TY - JOUR
T1 - Estimated impact of maternal vaccination on global paediatric influenza-related in-hospital mortality
T2 - A retrospective case series
AU - Löwensteyn, Yvette N
AU - Nair, Harish
AU - Nunes, Marta C
AU - van Roessel, Ichelle
AU - Vernooij, Femke S
AU - Willemsen, Joukje
AU - Bont, Louis J
AU - Mazur, Natalie I
N1 - Funding Information:
This publication is based on research funded in part by the Bill & Melinda Gates Foundation. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation.
Funding Information:
We thank our collaborators of the FLU GOLD study group for taking the time and effort to share data with the FLU GOLD registry. Furthermore, we thank Dianna Blau and Beth Tippett Barr for sharing data from the Child Health and Mortality Prevention Surveillance (CHAMPS) Network. We are grateful to Dr. Sheikh Wasik Rahman, Mr. Shuborno Islam, Ms. Naito Kanon, Mr. Zabed Ahmed and Dr. Rubana Sultana Aflatun of the Child Health Research Foundation for their intellectual, laboratory, and technical assistance. Lastly, we thank Stefano Tempia, Prachi Vora and Padmini Srikantiah for their scientific advice.
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/7
Y1 - 2021/7
N2 - 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.Funding: Bill & Melinda Gates Foundation.
AB - 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.Funding: Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85107774286&partnerID=8YFLogxK
U2 - 10.1016/j.eclinm.2021.100945
DO - 10.1016/j.eclinm.2021.100945
M3 - Article
C2 - 34386739
SN - 2589-5370
VL - 37
SP - 1
EP - 11
JO - EClinicalMedicine
JF - EClinicalMedicine
M1 - 100945
ER -