Influenza vaccination coverage among persons seeking outpatient medical care for acute respiratory illness in five states in the United States, 2011–2012 through 2018–2019

Vaccine ◽  
2021 ◽  
Author(s):  
Michael J. Wu ◽  
Jessie R. Chung ◽  
Sara S. Kim ◽  
Michael L. Jackson ◽  
Lisa A. Jackson ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Medical Care ◽  
Vaccination Coverage ◽  
Respiratory Illness ◽  
The United States ◽  
Acute Respiratory Illness

scholarly journals Influenza vaccine effectiveness against hospitalization in the United States, 2019-2020

2020 ◽  
Author(s):  
Mark W Tenforde ◽  
H Keipp Talbot ◽  
Christopher H Trabue ◽  
Manjusha Gaglani ◽  
Tresa M McNeal ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Respiratory Illness ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Influenza Viruses ◽  
Current Season ◽  
Hospital Resources ◽  
Negative Controls

Abstract Background Influenza causes significant morbidity and mortality and stresses hospital resources during periods of increased circulation. We evaluated the effectiveness of the 2019-2020 influenza vaccine against influenza-associated hospitalizations in the United States. Methods We included adults hospitalized with acute respiratory illness at 14 hospitals and tested for influenza viruses by reserve transcription polymerase chain reaction. Vaccine effectiveness (VE) was estimated by comparing the odds of current-season influenza vaccination in test-positive influenza cases versus test-negative controls, adjusting for confounders. VE was stratified by age and major circulating influenza types along with A(H1N1)pdm09 genetic subgroups. Results 3116 participants were included, including 18% (553) influenza-positive cases. Median age was 63 years. Sixty-seven percent (2079) received vaccination. Overall adjusted VE against influenza viruses was 41% (95% confidence interval [CI]: 27-52). VE against A(H1N1)pdm09 viruses was 40% (95% CI: 24-53) and 33% against B viruses (95% CI: 0-56). Of the two major A(H1N1)pdm09 subgroups (representing 90% of sequenced H1N1 viruses), VE against one group (5A+187A,189E) was 59% (95% CI: 34-75) whereas no significant VE was observed against the other group (5A+156K) [-1%, 95% CI: -61-37]. Conclusions In a primarily older population, influenza vaccination was associated with a 41% reduction in risk of hospitalized influenza illness.

scholarly journals Vaccine Effectiveness Against Influenza Hospitalization Among Children in the United States, 2015–2016

2020 ◽  
Author(s):  
Leora R Feldstein ◽  
Constance Ogokeh ◽  
Brian Rha ◽  
Geoffrey A Weinberg ◽  
Mary A Staat ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Respiratory Illness ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Limited Data ◽  
Surveillance Network ◽  
Number Of Children ◽  
Influenza Illness ◽  
Us Children

Abstract Background Annual United States (US) estimates of influenza vaccine effectiveness (VE) in children typically measure protection against outpatient medically attended influenza illness, with limited data evaluating VE against influenza hospitalizations. We estimated VE for preventing laboratory-confirmed influenza hospitalization among US children. Methods We included children aged 6 months–17 years with acute respiratory illness enrolled in the New Vaccine Surveillance Network during the 2015–2016 influenza season. Documented influenza vaccination status was obtained from state immunization information systems, the electronic medical record, and/or provider records. Midturbinate nasal and throat swabs were tested for influenza using molecular assays. We estimated VE as 100% × (1 – odds ratio), comparing the odds of vaccination among subjects testing influenza positive with subjects testing negative, using multivariable logistic regression. Results Of 1653 participants, 36 of 707 (5%) of those fully vaccinated, 18 of 226 (8%) of those partially vaccinated, and 85 of 720 (12%) of unvaccinated children tested positive for influenza. Of those vaccinated, almost 90% were documented to have received inactivated vaccine. The majority (81%) of influenza cases were in children ≤ 8 years of age. Of the 139 influenza-positive cases, 42% were A(H1N1)pdm09, 42% were B viruses, and 14% were A(H3N2). Overall, adjusted VE for fully vaccinated children was 56% (95% confidence interval [CI], 34%–71%) against any influenza-associated hospitalization, 68% (95% CI, 36%–84%) for A(H1N1)pdm09, and 44% (95% CI, –1% to 69%) for B viruses. Conclusions These findings demonstrate the importance of annual influenza vaccination in prevention of severe influenza disease and of reducing the number of children who remain unvaccinated or partially vaccinated against influenza.

scholarly journals Outbreaks of Adenovirus-associated Respiratory Illness on 5 College Campuses in the United States, 2018–2019

2020 ◽  
Author(s):  
Stephanie A Kujawski ◽  
Xiaoyan Lu ◽  
Eileen Schneider ◽  
David Blythe ◽  
Sameh Boktor ◽  
...  
Keyword(s):  
United States ◽  
Social History ◽  
Military Training ◽  
Respiratory Illness ◽  
The United States ◽  
College Campuses ◽  
Whole Genome Sequence ◽  
Whole Genome ◽  
Acute Respiratory Illness ◽  
Symptom Presentation

Abstract Background Human adenoviruses (HAdVs) are commonly associated with acute respiratory illness. HAdV outbreaks are well documented in congregate military training settings, but less is known about outbreaks on college campuses. During fall 2018 and spring 2019, 5 United States (US) colleges reported increases in HAdV-associated respiratory illness. Investigations were performed to better understand HAdV epidemiology in this setting. Methods A case was defined as a student at one of the 5 colleges, with acute respiratory illness and laboratory-confirmed HAdV infection during October 2018–December 2018 or March–May 2019. Available respiratory specimens were typed by HAdV type-specific real-time polymerase chain reaction assays, and for a subset, whole genome sequencing was performed. We reviewed available medical records and cases were invited to complete a questionnaire, which included questions on symptom presentation, social history, and absenteeism. Results We identified 168 HAdV cases. Median age was 19 (range, 17–22) years and 102 cases (61%) were male. Eleven cases were hospitalized, 10 with pneumonia; 2 cases died. Among questionnaire respondents, 80% (75/94) missed ≥ 1 day of class because of their illness. Among those with a type identified (79%), HAdV types 4 and 7 were equally detected, with frequency of each varying by site. Genome types 4a1 and 7d were identified, respectively, by whole genome sequence analysis. Conclusions HAdV respiratory illness was associated with substantial morbidity and missed class time among young, generally healthy adults on 5 US college campuses. HAdVs should be considered a cause of respiratory illness outbreaks in congregate settings such as college campuses.

scholarly journals The Impact of Influenza Vaccination on Antibiotic Use in the United States, 2010–2017

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Eili Y Klein ◽  
Emily Schueller ◽  
Katie K Tseng ◽  
Daniel J Morgan ◽  
Ramanan Laxminarayan ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
State Level ◽  
Population Level ◽  
Antibiotic Use ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Severe Illness ◽  
Antibiotic Prescribing

Abstract Background Influenza, which peaks seasonally, is an important driver for antibiotic prescribing. Although influenza vaccination has been shown to reduce severe illness, evidence of the population-level effects of vaccination coverage on rates of antibiotic prescribing in the United States is lacking. Methods We conducted a retrospective analysis of influenza vaccination coverage and antibiotic prescribing rates from 2010 to 2017 across states in the United States, controlling for differences in health infrastructure and yearly vaccine effectiveness. Using data from IQVIA’s Xponent database and the US Centers for Disease Control and Prevention’s FluVaxView, we employed fixed-effects regression analysis to analyze the relationship between influenza vaccine coverage rates and the number of antibiotic prescriptions per 1000 residents from January to March of each year. Results We observed that, controlling for socioeconomic differences, access to health care, childcare centers, climate, vaccine effectiveness, and state-level differences, a 10–percentage point increase in the influenza vaccination rate was associated with a 6.5% decrease in antibiotic use, equivalent to 14.2 (95% CI, 6.0–22.4; P = .001) fewer antibiotic prescriptions per 1000 individuals. Increased vaccination coverage reduced prescribing rates the most in the pediatric population (0–18 years), by 15.2 (95% CI, 9.0–21.3; P < .001) or 6.0%, and the elderly (aged 65+), by 12.8 (95% CI, 6.5–19.2; P < .001) or 5.2%. Conclusions Increased influenza vaccination uptake at the population level is associated with state-level reductions in antibiotic use. Expanding influenza vaccination could be an important intervention to reduce unnecessary antibiotic prescribing.

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