Clinical effectiveness of conventional influenza vaccination in asthmatic children

被引:44
作者
Smits, AJ [1 ]
Hak, E [1 ]
Stalman, WAB [1 ]
Van Essen, GA [1 ]
Hoes, AW [1 ]
Verheij, TJM [1 ]
机构
[1] Univ Utrecht, Med Ctr, Julius Ctr Gen Practice & Patient Oriented Res, NL-3508 AB Utrecht, Netherlands
关键词
D O I
10.1017/S0950268801006574
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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% Cl 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.
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页码:205 / 211
页数:7
相关论文
共 34 条
  • [1] *AM LUNG ASS, 1998, TRENDS ASTHM MORB MO
  • [2] IMMUNIZATION WITH KILLED INFLUENZA-VIRUS IN CHILDREN WITH CHRONIC ASTHMA
    BELL, TD
    CHAI, H
    BERLOW, B
    DANIELS, G
    [J]. CHEST, 1978, 73 (02) : 140 - 145
  • [3] The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenzavirus vaccine in children
    Belshe, RB
    Mendelman, PM
    Treanor, J
    King, J
    Gruber, WC
    Piedra, P
    Bernstein, DI
    Hayden, FG
    Kotloff, K
    Zangwill, K
    Iacuzio, D
    Wolff, M
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (20) : 1405 - 1412
  • [4] Protection against influenza after annually repeated vaccination -: A meta-analysis of serologic and field studies
    Beyer, WEP
    de Bruijn, IA
    Palache, AM
    Westendorp, RGJ
    Osterhaus, ADME
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1999, 159 (02) : 182 - 188
  • [5] BRAUN H, 1999, APPL MIXED MODELS ME, P360
  • [6] CATES CJ, 1999, COCHRANE LIB
  • [7] Claas E C, 1996, Ned Tijdschr Geneeskd, V140, P2047
  • [8] *CLASS COMM WONCA, 1983, ICHPPC 2 DEF INT CLA
  • [9] INFLUENZA-A VACCINE DECREASES THE INCIDENCE OF OTITIS-MEDIA IN 6- TO 30-MONTH-OLD CHILDREN IN DAY-CARE
    CLEMENTS, DA
    LANGDON, L
    BLAND, C
    WALTER, E
    [J]. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 1995, 149 (10): : 1113 - 1117
  • [10] WHAT ARE THE COMPLICATIONS OF INFLUENZA AND CAN THEY BE PREVENTED - EXPERIENCE FROM THE 1989 EPIDEMIC OF H3N2 INFLUENZA-A IN GENERAL-PRACTICE
    CONNOLLY, AM
    SALMON, RL
    LERVY, B
    WILLIAMS, DH
    [J]. BRITISH MEDICAL JOURNAL, 1993, 306 (6890) : 1452 - 1454