The Western Australian Influenza Vaccine Effectiveness
study commenced in 2008 to evaluate a new program to provide free influenza
vaccine to all children
aged 6 to 59 months. We aimed to assess the protective effect of inactivated influenza
vaccination in these children
We conducted a prospective case–control study
in general practices and a hospital emergency department, testing all eligible patients for influenza
and a range of other common respiratory viruses. Influenza vaccine effectiveness
(VE) against laboratory-confirmed influenza
was estimated with cases defined as children
with an influenza
-like illness who tested positive and controls as those with an influenza
-like illness who tested negative for influenza
virus. We calculated VE using the adjusted odds ratio from multivariate logistic regression. As a surrogate marker for adequate specimen collection, we explored the difference in VE point estimates defining controls as children
in whom another respiratory virus was detected.
A total of 75 children
were enrolled from general practices and 214 through the emergency department, with 12 (27%) and 36 (17%), respectively, having laboratory-confirmed influenza
. Using all the influenza
-negative controls, the adjusted VE was 58% (95% confidence interval, 9–81). When controls were limited to those with another virus present, the adjusted VE was 68% (95% confidence interval, 26–86).
VE estimates were higher when controls included only those children
with another respiratory virus detected. Testing for other common respiratory viruses enables the control group to be restricted to those for whom an adequate sample is likely.