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. 2014 Apr;33(4):569-75.
doi: 10.1007/s10096-013-1986-6. Epub 2013 Oct 4.

The healthcare and societal burden associated with influenza in vaccinated and unvaccinated European and Israeli children

C S Ambrose  1 , E N Antonova
Affiliations

The healthcare and societal burden associated with influenza in vaccinated and unvaccinated European and Israeli children

C S Ambrose et al. Eur J Clin Microbiol Infect Dis. 2014 Apr.

Abstract

Few data exist regarding the healthcare and societal burden of culture-confirmed influenza illness in European and Israeli children. The current analysis describes this burden in vaccinated and unvaccinated children 2-17 years of age. Healthcare and societal burden outcomes were prospectively collected for culture-confirmed influenza illness in three previous randomized studies: a study of live attenuated influenza vaccine (LAIV) versus placebo in children aged <48 months attending day care (N = 846-973), and studies of LAIV versus inactivated influenza vaccine (IIV) in children aged <72 months with recurrent respiratory infections (N = 1,609) and in children aged 6-17 years with asthma (N = 2,211). The incidence of each endpoint among enrolled subjects and subjects with influenza was determined by treatment group and by country. Among subjects with influenza, 57-91% missed school or day care, 45-90% used non-antibiotic medications, 29-55% of parents missed work, 17-55% used antibiotics, 11-62% had additional provider visits, and 9-20% had acute otitis media. Where evaluated, rates of outcomes were generally similar between countries. Among all children enrolled, LAIV recipients missed 324-902 and 150 fewer days of day care per 1,000 children than those of placebo and IIV recipients, respectively; parents of LAIV recipients missed 197-340 and 76 fewer days of work per 1,000 children than those of placebo and IIV recipients, respectively. Influenza illness in European and Israeli children 2-17 years of age resulted in a considerable absenteeism and healthcare utilization that was similar across the countries studied. These data underscore the potential benefits of annual vaccination of children against influenza.

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Figures

Fig. 1
Fig. 1
Healthcare resource use and absenteeism by year and treatment in study 1 among children with confirmed influenza. HCP = healthcare provider; LAIV = live attenuated influenza vaccine
Fig. 2
Fig. 2
Healthcare resource use and absenteeism by country in study 1 (years 1 and 2 combined) among children with confirmed influenza. *p < 0.001, p-values were calculated using Fisher’s exact test to assess differences among countries. HCP = healthcare provider
Fig. 3
Fig. 3
Healthcare resource use and absenteeism by treatment in studies 2 and 3 among children with confirmed influenza. HCP = healthcare provider; IIV = trivalent inactivated influenza vaccine; LAIV = live attenuated influenza vaccine
Fig. 4
Fig. 4
Influenza-associated absenteeism among all children enrolled per 1,000 children per season. a Study 1. b Studies 2 and 3. IIV = trivalent inactivated influenza vaccine; LAIV = live attenuated influenza vaccine. *p < 0.001, LAIV versus comparator; † p = 0.02, LAIV versus IIV
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