Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 2;7(12):e2452512.
doi: 10.1001/jamanetworkopen.2024.52512.

Estimated Vaccine Effectiveness for Pediatric Patients With Severe Influenza, 2015-2020

Kelsey M Sumner  1   2 , Leila C Sahni  3   4 , Julie A Boom  3   4 , Natasha B Halasa  5 , Laura S Stewart  5 , Janet A Englund  6 , Eileen J Klein  6 , Mary A Staat  7 , Elizabeth P Schlaudecker  7 , Rangaraj Selvarangan  8 , Christopher J Harrison  8 , Geoffrey A Weinberg  9 , Peter G Szilagyi  9   10 , Monica N Singer  11 , Parvin H Azimi  11 , Benjamin R Clopper  12 , Heidi L Moline  12 , Emma K Noble  1   13 , John V Williams  14   15 , Marian G Michaels  14 , Samantha M Olson  1 ; New Vaccine Surveillance Network Collaborators
Collaborators, Affiliations

Estimated Vaccine Effectiveness for Pediatric Patients With Severe Influenza, 2015-2020

Kelsey M Sumner et al. JAMA Netw Open. .

Abstract

Importance: Increasing the understanding of vaccine effectiveness (VE) against levels of severe influenza in children could help increase uptake of influenza vaccination and strengthen vaccine policies globally.

Objective: To investigate VE in children by severity of influenza illness.

Design, setting, and participants: This case-control study with a test-negative design used data from 8 participating medical centers located in geographically different US states in the New Vaccine Surveillance Network from November 6, 2015, through April 8, 2020. Participants included children 6 months through 17 years of age who were hospitalized or presented to an emergency department (ED) with acute respiratory illness.

Exposures: Receipt of at least 1 dose of the current season's influenza vaccine.

Main outcomes and measures: Demographic and clinical characteristics of patients presenting to the hospital or ED with or without influenza were recorded and grouped by influenza vaccination status. Estimated VE against severe influenza illness was calculated using multiple measures to capture illness severity. Data were analyzed between June 1, 2022, and September 30, 2023.

Results: Among 15 728 children presenting for care with acute respiratory illness (8708 [55.4%] male; 13 450 [85.5%] 6 months to 8 years of age and 2278 [14.5%] 9-17 years of age), 2710 (17.2%) had positive influenza tests and 13 018 (82.8%) had negative influenza tests (controls). Of the influenza test-positive cases, 1676 children (61.8%) had an ED visit, 896 children (33.1%) required hospitalization for noncritical influenza, and 138 children (5.1%) required hospitalization for critical influenza. About half (7779 [49.5%]) of the children (both influenza test positive and test negative) were vaccinated. Receiving at least 1 influenza vaccine dose was estimated to have a VE of 55.7% (95% CI, 51.6%-59.6%) for preventing influenza-associated ED visits or hospitalizations among children of all ages. The estimated VE was similar across severity levels: 52.8% (95% CI, 46.6%-58.3%) for ED visits, 52.3% (95% CI, 44.8%-58.8%) for noncritical hospitalization, and 50.4% (95% CI, 29.7%-65.3%) for critical hospitalization.

Conclusions and relevance: Findings from this case-control study with a test-negative design involving children with a spectrum of influenza severity suggest that influenza vaccination protects children against all levels of severe influenza illness.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Sahni reported receiving grants through her institution from the US Centers for Disease Control and Prevention (CDC) during the conduct of the study and travel support from the Gates Foundation outside the submitted work. Dr Boom reported receiving grants from the CDC New Vaccine Surveillance Network during the conduct of the study. Dr Halasa reported receiving grants from the CDC during the conduct of the study and receiving grants from Merck outside the submitted work. Dr Stewart reported receiving grants from the CDC during the conduct of the study. Dr Englund reported receiving grants from the CDC through her institution during the conduct of the study and receiving grants from AstraZeneca, Merck, GlaxoSmithKline, and Pfizer through her institution and personal fees from GlaxoSmithKline, Pfizer, Merck, and AstraZeneca outside the submitted work. Dr Klein reported receiving grants from the CDC during the conduct of the study. Dr Staat reported receiving grants from the CDC during the conduct of the study and receiving grants from the National Institutes of Health, Cepheid, Merck, and Pfizer outside the submitted work. Dr Schlaudecker reported receiving grants from the CDC during the conduct of the study and receiving grants from Pfizer and being on an advisory committee to Sanofi Pasteur outside the submitted work. Dr Selvarangan reported receiving grants from the CDC during the conduct of the study and receiving grants from Biomerieux, Cepheid, Hologic, Qiagen, Abbott, and Merck outside the submitted work. Dr Harrison reported receiving grants from the CDC during the conduct of the study and receiving grants from GlaxoSmithKline, Merck, and Pfizer outside the submitted work and honoraria from WebMD and UpToDate. Dr Weinberg reported receiving grants from the CDC during the conduct of the study and from the New York State Department of Health, and receiving personal fees from the New York State Department of Health, Inhalon Biopharma, Merck & Company, Emory University, and ReViral outside the submitted work. Dr Szilagyi reported receiving grants from the University of California, Los Angeles, subcontracted to the University of Rochester, from the CDC during the conduct of the study. Drs Williams and Michaels reported receiving grants from the CDC during the conduct of the study. Dr Williams also reported receiving financial support from the Henry L. Hillman Foundation. Ms Olson reported receiving travel support from the Gates Foundation. No other disclosures were reported.

Figures

Figure.
Figure.. New Vaccine Surveillance Network Enrollment by Influenza Case and Control Status, 2015 to 2020
See this image and copyright information in PMC

Similar articles

  • Maternal Vaccine Effectiveness Against Influenza-Associated Hospitalizations and Emergency Department Visits in Infants.
    Sahni LC, Olson SM, Halasa NB, Stewart LS, Michaels MG, Williams JV, Englund JA, Klein EJ, Staat MA, Schlaudecker EP, Selvarangan R, Schuster JE, Weinberg GA, Szilagyi PG, Boom JA, Patel MM, Muñoz FM; New Vaccine Surveillance Network Collaborators. Sahni LC, et al. JAMA Pediatr. 2024 Feb 1;178(2):176-184. doi: 10.1001/jamapediatrics.2023.5639. JAMA Pediatr. 2024. PMID: 38109102 Free PMC article.
  • Estimated 2023-2024 COVID-19 Vaccine Effectiveness in Adults.
    Link-Gelles R, Rowley EAK, Irving SA, Klein NP, Grannis SJ, Ong TC, Ball SW, DeSilva MB, Dascomb K, Naleway AL, Koppolu P, Zerbo O, Fireman B, Hansen J, Timbol J, Block L, Dixon BE, Duszynski TJ, Allen KS, Mayer D, Chavez C, Barron M, Reese SE, Chickery S, Davis JM, Ciesla AA, Mak J, Najdowski M, Akinsete OO, McEvoy CE, Essien IJ, Sheffield T, Bride D, Arndorfer J, Van Otterloo J, Natarajan K, Tenforde MW, DeCuir J, Payne AB. Link-Gelles R, et al. JAMA Netw Open. 2025 Jun 2;8(6):e2517402. doi: 10.1001/jamanetworkopen.2025.17402. JAMA Netw Open. 2025. PMID: 40560584 Free PMC article.
  • Effectiveness of 2023 southern hemisphere influenza vaccines against severe influenza-associated illness: pooled estimates from eight countries using the test-negative design.
    Gharpure R, Regan AK, Nogareda F, Cheng AC, Blyth CC, George SS, Huang QS, Wood T, Anglemyer A, Prasert K, Praphasiri P, Davis WW, Pittayawonganon C, Ercole R, Iturra A, de Almeida WAF, de Paula Júnior FJ, Vigueras MA, Barraza MFO, Domínguez C, Penayo E, Goñi N, Tritten D, Couto P, Salas D, Fowlkes AL, Duca LM, Azziz-Baumgartner E, Sullivan SG. Gharpure R, et al. Lancet Glob Health. 2025 Feb;13(2):e203-e211. doi: 10.1016/S2214-109X(24)00473-X. Lancet Glob Health. 2025. PMID: 39890222 Free PMC article.
  • Vaccines for preventing influenza in healthy children.
    Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V. Jefferson T, et al. Cochrane Database Syst Rev. 2018 Feb 1;2(2):CD004879. doi: 10.1002/14651858.CD004879.pub5. Cochrane Database Syst Rev. 2018. PMID: 29388195 Free PMC article.
  • Vaccines for preventing influenza in healthy adults.
    Demicheli V, Jefferson T, Ferroni E, Rivetti A, Di Pietrantonj C. Demicheli V, et al. Cochrane Database Syst Rev. 2018 Feb 1;2(2):CD001269. doi: 10.1002/14651858.CD001269.pub6. Cochrane Database Syst Rev. 2018. PMID: 29388196 Free PMC article.
See all similar articles

Cited by

References

    1. Centers for Disease Control and Prevention . Flu and children at higher risk. Accessed October 27, 2022. https://www.cdc.gov/flu/highrisk/children.html?CDC_AAref_Val=https://www...
    1. US Department of Health and Human Services Office of Disease Prevention and Health Promotion . Increase the proportion of people who get the flu vaccine every year—IID-09. Accessed January 9, 2024. https://health.gov/healthypeople/objectives-and-data/browse-objectives/v...
    1. Centers for Disease Control and Prevention . Flu vaccination coverage, United States, 2021-22 influenza season. Accessed October 27, 2022. https://www.cdc.gov/fluvaxview/coverage-by-season/2021-2022.html?CDC_AAr...
    1. Centers for Disease Control and Prevention . Influenza vaccination coverage, children 6 months through 17 years. Accessed February 15, 2024. https://www.cdc.gov/fluvaxview/dashboard/children-vaccination-coverage.h...
    1. Préziosi MP, Halloran ME. Effects of pertussis vaccination on disease: vaccine efficacy in reducing clinical severity. Clin Infect Dis. 2003;37(6):772-779. doi:10.1086/377270 - DOI - PubMed

Publication types

Substances