Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium

Gerlier L, Lamotte M, Mendes SDS, Damm O, Schwehm M, Eichner M (2016)
PEDIATRIC DRUGS 18(4): 303-318.

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Objectives Our objectives were to estimate the public health outcomes of vaccinating Belgian children using an intranasal tetravalent live-attenuated influenza vaccine (QLAIV) combined with current coverage of high-risk/elderly individuals using the trivalent inactivated vaccine. Methods We used a deterministic, age-structured, dynamic model to simulate seasonal influenza transmission in the Belgian population under the current coverage or after extending vaccination with QLAIV to healthy children aged 2-17 years. Differential equations describe demographic changes, exposure to infectious individuals, infection recovery, and immunity dynamics. The basic reproduction number (R-0) was calibrated to the observed number of influenza doctor visits/year. Vaccine efficacy was 80 % (live-attenuated) and 59-68 % (inactivated). The 10-year incidence of symptomatic influenza was calculated with different coverage scenarios (add-on to current coverage). Results Model calibration yielded R-0 = 1.1. QLAIV coverage of 75 % of those aged 2-17 years averted 374,000 symptomatic cases/year (57 % of the current number), 244,000 of which were among adults (indirect effect). Vaccinating 75 % of those aged 2-11 years and 50 % of those aged 12-17 years averted 333,200 cases/year (213,000 adult cases/year). Vaccinating only healthy children aged 2-5 years generated direct protection but limited indirect protection, even with 90 % coverage (40,800 averted adult cases/year; -8.4 %). Targeting all children averted twice as many high-risk cases as targeting high-risk children only (8485 vs. 4965/year with 75 % coverage). Sensitivity analyses showed the robustness of results. Conclusions The model highlights the direct and indirect protection benefits when vaccinating healthy children with QLAIV in Belgium. Policies targeting only high-risk individuals or the youngest provide limited herd protection, as school-age children are important influenza vectors in the community.
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Gerlier L, Lamotte M, Mendes SDS, Damm O, Schwehm M, Eichner M. Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium. PEDIATRIC DRUGS. 2016;18(4):303-318.
Gerlier, L., Lamotte, M., Mendes, S. D. S., Damm, O., Schwehm, M., & Eichner, M. (2016). Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium. PEDIATRIC DRUGS, 18(4), 303-318. doi:10.1007/s40272-016-0180-6
Gerlier, L., Lamotte, M., Mendes, S. D. S., Damm, O., Schwehm, M., and Eichner, M. (2016). Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium. PEDIATRIC DRUGS 18, 303-318.
Gerlier, L., et al., 2016. Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium. PEDIATRIC DRUGS, 18(4), p 303-318.
L. Gerlier, et al., “Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium”, PEDIATRIC DRUGS, vol. 18, 2016, pp. 303-318.
Gerlier, L., Lamotte, M., Mendes, S.D.S., Damm, O., Schwehm, M., Eichner, M.: Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium. PEDIATRIC DRUGS. 18, 303-318 (2016).
Gerlier, Laetitia, Lamotte, Mark, Mendes, Sofia Dos Santos, Damm, Oliver, Schwehm, Markus, and Eichner, Martin. “Estimates of the Public Health Impact of a Pediatric Vaccination Program Using an Intranasal Tetravalent Live-Attenuated Influenza Vaccine in Belgium”. PEDIATRIC DRUGS 18.4 (2016): 303-318.
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