Live-attenuated influenza vaccine effectiveness against hospitalization in children aged 2–6 years, the first three seasons of the childhood influenza vaccination program in England, 2013/14–2015/16

Introduction: In 2013, the United Kingdom began to roll-out a universal annual influenza vaccination program for children. An important component of any new vaccination program is measuring its effectiveness. Live-attenuated influenza vaccines (LAIVs) have since shown mixed results with vaccine effectiveness (VE) varying across seasons and countries elsewhere. This study aims to assess the effectiveness of influenza vaccination in children against severe disease during the first three seasons of the LAIV program in England. Methods: Using the screening method, LAIV vaccination coverage in children hospitalized with laboratory-confirmed influenza infection was compared with vaccination coverage in 2–6-year-olds in the general population to estimate VE in 2013/14–2015/16. Results: The overall LAIV VE, adjusted for age group, week/month and geographical area, for all influenza types pooled over the three influenza seasons was 50.1% (95% confidence interval [CI] 31.2, 63.8). By age, there was evidence of protection against hospitalization from influenza vaccination in both the pre-school (2–4-year-olds) (48.1%, 95% CI 27.2, 63.1) and school-aged children (5–6-year-olds) (62.6%, 95% CI 2.6, 85.6) over the three seasons. Conclusion: LAIV vaccination in children provided moderate annual protection against laboratory-confirmed influenza-related hospitalization in England over the three influenza seasons. This study contributes further to the limited literature to date on influenza VE against severe disease in children.