title: Influenza vaccination coverage and effectiveness in young children in Thailand, 2011-2013.
abstract: BACKGROUND
  Since 2009, Thailand has recommended influenza vaccine for children aged 6 months through 2 years, but no estimates of influenza vaccine coverage or effectiveness are available for this target group.
  
  
  METHODS
  During August 2011-May 2013, high-risk and healthy children aged ≤36 months were enrolled in a 2-year prospective cohort study. Parents were contacted weekly about acute respiratory illness (ARI) in their child. Ill children had combined nasal and throat swabs tested for influenza viruses by real-time reverse transcription-polymerase chain reaction. Influenza vaccination status was verified with vaccination cards. The Cox proportional hazards approach was used to estimate hazard ratios. Vaccine effectiveness (VE) was estimated as 100% x (1-hazard ratio).
  
  
  RESULTS
  During 2011-2013, 968 children were enrolled (median age, 10·3 months); 948 (97·9%) had a vaccination record and were included. Of these, 394 (41·6%) had ≥1 medical conditions. Vaccination coverage for the 2011-2012 and 2012-2013 seasons was 29·3% (93/317) and 30·0% (197/656), respectively. In 2011-2012, there were 213 ARI episodes, of which 10 (4·6%) were influenza positive (2·3 per 1000 vaccinated and 3·8 per 1000 unvaccinated child-weeks). The VE was 55% (95% confidence interval [CI], -72, 88). In 2012-2013, there were 846 ARIs, of which 52 (6·2%) were influenza positive (1·8 per 1000 vaccinated and 4·5 per 1000 unvaccinated child-weeks). The VE was 64% (CI, 13%, 85%).
  
  
  CONCLUSIONS
  Influenza vaccination coverage among young children in Thailand was low, although vaccination was moderately effective. Continued efforts are needed to increase influenza vaccination coverage and evaluate VE among young children in Thailand.
authors.affiliation: Influenza Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Wanitchaya
authors.initials: W
authors.lastname: Kittikraisak
authors.forename: Piyarat
authors.initials: P
authors.lastname: Suntarattiwong
authors.forename: Jens
authors.initials: J
authors.lastname: Levy
authors.forename: Stefan
authors.initials: S
authors.lastname: Fernandez
authors.forename: Fatimah S
authors.initials: FS
authors.lastname: Dawood
authors.forename: Sonja J
authors.initials: SJ
authors.lastname: Olsen
authors.forename: Tawee
authors.initials: T
authors.lastname: Chotpitayasunondh
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D012621:Seasons; D013785:Thailand; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines
keywords: Influenza; Thailand; children; coverage; effectiveness; vaccination