Vaccine effectiveness against severe laboratory-confirmed influenza in children: results of two consecutive seasons in Italy.
OBJECTIVE
To evaluate the effectiveness of seasonal influenza vaccine in preventing Emergency Department (ED) visits and hospitalisations for influenza like illness (ILI) in children.


METHODS
We conducted a test negative case-control study during the 2011-2012 and 2012-2013 influenza seasons. Eleven paediatric hospital/wards in seven Italian regions participated in the study. Consecutive children visiting the ED with an ILI, as diagnosed by the doctor according to the European Centre for Disease Control case definition, were eligible for the study. Data were collected from trained pharmacists/physicians by interviewing parents during the ED visit (or hospital admission) of their children. An influenza microbiological test (RT-PCR) was carried out in all children.


RESULTS
Seven-hundred and four children, from 6 months to 16 years of age, were enrolled: 262 children tested positive for one of the influenza viruses (cases) and 442 tested negative (controls). Cases were older than controls (median age 46 vs. 29 months), though with a similar prevalence of chronic conditions. Only 25 children (4%) were vaccinated in the study period. The overall age-adjusted vaccine effectiveness (VE) was 38% (95% confidence interval -52% to 75%). A higher VE was estimated for hospitalised children (53%; 95% confidence interval -45% to 85%).


DISCUSSION
This study supports the effectiveness of the seasonal influenza vaccine in preventing visits to the EDs and hospitalisations for ILI in children, although the estimates were not statistically significant and with wide confidence intervals. Future systematic reviews of available data will provide more robust evidence for recommending influenza vaccination in children.
['Menniti-Ippolito|Francesca|F|', 'Da Cas|Roberto|R|', 'Traversa|Giuseppe|G|', 'Santuccio|Carmela|C|', 'Felicetti|Patrizia|P|', 'Tartaglia|Loriana|L|', 'Trotta|Francesco|F|', 'Di Pietro|Pasquale|P|', 'Barabino|Paola|P|', 'Renna|Salvatore|S|', 'Riceputi|Laura|L|', 'Tovo|Pier-Angelo|PA|', 'Gabiano|Clara|C|', 'Urbino|Antonio|A|', 'Baroero|Luca|L|', 'Le Serre|Daniele|D|', 'Virano|Silvia|S|', 'Perilongo|Giorgio|G|', 'Daverio|Marco|M|', 'Gnoato|Elisa|E|', 'Maretti|Michela|M|', 'Galeazzo|Beatrice|B|', 'Rubin|Giulia|G|', 'Scanferla|Stefania|S|', 'Da Dalt|Liviana|L|', 'Stefani|Chiara|C|', 'Zerbinati|Claudia|C|', 'Chiappini|Elena|E|', 'Sollai|Sara|S|', 'De Martino|Maurizio|M|', 'Mannelli|Francesco|F|', 'Becciani|Sabrina|S|', 'Giacalone|Martina|M|', 'Montano|Simona|S|', 'Remaschi|Giulia|G|', 'Stival|Alessia|A|', 'Furbetta|Mario|M|', 'Abate|Piera|P|', 'Leonardi|Ilaria|I|', 'Pirozzi|Nicola|N|', 'Raucci|Umberto|U|', 'Reale|Antonino|A|', 'Rossi|Rossella|R|', 'Russo|Cristina|C|', 'Mancinelli|Livia|L|', 'Manuela|Onori|O|', 'Carlo|Concato|C|', 'Mores|Nadia|N|', 'Romagnoli|Costantino|C|', 'Chiaretti|Antonio|A|', 'Compagnone|Adele|A|', 'Riccardi|Riccardo|R|', 'Delogu|Giovanni|G|', 'Sali|Michela|M|', 'Prete|Valentina|V|', 'Tipo|Vincenzo|V|', 'Dinardo|Michele|M|', 'Auricchio|Fabiana|F|', 'Polimeno|Teodoro|T|', 'Sodano|Giuseppe|G|', 'Maccariello|Alessandra|A|', 'Rafaniello|Concita|C|', 'Fucà|Fortunata|F|', 'Di Rosa|Eleonora|E|', 'Altavilla|Domenica|D|', 'Mecchio|Anna|A|', 'Arrigo|Teresa|T|', '|||']
D000293:Adolescent D016022:Case-Control Studies D002648:Child D002675:Child, Preschool D004632:Emergency Medical Services D005260:Female D006760:Hospitalization D006801:Humans D007223:Infant D007252:Influenza Vaccines D007251:Influenza, Human D007558:Italy D008297:Male D016896:Treatment Outcome
Children Case-control study Influenza vaccine effectiveness Laboratory-confirmed cases