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dc.contributor.authorNorman DAen
dc.contributor.authorCheng ACen
dc.contributor.authorMacartney KKen
dc.contributor.authorMoore HCen
dc.contributor.authorDanchin Men
dc.contributor.authorSeale Hen
dc.contributor.authorMcRae Jen
dc.contributor.authorClark JEen
dc.contributor.authorMarshall HSen
dc.contributor.authorButtery Jen
dc.contributor.authorFrancis JRen
dc.contributor.authorCrawford NWen
dc.contributor.authorBlyth CCen
dc.identifier.citation© 2021 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.en
dc.identifier.citationInfluenza Other Respir Viruses. 2021 Nov 16. doi: 10.1111/irv.12939.en
dc.description.abstractBACKGROUND: Children with comorbidities are at greater risk of severe influenza outcomes compared with healthy children. In Australia, influenza vaccination was funded for those with comorbidities from 2010 and all children aged <5 years from 2018. Influenza vaccine coverage remains inadequate in children with and without comorbidities. METHODS: Children ≤16 years admitted with acute respiratory illness and tested for influenza at sentinel hospitals were evaluated (2010-2019). Multivariable regression was used to identify predictors of severe outcomes. Vaccine effectiveness was estimated using the modified incidence density test-negative design. RESULTS: Overall, 6057 influenza-confirmed hospitalized cases and 3974 test-negative controls were included. Influenza A was the predominant type (68.7%). Comorbidities were present in 40.8% of cases. Children with comorbidities were at increased odds of ICU admission, respiratory support, longer hospitalizations, and mortality. Specific comorbidities including neurological and cardiac conditions increasingly predisposed children to severe outcomes. Influenza vaccine coverage in influenza negative children with and without comorbidities was low (33.5% and 17.9%, respectively). Coverage improved following introduction of universal influenza vaccine programs for children <5 years. Similar vaccine effectiveness was demonstrated in children with (55% [95% confidence interval (CI): 45; 63%]) and without comorbidities (57% [(95%CI: 44; 67%]). CONCLUSIONS: Comorbidities were present in 40.8% of influenza-confirmed admissions and were associated with more severe outcomes. Children with comorbidities were more likely experience severe influenza with ICU admission, mechanical ventilation, and in-hospital morality. Despite demonstrated vaccine effectiveness in those with and without comorbidities, vaccine coverage was suboptimal. Interventions to increase vaccination are expected to reduce severe influenza outcomes.en
dc.titleInfluenza hospitalizations in Australian children 2010-2019: The impact of medical comorbidities on outcomes, vaccine coverage, and effectiveness.en
dc.typeJournal Articleen
dc.identifier.journaltitleInfluenza and other respiratory virusesen
dc.description.affiliationWesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia.en
dc.description.affiliationSchool of Medicine, University of Western Australia, Crawley, Western Australia, Australia.en
dc.description.affiliationInfection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia.en
dc.description.affiliationSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.en
dc.description.affiliationNational Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.en
dc.description.affiliationDepartment of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.en
dc.description.affiliationDiscipline of Child and Adolescent Health, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.en
dc.description.affiliationDepartment of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.en
dc.description.affiliationVaccine Hesitancy, Murdoch Children's Research Institute, Parkville, Victoria, Australia.en
dc.description.affiliationDepartment of General Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia.en
dc.description.affiliationSchool of Population Health, University of New South Wales, Randwick, New South Wales, Australia.en
dc.description.affiliationInfection Management and Prevention Service, Queensland Children's Hospital, South Brisbane, Queensland, Australia.en
dc.description.affiliationAdelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.en
dc.description.affiliationRobinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.en
dc.description.affiliationThe Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.en
dc.description.affiliationDepartment of Infection and Immunity, Monash Children's Hospital, Monash Health, Clayton, Victoria, Australia.en
dc.description.affiliationMonash Centre of Health Care Research and Implementation, Departments of Paediatrics, Monash University, Melbourne, Victoria, Australia.en
dc.description.affiliationRoyal Darwin Hospital, Top End Health Service, Darwin, Northern Territory, Australia.en
dc.description.affiliationMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.en
dc.description.affiliationSAFEVIC, Murdoch Children's Research Institute, Parkville, Victoria, Australia.en
dc.description.affiliationDepartment of Infectious Disease, Perth Children's Hospital, Nedlands, Western Australia, Australia.en
dc.description.affiliationPathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia.en
local.issue.number1750-2659 (Electronic)-
local.issue.number1750-2640 (Linking)-
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