Published online August 31, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. 467-472 (doi:10.1542/peds.2007-0167)
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ARTICLE

Childhood Influenza: Number Needed to Vaccinate to Prevent 1 Hospitalization or Outpatient Visit

Elizabeth N. Lewis, MDa, Marie R. Griffin, MD, MPHb,c, Peter G. Szilagyi, MD, MPHd,e, Yuwei Zhu, MD, MSf, Kathryn M. Edwards, MDg and Katherine A. Poehling, MD, MPHg

a Vanderbilt University Medical School
Departments of b Medicine
c Preventive Medicine
f Biostatistics
g Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
d Department of Pediatrics
e Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, New York

OBJECTIVE. The goal was to assess the potential benefits of the influenza vaccine recommendations for children 6 to 59 months of age by estimating the number of children needed to be vaccinated to prevent 1 hospitalization or 1 outpatient visit attributable to influenza.

METHODS. The influenza burden was obtained from published studies in which rates for children 6 to 23 months and 24 to 59 months of age could be ascertained. We assumed a range of influenza vaccine efficacies of 25% to 75%, consistent with the literature. We estimated the number of children who needed to be vaccinated to prevent 1 influenza-attributable hospitalization or 1 outpatient visit for each age group.

RESULTS. As both vaccine efficacy and severity of the influenza season increased, the number of children who needed to be vaccinated to prevent 1 hospitalization or 1 outpatient visit decreased. The numbers of children who needed to be vaccinated to prevent 1 hospitalization in a year with 50% vaccine efficacy ranged from 1031 to 3050 for children 6 to 23 months of age and from 4255 to 6897 for children 24 to 59 months of age. For every 12 to 42 children 6 to 59 months of age vaccinated in a year with 50% vaccine efficacy, we estimated that 1 influenza-attributable outpatient visit would be prevented.

CONCLUSIONS. With 1 outpatient visit being prevented through vaccination of <50 children, influenza vaccination can reduce influenza-attributable medical visits in children significantly, even in years with modest vaccine efficacy.

Key Words: influenza • vaccine efficacy • number needed to treat • hospitalizations • outpatient visits • children

Abbreviations: ACIP—Advisory Committee on Immunization Practices

Accepted Apr 24, 2007.