An analysis of national target groups for monovalent 2009 pandemic influenza vaccine and trivalent seasonal influenza vaccines in 2009-10 and 2010-11

BMC Infectious Diseases

Benjamin J Cowling¹  Esther ST Lee¹  Dennis KM Ip¹  Hiroshi Nishiura²  Peng Wu¹  Sophia Ng¹ 

[1] School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China;PRESTO, Japan Science and Technology Agency, Saitama 332-0012, Japan

关键词: subsidy;    target groups;    vaccine;    seasonal;    pandemic;    influenza;   

Others  :  1175619
DOI  :  10.1186/1471-2334-11-230

 received in 2011-05-19, accepted in 2011-08-26,  发布年份 2011

【 摘 要 】

Background

Vaccination is generally considered to be the best primary prevention measure against influenza virus infection. Many countries encourage specific target groups of people to undertake vaccination, often with financial subsidies or a priority list. To understand differential patterns of national target groups for influenza vaccination before, during and after the 2009 influenza pandemic, we reviewed and analyzed the country-specific policies in the corresponding time periods.

Methods

Information on prioritized groups targeted to receive seasonal and pandemic influenza vaccines was derived from a multi-step internet search of official health department websites, press releases, media sources and academic journal articles. We assessed the frequency and consistency of targeting 20 different groups within populations which are associated with age, underlying medical conditions, role or occupations among different countries and vaccines. Information on subsidies provided to specific target groups was also extracted.

Results

We analyzed target groups for 33 (seasonal 2009 and 2009-10 vaccines), 72 (monovalent pandemic 2009-10 vaccine) and 34 (seasonal 2010 and 2010-11 vaccines) countries. In 2009-10, the elderly, those with chronic illness and health care workers were common targets for the seasonal vaccine. Comparatively, the elderly, care home residents and workers, animal contacts and close contacts were less frequently targeted to receive the pandemic vaccine. Pregnant women, obese persons, essential community workers and health care workers, however, were more commonly targeted. After the pandemic, pregnant women, obese persons, health care and care home workers, and close contacts were more commonly targeted to receive the seasonal vaccine compared to 2009-10, showing continued influence from the pandemic. Many of the countries provided free vaccines, partial subsidies, reimbursements or national health insurance coverage to specific target groups and over one-third of the countries offered universal subsidy regarding the pandemic vaccine. There was also some inconsistency between countries in target groups.

Conclusions

Differences in target groups between countries may reflect variable objectives as well as uncertainties regarding the transmission dynamics, severity and age-specific immunity against influenza viruses before and after vaccination. Clarification on these points is essential to elucidate optimal and object-oriented vaccination strategies.

【 授权许可】

   
2011 Ng et al; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Heinonen S, Silvennoinen H, Lehtinen P, Vainionpaa R, Ziegler T, Heikkinen T: Effectiveness of inactivated influenza vaccine in children aged 9 months to 3 years: an observational cohort study. Lancet Infect Dis 2011, 11(1):23-29.
• [2]Jefferson T, Rivetti A, Harnden A, Di Pietrantonj C, Demicheli V: Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev 2008, (2):CD004879.
• [3]Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E: Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev 2010, (7):CD001269.
• [4]Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ, Fukuda K: Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003, 289(2):179-186.
• [5]Mullooly JP, Bridges CB, Thompson WW, Chen J, Weintraub E, Jackson LA, Black S, Shay DK: Influenza- and RSV-associated hospitalizations among adults. Vaccine 2007, 25(5):846-855.
• [6]Jefferson T, Di Pietrantonj C, Al-Ansary LA, Ferroni E, Thorning S, Thomas RE: Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev 2010, (2):CD004876.
• [7]Hancock K, Veguilla V, Lu X, Zhong W, Butler EN, Sun H, Liu F, Dong L, DeVos JR, Gargiullo PM, et al.: Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med 2009, 361(20):1945-1952.
• [8]Schwartz B, Orenstein WA: Prioritization of pandemic influenza vaccine: rationale and strategy for decision making. Curr Top Microbiol Immunol 2009, 333:495-507.
• [9]Straetemans M, Buchholz U, Reiter S, Haas W, Krause G: Prioritization strategies for pandemic influenza vaccine in 27 countries of the European Union and the Global Health Security Action Group: a review. BMC Public Health 2007, 7:236. BioMed Central Full Text
• [10]Mereckiene J, Cotter S, Nicoll A, Levy-Bruhl D, Ferro A, Tridente G, Zanoni G, Berra P, Salmaso S, O'Flanagan D, et al.: National seasonal influenza vaccination survey in Europe, 2008. Euro Surveill 2008, 13(43):pii: 19017.
• [11]Pan American Health Organization: Report on the progress of pandemic influenza (H1N1) vaccination in Latin America and the Caribbean (LAC). 2010.
• [12]Pan American Health Organization: Report on the progress of pandemic influenza (H1N1) vaccination in the region of the Americas. 2010.
• [13]The World Bank: Data: countries and economies. [http://data.worldbank.org/country] webcite (accessed 10-05-2011)
• [14]Gwet KL, (ed.): Handbook of Inter-rater Reliability. second edition. Gaithersburg, MD, USA: Advanced Analytics; 2010.
• [15]World Health Organization: Pandemic (H1N1) 2009 vaccine deployment update. [http:/ / www.who.int/ csr/ disease/ swineflu/ h1n1_vaccine_deployment_update20100 927.pdf] webcite (accessed 10-05-2011)
• [16]Wallinga J, van Boven M, Lipsitch M: Optimizing infectious disease interventions during an emerging epidemic. Proc Natl Acad Sci USA 2010, 107(2):923-928.
• [17]Longini IM, Halloran ME: Strategy for distribution of influenza vaccine to high-risk groups and children. Am J Epidemiol 2005, 161(4):303-306.
• [18]Medlock J, Galvani AP: Optimizing influenza vaccine distribution. Science 2009, 325(5948):1705-1708.
• [19]Yang Y, Sugimoto JD, Halloran ME, Basta NE, Chao DL, Matrajt L, Potter G, Kenah E, Longini IM Jr: The transmissibility and control of pandemic influenza A (H1N1) virus. Science 2009, 326(5953):729-733.
• [20]Longini IM, Ackermana E, Elveback LR: An optimization model for influenza A epidemics. Math Biosci 1978, 38(1-2):141-157.
• [21]Centers for Disease Control and Prevention: 2009 Pandemic Influenza A (H1N1) Virus Infections - Chicago, Illinois, April-July 2009. Morb Mortal Wkly Rep 2009, 58(33):913-918.
• [22]Matrajt L, Longini IM Jr: Optimizing vaccine allocation at different points in time during an epidemic. PLoS One 2010, 5(11):e13767..
• [23]Wu JT, Ma ES, Lee CK, Chu DK, Ho PL, Shen AL, Ho A, Hung IF, Riley S, Ho LM, et al.: The infection attack rate and severity of 2009 pandemic H1N1 influenza in Hong Kong. Clin Infect Dis 2010, 51(10):1184-1191.
• [24]Centers for Disease Control and Prevention: 2009 pandemic influenza A (H1N1) in pregnant women requiring intensive care - New York City, 2009. Morb Mortal Wkly Rep 2010, 59(11):321-326.
• [25]Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, Lindstrom S, Louie JK, Christ CM, Bohm SR, et al.: H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009, 374(9688):451-458.
• [26]Louie JK, Acosta M, Winter K, Jean C, Gavali S, Schechter R, Vugia D, Harriman K, Matyas B, Glaser CA, et al.: Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1) infection in California. JAMA 2009, 302(17):1896-1902.
• [27]The ANZIC Influenza Investigators, Australasian Maternity Outcomes Surveillance System: Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study. BMJ 2010, 340:c1279.
• [28]Cox S, Posner SF, McPheeters M, Jamieson DJ, Kourtis AP, Meikle S: Hospitalizations with respiratory illness among pregnant women during influenza season. Obstet Gynecol 2006, 107(6):1315-1322.
• [29]Mullooly JP, Barker WH, Nolan TF Jr: Risk of acute respiratory disease among pregnant women during influenza A epidemics. Public Health Rep 1986, 101(2):205-211.
• [30]Irving WL, James DK, Stephenson T, Laing P, Jameson C, Oxford JS, Chakraverty P, Brown DW, Boon AC, Zambon MC: Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study. BJOG 2000, 107(10):1282-1289.
• [31]Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, Sugerman DE, Druckenmiller JK, Ritger KA, Chugh R, et al.: Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med 2009, 361(20):1935-1944.
• [32]Morgan OW, Bramley A, Fowlkes A, Freedman DS, Taylor TH, Gargiullo P, Belay B, Jain S, Cox C, Kamimoto L, et al.: Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1) disease. PLoS One 2010, 5(3):e9694..
• [33]Cui W, Zhao H, Lu X, Wen Y, Zhou Y, Deng B, Wang Y, Wang W, Kang J, Liu P: Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China. BMC Infect Dis 2010, 10:145. BioMed Central Full Text
• [34]Zhou Y, Ng DMW, Seto W-H, Ip DKM, Kwok HKH, Ma ESK, Ng S, Lau LLH, Wu JT, Peiris JSM, et al.: Seroprevalence of antibody to pandemic influenza A (H1N1) 2009 among healthcare workers after the first wave in Hong Kong. J Hosp Infect 2011, in press.
• [35]Seto W-H, Cowling BJ, Ching H-SLPTY, To M-L, Pittet D: Clinical and Non-Clinical Healthcare Workers Faced a Similar Risk of Acquiring 2009 Pandemic H1N1 Infection. Clin Infect Dis 2011, in press.
• [36]Helms CM, Polgreen PM: Should influenza immunisation be mandatory for healthcare workers? Yes. BMJ 2008, 337:a2142.
• [37]Isaacs D, Leask J: Should influenza immunisation be mandatory for healthcare workers? No. BMJ 2008, 337:a2140.