Incidence of live-attenuated influenza vaccine administration beyond expiry date in children and adolescents aged 2–17 years in the UK: a population-based cohort study

Abstract Aims Prevalence of the use of antipsychotics (APs) in the paediatric population is globally increasing. The aim of this study was to describe multinational trends and patterns in AP use in children and adolescents in Europe. Methods This was a dynamic retrospective cohort study comprising all children and adolescents (⩽18 years of age). Data were extracted from five population-based electronic healthcare databases in Europe (Denmark, Germany, Italy, the Netherlands and United Kingdom) from 2000 to 2010. Yearly prevalence and incidence of AP use was expressed per 1000 person-years (PYs). Results Prevalence increased from 1.44 to 3.41/1000 PYs (2008) in Denmark and from 2.07 to 4.35/1000 PYs in the NL (2009), moderately increased from 2.8 to 3.24/1000 in UK (2009) and from 1.53 to 1.74/1000 PYs in Germany (2008) and remained low from 0.61 to 0.34/1000 PYs in Italy (2010). Similarly, incidence rates increased from 0.69 to 1.52/1000 PYs in Denmark and from 0.86 to 1.49/1000 PYs in the NL, stabilised from 2.29 to 2.37/1000 PYs in the UK and from 0.79 to 0.80/1000 PYs in Germany and remained low from 0.32 to 0.2/1000 PYs in Italy. AP use was highest in 15–18 year olds and in boys compared to girls. Yet, the use observed in the 5–9 year olds was found to be comparatively high in the NL. Prescriptions of second generation APs, especially risperidone, were privileged but the first generation APs were still prescribed in the youngest. Conclusions A steady increase in AP use in children and adolescents was observed essentially in the NL and Denmark. The use in Germany and Italy was lowest among countries. The use of APs under 9 years of age underlines their off-label use and should be carefully monitored as the risk/benefit ratio of these medications remains unclear in young children. AP use was altogether lower in Europe as compared to that reported in North America.

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Evaluation of the safety of live attenuated influenza vaccine (LAIV) in children and adolescents with asthma and high-risk conditions: a population-based prospective cohort study conducted in England with the Clinical Practice Research Datalink

BMJ Open ◽

10.1136/bmjopen-2018-023118 ◽

2018 ◽

Vol 8 (12) ◽

pp. e023118 ◽

Cited By ~ 1

Author(s):

Herve Caspard ◽

Amy Steffey ◽

Raburn M Mallory ◽

Christopher S Ambrose

Keyword(s):

Cohort Study ◽

Clinical Practice ◽

High Risk ◽

Influenza Vaccine ◽

Children And Adolescents ◽

Influenza Season ◽

Risk Groups ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Live Attenuated Influenza Vaccine

ObjectivesTo assess the safety of live attenuated influenza vaccine (LAIV) in children in high-risk groups.DesignNon-interventional cohort study.SettingEngland during 2013–2014 and 2014–2015 influenza seasons.ParticipantsLAIV recipients identified from the Clinical Practice Research Datalink, aged 2–17 years, and with at least one underlying high-risk condition. LAIV recipients were matched with inactivated influenza vaccine (IIV) recipients and unvaccinated controls.Primary outcome measuresPrimary safety endpoints were any hospitalisation documented in the linked Hospital Episodes Statistics database within 42 days and up to 6 months after vaccination.Results11 463 children and adolescents were included: 4718 received the trivalent LAIV formulation during the 2013–2014 influenza season and 6745 received the quadrivalent formulation during the 2014–2015 influenza season. The risks of hospitalisation within 42 days were 231 per 1000 person-years (95% CI 193 to 275) in season 2013–2014 and 231 (95% CI 198 to 267) in season 2014–2015. These risks were not significantly different when compared with matched unvaccinated children (relative risks (RR) 0.96 (95% CI 0.78 to 1.19) in season 2013–2014, 0.90 (95% CI 0.76 to 1.07) in season 2014–2015) and consistently lower than after IIV administration (RR 0.47 (95% CI: 0.37 to 0.59) in season 2013–2014, 0.42 (95% CI 0.35 to 0.51) in season 2014–2015). A similar pattern was observed up to 6 months postvaccination with a risk of hospitalisation after LAIV administration that did not differ from what was observed in unvaccinated controls and was lower than after IIV administration.ConclusionsThis study did not identify new safety concerns associated with the administration of LAIV in children and adolescents with high-risk conditions. However, as with any other observational study, treatment administration was not randomly assigned and our findings may be confounded by differences between the groups at baseline.Trial registration numberEUPAS18527.

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Faculty Opinions recommendation of Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: a population-based cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725917838.793530591 ◽

2017 ◽

Author(s):

Adam Hill

Keyword(s):

Cohort Study ◽

Population Based ◽

The Uk ◽

Incidence Prevalence

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Persistence of Health Inequalities in Childhood Injury in the UK; A Population-Based Cohort Study of Children under 5

PLoS ONE ◽

10.1371/journal.pone.0111631 ◽

2014 ◽

Vol 9 (10) ◽

pp. e111631 ◽

Cited By ~ 21

Author(s):

Elizabeth Orton ◽

Denise Kendrick ◽

Joe West ◽

Laila J. Tata

Keyword(s):

Cohort Study ◽

Health Inequalities ◽

Population Based ◽

Childhood Injury ◽

The Uk ◽

Children Under 5

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Rise in psychotropic drug prescribing in children and adolescents during 1992–2001: a population-based study in the UK

European Journal of Epidemiology ◽

10.1007/s10654-009-9321-3 ◽

2009 ◽

Vol 24 (4) ◽

pp. 211-216 ◽

Cited By ~ 44

Author(s):

Yingfen Hsia ◽

Karyn Maclennan

Keyword(s):

Children And Adolescents ◽

Psychotropic Drug ◽

Population Based ◽

Drug Prescribing ◽

Population Based Study ◽

The Uk

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Effectiveness of seasonal influenza vaccine for adults and children in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2015/16 end-of-season results

Eurosurveillance ◽

10.2807/1560-7917.es.2016.21.38.30348 ◽

2016 ◽

Vol 21 (38) ◽

Cited By ~ 56

Author(s):

Richard Pebody ◽

Fiona Warburton ◽

Joanna Ellis ◽

Nick Andrews ◽

Alison Potts ◽

...

Keyword(s):

Primary Care ◽

United Kingdom ◽

Influenza Vaccine ◽

Influenza A ◽

Immunisation Programme ◽

Influenza B ◽

Live Attenuated Influenza Vaccine ◽

The United Kingdom ◽

Influenza A H1n1 ◽

The Uk

The United Kingdom (UK) is in the third season of introducing universal paediatric influenza vaccination with a quadrivalent live attenuated influenza vaccine (LAIV). The 2015/16 season in the UK was initially dominated by influenza A(H1N1)pdm09 and then influenza of B/Victoria lineage, not contained in that season’s adult trivalent inactivated influenza vaccine (IIV). Overall adjusted end-of-season vaccine effectiveness (VE) was 52.4% (95% confidence interval (CI): 41.0–61.6) against influenza-confirmed primary care consultation, 54.5% (95% CI: 41.6–64.5) against influenza A(H1N1)pdm09 and 54.2% (95% CI: 33.1–68.6) against influenza B. In 2–17 year-olds, adjusted VE for LAIV was 57.6% (95% CI: 25.1 to 76.0) against any influenza, 81.4% (95% CI: 39.6–94.3) against influenza B and 41.5% (95% CI: −8.5 to 68.5) against influenza A(H1N1)pdm09. These estimates demonstrate moderate to good levels of protection, particularly against influenza B in children, but relatively less against influenza A(H1N1)pdm09. Despite lineage mismatch in the trivalent IIV, adults younger than 65 years were still protected against influenza B. These results provide reassurance for the UK to continue its influenza immunisation programme planned for 2016/17.

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