title: Uptake and impact of vaccinating school age children against influenza during a season with circulation of drifted influenza A and B strains, England, 2014/15.
abstract: The 2014/15 influenza season was the second season of roll-out of a live attenuated influenza vaccine (LAIV) programme for healthy children in England. During this season, besides offering LAIV to all two to four year olds, several areas piloted vaccination of primary (4-11 years) and secondary (11-13 years) age children. Influenza A(H3N2) circulated, with strains genetically and antigenically distinct from the 2014/15 A(H3N2) vaccine strain, followed by a drifted B strain. We assessed the overall and indirect impact of vaccinating school age children, comparing cumulative disease incidence in targeted and non-targeted age groups in vaccine pilot to non-pilot areas. Uptake levels were 56.8% and 49.8% in primary and secondary school pilot areas respectively. In primary school age pilot areas, cumulative primary care influenza-like consultation, emergency department respiratory attendance, respiratory swab positivity, hospitalisation and excess respiratory mortality were consistently lower in targeted and non-targeted age groups, though less for adults and more severe end-points, compared with non-pilot areas. There was no significant reduction for excess all-cause mortality. Little impact was seen in secondary school age pilot only areas compared with non-pilot areas. Vaccination of healthy primary school age children resulted in population-level impact despite circulation of drifted A and B influenza strains.
authors.affiliation: Public Health England (PHE), United Kingdom.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Pebody
authors.forename: Helen K
authors.initials: HK
authors.lastname: Green
authors.forename: Nick
authors.initials: N
authors.lastname: Andrews
authors.forename: Nicola L
authors.initials: NL
authors.lastname: Boddington
authors.forename: Hongxin
authors.initials: H
authors.lastname: Zhao
authors.forename: Ivelina
authors.initials: I
authors.lastname: Yonova
authors.forename: Joanna
authors.initials: J
authors.lastname: Ellis
authors.forename: Sophia
authors.initials: S
authors.lastname: Steinberger
authors.forename: Matthew
authors.initials: M
authors.lastname: Donati
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Elliot
authors.forename: Helen E
authors.initials: HE
authors.lastname: Hughes
authors.forename: Sameera
authors.initials: S
authors.lastname: Pathirannehelage
authors.forename: David
authors.initials: D
authors.lastname: Mullett
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Smith
authors.forename: Simon
authors.initials: S
authors.lastname: de Lusignan
authors.forename: Maria
authors.initials: M
authors.lastname: Zambon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D015994:Incidence; D007223:Infant; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D010865:Pilot Projects; D012574:Schools; D012621:Seasons; D014611:Vaccination / Q000706:statistics & numerical data*; D014613:Vaccines, Attenuated / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D007252:Influenza Vaccines; D014613:Vaccines, Attenuated