Estimated impact of maternal vaccination on global paediatric influenza-related in-hospital mortality: A retrospective case series. (July 2021)

• Record Type: Journal Article
• Authors: Löwensteyn, Yvette N; Nair, Harish; Nunes, Marta C; van Roessel, Ichelle; Vernooij, Femke S; Willemsen, Joukje; Bont, Louis J; Mazur, Natalie I; Thorburn, Kentigern; Nunes, Marta; Chawana, Richard; Madhi, Shabir A.; Vittuci, Anna C.; Bassat, Quique; Bardají, Azucena; Goka, Edward; Roglić, Srđan; Paes, Bosco; Elliott, LouAnn; Oshitani, Hitoshi; Lupisan, Socorro; Gentile, Angela; Lucion, María Florencia; Spaeder, Michael C.; Butt, Warwick; Thompson, Jenny; Mejias, Asuncion; Ramilo, Octavio; Fasce, Rodrigo A.; Werner, Marta; Hijano, Diego R.; Allison, Kim J.; Pires, Márcia Rosane; de-Paris, Fernanda; Chakhunashvili, Giorgi; Karseladze, Irakli; Otieno, Grieven P.; Nokes, D. James; Scheuerman, Oded; Prais, Dario; Amad, Mohammed Al; Serouri, Abdul Wahed Al; Ali, Asad; Yousafzai, Mohammad Tahir; Bruno, Alfredo; de Mora, Domenica; Ojeda, Jenny; Dbaibo, Ghassan; Hanna-Wakim, Rima; Papaevangelou, Vassiliki; Kartisouni, Elpiniki; Cohen, Cheryl; Walaza, Sibongile; Linssen, Rosalie S.; Chi, Hsin; Eşki, Aykut; Demir, Esen; Saha, Senjuti; Saha, Samir K; Sochet, Anthony A.; Teppa-Sanchez, Beatriz E.; Ravindranath, Thyyar M.; Baird, J. Scott; Morris, Shaun K.; Wong, Waison; Breiman, Robert F.; Gurley, Emily S.; Arifeen, Shams El; Assefa, Nega; Scott, J. Anthony G.; Onyango, Dickens; Kotloff, Karen L.; Sow, Samba O.; Mandomando, Inacio; Ogbuanu, Ikechukwu U.; Jambai, Amara; Kendirli, Tanil; Botan, Edin; Rubio, Franco Díaz; Serra, Alberto; Martinez, Luis; Pedroso, Luis; Menta, Soledad; Pardo, Rosalba; Donoso, Alejandro; Mahmood, Syed Faisal; Khan, Naveera;
• Is Part Of: EClinicalMedicine. Volume 37(2021)
• Publication Date: 2021-07
• Subjects: Medicine -- Research -- Periodicals; Medical policy -- Periodicals; Clinical Medicine; Health Policy; Public Health; Medical policy; Medicine -- Research; Periodical; Electronic journals; Periodicals; 613
• DOI: 10.1016/j.eclinm.2021.100945
• Languages: English
• ISSNs: 2589-5370

Abstract

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. Funding: Bill & Melinda Gates Foundation.