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Estimated impact of maternal vaccination on global paediatric influenza-related in-hospital mortality : a retrospective case series
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FLU GOLD study group (Including: Löwensteyn, Yvette N., Nair, Harish, Nunes, Marta C., van Roessel, Ichelle, Vernooij, Femke S., Willemsen, Joukje, Bont, Louis J. and Mazur, Natalie I.). (2021) Estimated impact of maternal vaccination on global paediatric influenza-related in-hospital mortality : a retrospective case series. eClinicalMedicine, 37 . 100945. doi:10.1016/j.eclinm.2021.100945 ISSN 2589-5370.
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Official URL: https://doi.org/10.1016/j.eclinm.2021.100945
Abstract
Background
Influenza virus infection is an important cause of under-five mortality. Maternal vaccination protects children younger than 3 months of age from influenza infection. However, it is unknown to what extent paediatric influenza-related mortality may be prevented by a maternal vaccine since global age-stratified mortality data are lacking.
Methods
We invited clinicians and researchers to share clinical and demographic characteristics from children younger than 5 years who died with laboratory-confirmed influenza infection between January 1, 1995 and March 31, 2020. We evaluated the potential impact of maternal vaccination by estimating the number of children younger than 3 months with in-hospital influenza-related death using published global mortality estimates.
Findings
We included 314 children from 31 countries. Comorbidities were present in 166 (53%) children and 41 (13%) children were born prematurely. Median age at death was 8·6 (IQR 4·5–16·6), 11·5 (IQR 4·3–24·0), and 15·5 (IQR 7·4–27·0) months for children from low- and lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs), respectively. The proportion of children younger than 3 months at time of death was 17% in LMICs, 12% in UMICs, and 7% in HICs. We estimated that 3339 annual influenza-related in-hospital deaths occur in the first 3 months of life globally.
Interpretation
In our study, less than 20% of children is younger than 3 months at time of influenza-related death. Although maternal influenza vaccination may impact maternal and infant influenza disease burden, additional immunisation strategies are needed to prevent global influenza-related childhood mortality. The missing data, global coverage, and data quality in this study should be taken into consideration for further interpretation of the results.
| Item Type: | Journal Article | |||||||||
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| Subjects: | Q Science > QR Microbiology R Medicine > RA Public aspects of medicine R Medicine > RG Gynecology and obstetrics R Medicine > RJ Pediatrics |
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| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | |||||||||
| Library of Congress Subject Headings (LCSH): | Virus diseases in children, Pregnancy -- Immunological aspects, Influenza vaccines -- Research, Vaccination, Vaccination of children | |||||||||
| Journal or Publication Title: | eClinicalMedicine | |||||||||
| Publisher: | Elsevier | |||||||||
| ISSN: | 2589-5370 | |||||||||
| Official Date: | July 2021 | |||||||||
| Dates: |
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| Volume: | 37 | |||||||||
| Article Number: | 100945 | |||||||||
| DOI: | 10.1016/j.eclinm.2021.100945 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||
| Date of first compliant deposit: | 21 May 2021 | |||||||||
| Date of first compliant Open Access: | 14 June 2021 | |||||||||
| RIOXX Funder/Project Grant: |
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