Influenza vaccines can prevent serious outcomes of infection, but vaccine policies should be based on the best contemporary evidence
In this issue of the Journal, two studies draw attention to potential difficulties in protecting vulnerable people from influenza infection. In the first study, Wiley and colleagues report a 27% uptake of influenza vaccine by pregnant women in three hospitals in New South Wales in 2011, with differences in uptake attributable to how the vaccine was promoted and the ease of accessing it.1 Influenza vaccination of pregnant women is an important issue that was highlighted during the 2009 pandemic. In Australia, the risk of hospitalisation with pandemic (H1N1) 2009 influenza for pregnant women compared with non-pregnant women aged 15–44 years was increased by about fivefold2 and the risk of admission to intensive care, by about sevenfold.3 The World Health Organization recently recommended influenza vaccination for pregnant women as the highest priority for countries considering initiation or expansion of programs for seasonal influenza vaccines.4
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- 1. Wiley KE, Massey PD, Cooper SC, et al. Uptake of influenza vaccine by pregnant women: a cross-sectional survey. Med J Aust 2013; 198: 373-375.
- 2. Kelly H, Mercer G, Cheng A. Quantifying the risk of pandemic influenza in pregnancy and Indigenous people in Australia in 2009. Euro Surveill 2009; 14: pii 19441.
- 3. ANZIC Influenza Investigators and 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. doi: 10.1136/bmj.c1279.
- 4. World Health Organization. Vaccines against influenza: WHO position paper – November 2012. Wkly Epidemiol Rec 2012; 87: 461-476.
- 5. Macesic N, Kotsimbos TC, Kelly P, Cheng AC; FluCAN investigators. Hospital-acquired influenza in an Australian sentinel surveillance system. Med J Aust 2013; 198: 370-372.
- 6. National Health and Medical Research Council. Influenza. In: Australian immunisation handbook. 9th ed. Canberra: NHMRC, 2008. http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-influenza (accessed Nov 2012).
- 7. Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis 2012; 12: 36-44.
- 8. CSL Limited. A study of the efficacy, safety and tolerability profile of CSL Limited’s influenza virus vaccine (CSL’s IVV) administered intramuscularly in healthy adults. http://clinicaltrials.gov/ct2/show/NCT00562484 (accessed Mar 2013).
- 9. Kelly HA, Sullivan SG, Grant KA, Fielding JE. Moderate influenza vaccine effectiveness with variable effectiveness by match between circulating and vaccine strains in Australian adults aged 20-64 years, 2007-2011. Influenza Other Respir Viruses 2012; 19 Oct. doi: 10.1111/irv.12018.
- 10. Cheng AC, Kotsimbos T, Kelly HA, et al. Effectiveness of H1N1/09 monovalent and trivalent influenza vaccines against hospitalization with laboratory-confirmed H1N1/09 influenza in Australia: a test-negative case control study. Vaccine 2011; 29: 7320-7325.
- 11. Nicoll A, Sprenger M. Low effectiveness undermines promotion of seasonal influenza vaccine. Lancet Infect Dis 2013; 13: 7-9.
- 12. Osterholm MT, Kelley NS, Manske JM, et al. The compelling need for game-changing influenza vaccines: an analysis of the influenza vaccine enterprise and recommendations for the future. Minneapolis: University of Minnesota Center for Infectious Disease Research and Policy, 2012. http://www.cidrap. umn.edu/cidrap/center/mission/articles/ccivi-landing.html (accessed Mar 2013).
No relevant disclosures.