Vaccines for Preventing Influenza in Healthy Children

AIM

Influenza is a common health problem observed in both children and adults. It is a communicable infection and the risk of complications is greatest in children and people over 65 years of age. Thus, the article aimed to assess the efficacy, effectiveness, and side effects of vaccination against influenza in healthy children.

SEARCH METHODS AND SELECTION CRITERIA

The Cochrane Central Register of Controlled Trials are searched including the Cochrane Acute Respiratory Infections Group Specialized Register, MEDLINE, Embase, WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. Data from randomized controlled trials are taken and compared influenza vaccines with placebo or no intervention in children (under 16 years) with influenza. 

DATA COLLECTION

Assessment of risk of bias and extracted data were done and GRADE is used to rate the certainty of evidence for the key outcomes of influenza, influenza‐like illness (ILI), complications (hospitalization, ear infection), and adverse events.

RESULTS

41 clinical trials were included with children over the age of two and compared live attenuated or inactivated vaccines with placebo or no vaccine. 

• For live attenuated vaccines, it is observed that it can reduce the risk of influenza infection in children aged 3 to 16 years from 18% to 4% (risk ratio (RR) 0.22, 95% confidence interval (CI) 0.11 to 0.41; 7718 children; moderate‐certainty evidence), and they may reduce ILI by a smaller degree, from 17% to 12% (RR 0.69, 95% CI 0.60 to 0.80; 124,606 children; low‐certainty evidence). 
• For inactivated vaccines, it can reduce the risk of influenza in children aged 2 to 16 years from 30% to 11% (RR 0.36, 95% CI 0.28 to 0.48; 1628 children; high‐certainty evidence), and they probably reduce ILI from 28% to 20% (RR 0.72, 95% CI 0.65 to 0.79; 19,044 children; moderate‐certainty evidence). 

LIMITATIONS 

There was limited evidence on secondary cases, requirement for treatment of lower respiratory tract disease, and drug prescriptions and evidence of serious harms (such as febrile fits) was sparse.
 
KEYNOTE

Live attenuated and inactivated vaccines have the potential to reduce the proportion of children who have influenza and ILI. Variation in the results of studies indicates uncertainty about the effects of these vaccines across different seasons.

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