title: Influenza Vaccine Effectiveness for Fully and Partially Vaccinated Children 6 Months to 8 Years Old During 2011-2012 and 2012-2013: The Importance of Two Priming Doses.
abstract: BACKGROUND
  Few studies have examined the effectiveness of full versus partial vaccination with inactivated trivalent influenza vaccines (IIV3) as defined by the US CDC Advisory Committee on Immunization Practices.
  
  
  METHODS
  Respiratory swabs were collected from outpatients aged 6 months to 8 years with acute cough for ≤7 days in clinics in 5 states during the 2011-2012 and 2012-2013 influenza seasons. Influenza was confirmed by real-time reverse transcription polymerase chain reaction assay. Receipt of current season IIV3 and up to 4 prior vaccinations was documented from medical records and immunization registries. Using a test-negative design, vaccine effectiveness (VE) was estimated adjusting for age, race/ethnicity, medical conditions, study site and month of enrollment.
  
  
  RESULTS
  We did not observe higher VE for children fully versus partially vaccinated with IIV3, as defined by US Advisory Committee on Immunization Practice, although our sample of partially vaccinated children was relatively small. However, among children aged 2-8 years in both seasons and against A(H3N2) and B influenza illness separately, VE point estimates were consistently higher for children who had received 2 doses in the same prior season compared with those without (VE range of 58%-80% vs. 33%-44%, respectively). Across seasons, the odds of A(H3N2) illness despite IIV3 vaccination were 2.4-fold (95% confidence interval: 1.4-4.3) higher among children who had not received 2 doses in the same prior season. We also noted residual protection among unvaccinated children who were vaccinated the previous season (VE range = 36%-40% across outcomes).
  
  
  CONCLUSIONS
  Vaccination with IIV3 may provide preventive benefit in subsequent seasons, including possible residual protection if vaccination is missed. Two vaccine doses in the same season may be more effective than alternative priming strategies.
authors.affiliation: From the *Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia; †University of Michigan, Ann Arbor, Michigan; ‡Group Health Cooperative, Seattle, Washington; §Marshfield Clinic Research Foundation, Marshfield, Wisconsin; ¶Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple, Texas; and ‖University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Thompson
authors.forename: Jessie
authors.initials: J
authors.lastname: Clippard
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Petrie
authors.forename: Michael L
authors.initials: ML
authors.lastname: Jackson
authors.forename: Huong Q
authors.initials: HQ
authors.lastname: McLean
authors.forename: Manjusha
authors.initials: M
authors.lastname: Gaglani
authors.forename: Evelyn C
authors.initials: EC
authors.lastname: Reis
authors.forename: Brendan
authors.initials: B
authors.lastname: Flannery
authors.forename: Arnold S
authors.initials: AS
authors.lastname: Monto
authors.forename: Lisa
authors.initials: L
authors.lastname: Jackson
authors.forename: Edward A
authors.initials: EA
authors.lastname: Belongia
authors.forename: Kempapura
authors.initials: K
authors.lastname: Murthy
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Swathi
authors.initials: S
authors.lastname: Thaker
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000145:classification / Q000276:immunology; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D007251:Influenza, Human / Q000453:epidemiology* / Q000266:history / Q000517:prevention & control*; D008297:Male; D017063:Outcome Assessment, Health Care; D012621:Seasons; D014481:United States / Q000453:epidemiology; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines