Vaccine · 2026
Influenza epidemiology, treatment and prevention in Australian children: Trends from 6 years of PAEDS-FluCAN influenza surveillance (2019-2024).
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Rice Emily, Cheng Allen C, Britton Phillip N, Carr Jeremy, Clark Julia E, Crawford Nigel W, Francis Joshua R, Macartney Kristine K, Marshall Helen S, Wood Nicholas J, Blyth Christopher C, PAEDS-FluCAN network
Аннотация
BACKGROUND: Influenza remains an important cause of pediatric morbidity and mortality. Immunisation is critical to prevent hospitalisation and severe disease. The COVID-19 pandemic had far-reaching effects on influenza epidemiology and vaccine use.
METHODS: Participants were recruited prospectively from sentinel hospital sites (2019-2024). Children hospitalised with an acute respiratory illness (ARI) and laboratory-confirmed influenza were considered cases whilst those testing negative were considered controls. Vaccine effectiveness was estimated from the adjusted odds ratio of vaccination in cases and controls.
RESULTS: There were 8762 hospitalised influenza cases and 10,955 influenza-test-negative controls in children <16 years. Of cases, 25.0% were < 2 years of age, 38.4% had underlying medical risk factors and 6.9% were First Nations children. 7.1% required intensive care unit admission and 0.32% died. COVID-19 restrictions dramatically impacted on influenza activity: 12 cases were identified in 2020-2021, compared to 1557-2818 cases per annum in 2019 and 2022-2024 respectively. Antivirals were used in only 26.5% of cases. Reduced vaccine coverage following the COVID-19 pandemic was observed with 19.6% of test-negative controls vaccinated in 2022 compared to 43.9% in 2019. Reduced coverage persisted across all states, age groups and in those with medical comorbidities. Estimated vaccine effectiveness ranged from 56.3% (95%CI:46.7,64.2) in 2019 to 82.5% (76.6,86.9) in 2023. Effectiveness was demonstrated in all age groups and in those with and without medical risk factors.
CONCLUSION: Reduced influenza vaccine coverage was observed Australia-wide in 2022-24 compared to 2019. Despite this, influenza vaccine remains an effective influenza-prevention tool. Strategies to improve vaccine coverage are urgently required.
METHODS: Participants were recruited prospectively from sentinel hospital sites (2019-2024). Children hospitalised with an acute respiratory illness (ARI) and laboratory-confirmed influenza were considered cases whilst those testing negative were considered controls. Vaccine effectiveness was estimated from the adjusted odds ratio of vaccination in cases and controls.
RESULTS: There were 8762 hospitalised influenza cases and 10,955 influenza-test-negative controls in children <16 years. Of cases, 25.0% were < 2 years of age, 38.4% had underlying medical risk factors and 6.9% were First Nations children. 7.1% required intensive care unit admission and 0.32% died. COVID-19 restrictions dramatically impacted on influenza activity: 12 cases were identified in 2020-2021, compared to 1557-2818 cases per annum in 2019 and 2022-2024 respectively. Antivirals were used in only 26.5% of cases. Reduced vaccine coverage following the COVID-19 pandemic was observed with 19.6% of test-negative controls vaccinated in 2022 compared to 43.9% in 2019. Reduced coverage persisted across all states, age groups and in those with medical comorbidities. Estimated vaccine effectiveness ranged from 56.3% (95%CI:46.7,64.2) in 2019 to 82.5% (76.6,86.9) in 2023. Effectiveness was demonstrated in all age groups and in those with and without medical risk factors.
CONCLUSION: Reduced influenza vaccine coverage was observed Australia-wide in 2022-24 compared to 2019. Despite this, influenza vaccine remains an effective influenza-prevention tool. Strategies to improve vaccine coverage are urgently required.