician-diagnosed acute respiratory disease episodes including influenza-like illness, pneumonia, bronchitis, bronchiolitis, asthma exacerbation and acute otitis media in vaccinated and unvaccinated children were compared after adjustments for age, prior health care and medication use. The occurrence of acute respiratory disease in unvaccinated children was 28% and 24% in the 1995–6 and 1996–7 season, respectively, and was highest in children under 6 years of age (43%). The overall pooled clinical vaccine effectiveness was 27% (95% confidence interval −7 to 51%, P = 0·11) after adjustments. A statistically higher vaccine protectiveness of 55% (95% CI 20–75%, P = 0·01) was observed among asthmatics under 6 years of age compared with −5% in older children (95% CI −81 to 39%). The occurrence of acute respiratory disease among asthmatic children during influenza epidemics is very high, notably in the youngest. Influenza vaccination may reduce morbidity in asthmatic infants and pre-school children. However, larger, preferably experimental, studies are needed to establish the benefits of vaccination, notably in older asthmatic children.

Type
Research Article
Information
Epidemiology & Infection , Volume 128 , Issue 2 , April 2002 , pp. 205 - 211
Copyright
© 2002 Cambridge University Press