title: Vaccine Effectiveness Against Laboratory-confirmed Influenza in Healthy Young Children: A Case-Control Study.
abstract: BACKGROUND
  the Western Australian Influenza Vaccine Effectiveness study commenced in 2008 to evaluate a new program to provide free influenza vaccine to all children aged 6 to 59 months. We aimed to assess the protective effect of inactivated influenza vaccination in these children.
  
  
  METHODS
  We conducted a prospective case-control study in general practices and a hospital emergency department, testing all eligible patients for influenza and a range of other common respiratory viruses. Influenza vaccine effectiveness (VE) against laboratory-confirmed influenza was estimated with cases defined as children with an influenza-like illness who tested positive and controls as those with an influenza-like illness who tested negative for influenza virus. We calculated VE using the adjusted odds ratio from multivariate logistic regression. As a surrogate marker for adequate specimen collection, we explored the difference in VE point estimates defining controls as children in whom another respiratory virus was detected.
  
  
  RESULTS
  a total of 75 children were enrolled from general practices and 214 through the emergency department, with 12 (27%) and 36 (17%), respectively, having laboratory-confirmed influenza. Using all the influenza-negative controls, the adjusted VE was 58% (95% confidence interval, 9-81). When controls were limited to those with another virus present, the adjusted VE was 68% (95% confidence interval, 26-86).
  
  
  CONCLUSIONS
  VE estimates were higher when controls included only those children with another respiratory virus detected. Testing for other common respiratory viruses enables the control group to be restricted to those for whom an adequate sample is likely.
authors.affiliation: School of Computer Science and Software Engineering, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Heath
authors.initials: H
authors.lastname: Kelly
authors.forename: Peter
authors.initials: P
authors.lastname: Jacoby
authors.forename: Gabriela A
authors.initials: GA
authors.lastname: Dixon
authors.forename: Dale
authors.initials: D
authors.lastname: Carcione
authors.forename: Simon
authors.initials: S
authors.lastname: Williams
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Moore
authors.forename: David W
authors.initials: DW
authors.lastname: Smith
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Keil
authors.forename: Paul
authors.initials: P
authors.lastname: Van Buynder
authors.forename: Peter C
authors.initials: PC
authors.lastname: Richmond
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000175:diagnosis* / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D015164:Vaccines, Inactivated / Q000008:administration & dosage; D014904:Western Australia
chemical_list: D007252:Influenza Vaccines; D015164:Vaccines, Inactivated