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Risk factors for admission to hospital with laboratory-confirmed influenza in young children: birth cohort study

Pia Hardelid, Maximiliane Verfuerden, Jim McMenamin, Ruth Gilbert
European Respiratory Journal 2017 50: 1700489; DOI: 10.1183/13993003.00489-2017
Pia Hardelid
Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
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  • For correspondence: p.hardelid@ucl.ac.uk
Maximiliane Verfuerden
Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
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Jim McMenamin
Health Protection Scotland, Glasgow, UK
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Ruth Gilbert
Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
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Abstract

We determined risk factors for influenza hospital admission in children aged <2 years to guide the design of paediatric vaccination programmes.

We linked all singleton live births in Scotland from 2007 to 2015 to hospital administrative data and influenza laboratory reports. Cox proportional hazard models were used to identify birth and family risk factors for influenza admissions.

There were 1115 influenza admissions among 424 048 children. 85.1% of admitted children were born at term and were not in a high-risk group. Presence of an older sibling was strongly associated with increased risk of influenza admission, particularly for children aged <6 months: hazard ratio for second- versus first-born child was 2.02 (95% CI 1.52–2.69). Maternal age <30 years and birth during autumn (age <6 months) or spring (age 6–23 months) were also associated with admission risk.

Targeting vaccination programmes to high-risk children will not prevent the vast majority of influenza admissions. Parents of children aged <2 years should be advised that vaccination of older siblings will protect younger children against influenza infection. As evidence of the impact of the universal influenza vaccine programme emerges, there may be a need to reconsider universal influenza vaccination in children aged 6 months to 2 years in the UK.

Abstract

Older siblings pose risk of serious influenza for babies and toddlers http://ow.ly/RQDS30dbtIo

Footnotes

  • This article has supplementary material available from erj.ersjournals.com

  • Support statement: This study was funded by a National Institute for Health Research Postdoctoral Fellowship to P. Hardelid, reference number PDF-2013–06–004. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. The study sponsor had no role in the study design, data analysis, interpretation, writing the report, or in the decision to submit the paper for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com

  • Received March 9, 2017.
  • Accepted June 22, 2017.
  • Copyright ©ERS 2017
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Risk factors for admission to hospital with laboratory-confirmed influenza in young children: birth cohort study
Pia Hardelid, Maximiliane Verfuerden, Jim McMenamin, Ruth Gilbert
European Respiratory Journal Sep 2017, 50 (3) 1700489; DOI: 10.1183/13993003.00489-2017

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Risk factors for admission to hospital with laboratory-confirmed influenza in young children: birth cohort study
Pia Hardelid, Maximiliane Verfuerden, Jim McMenamin, Ruth Gilbert
European Respiratory Journal Sep 2017, 50 (3) 1700489; DOI: 10.1183/13993003.00489-2017
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