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Flu Vaccine – Does it work for Indian Children? Dr. Gaurav Gupta,  Practising Pediatrician DCH, DNB, Member AAP, IAP Chara...
Today’s discussion <ul><li>Though vaccine available in India since 2004, is it safe in Indian population?  </li></ul><ul><...
 
WHO collaborated Influenza  surveillance network in India AIIMS NICED  Kolkata Chennai RMRC  Dibrugarh Pune Regional Cente...
Indian Scenario: Reality <ul><li>No data in public domain on annual Influenza cases and deaths in Indian scenario* </li></...
Private pediatric outpatient (clinical) setting <ul><li>Aims of the study -   </li></ul><ul><li>Efficacy of Seasonal Flu v...
 
Methodology-Clinical Effectiveness Study
Methodology-Clinical Effectiveness Study Continued…..
Clinical Effectiveness of Influenza vaccine-1 Fully vaccinated cohort (n=101) vs. Unvaccinated cohort (n=141)* Conclusion ...
Clinical Effectiveness of Influenza vaccine-2 Partially vaccinated cohort (n=52) vs. Unvaccinated cohort (n=141)* Conclusi...
*Ritzwoller DP, Bridges CB, Shetterly S, Yamasaki K, Kolczak M, France EK. Effectiveness of the 2003-2004 influenza vaccin...
 
Cont… <ul><li>Lack of awareness among pediatricians and physicians regarding influenza vaccine </li></ul><ul><li>Lack of a...
# Knowledge of parents of Vaccinated  children Percentage 1 Influenza is a serious problem and influenza vaccine prevents ...
# Attitude of parents of Vaccinated  children Percentage 1 Influenza vaccine prevents all ailments like cough or cold or r...
# Practices of parents of Vaccinated  children Percentage 1 Parents want to take Influenza vaccine next year also 48% 2 Fi...
* Singh H, Gupta G, Tiwari P. Safety and tolerability of Influenza vaccine in Indian Children. NIPER & Charak Care Clinics...
* Singh H, Gupta G, Tiwari P. Safety and tolerability of Influenza vaccine in Indian Children. NIPER & Charak Care Clinics...
*Delore V, Salamand C, Marsh G, Arnoux S, Pepin S and Saliou P. Long-term clinical trial safety experience with the inacti...
Conclusion <ul><li>Flu vaccine is effective in reducing ILI in fully vaccinated children – 43 % reduction in ILI, 57 % red...
Conclusions <ul><li>More studies are needed with larger sample size to establish the efficacy of Seasonal Influenza vaccin...
<ul><li>Research Team </li></ul><ul><li>Himmat Singh </li></ul><ul><li>Dr. Gaurav Gupta </li></ul><ul><li>Prof. Pramil Tiw...
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Influenza Vaccine - Is it needed in Indian Children - presented at 1st IFICON 2010

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Influenza Vaccine - Is it needed in Indian Children - presented at 1st IFICON 2010, TAJ Hotel, New Delhi

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Influenza Vaccine - Is it needed in Indian Children - presented at 1st IFICON 2010

  1. 1. Flu Vaccine – Does it work for Indian Children? Dr. Gaurav Gupta, Practising Pediatrician DCH, DNB, Member AAP, IAP Charak Clinics, Mohali, Punjab
  2. 2. Today’s discussion <ul><li>Though vaccine available in India since 2004, is it safe in Indian population? </li></ul><ul><li>Is the flu vaccine effective in Indian context, especially clinically? </li></ul><ul><li>What is the public perception of Flu vaccine in India? </li></ul><ul><li>Ours is the first set of studies from India </li></ul>
  3. 4. WHO collaborated Influenza surveillance network in India AIIMS NICED Kolkata Chennai RMRC Dibrugarh Pune Regional Centers New Regional Centers Mumbai V P Chest New Delhi IGGMC Nagpur CMC Vellore Referral Center Haffkine Inst NIV KIPM
  4. 5. Indian Scenario: Reality <ul><li>No data in public domain on annual Influenza cases and deaths in Indian scenario* </li></ul><ul><li>Influenza vaccine is in Indian market since 2004 </li></ul><ul><li>There is no published data on safety, tolerability and effectiveness of Influenza vaccine in Indian children** </li></ul>*India to compile database for influenza. Available from: URL: http://www.livemint.com/2009/05/31215156/India-to-compile-database-on-s.html . Accessed on 22 May, 2010. ** Joseph L Mathew. Influenza vaccination for children in India. Indian Pediatrics. 2009 ;46:304-307.
  5. 6. Private pediatric outpatient (clinical) setting <ul><li>Aims of the study - </li></ul><ul><li>Efficacy of Seasonal Flu vaccine in preventing ILI 1 </li></ul><ul><li>Safety & Tolerability of the Seasonal Flu Vaccine 2 </li></ul><ul><li>KAP Survey of Caregivers of children given the Seasonal Flu Vaccine 3 </li></ul>1. ISPOR Asia Conference, September 2010, Thailand. 2. Data on File 3. Under Review for Publication in Indian Pediatrics
  6. 8. Methodology-Clinical Effectiveness Study
  7. 9. Methodology-Clinical Effectiveness Study Continued…..
  8. 10. Clinical Effectiveness of Influenza vaccine-1 Fully vaccinated cohort (n=101) vs. Unvaccinated cohort (n=141)* Conclusion : Influenza vaccine is effective in reducing the ILI and visits to physician for ARI in fully vaccinated Indian children as compared to unvaccinated children. *Singh H, Gupta G, Tiwari P. Clinical effectiveness of the 2009-2010 seasonal influenza vaccine among healthy Indian children. ISPOR 4 th Asia Pacific Conference, Phuket, Thailand. (Abstract accepted for Presentation on 5 th Sep, 2010). Sr.No Parameters Odds Ratio CI P-value 1 Influenza like illness 0.57 0.32-0.09 0.05 2 Visits to Physician 0.43 0.22-0.79 0.007
  9. 11. Clinical Effectiveness of Influenza vaccine-2 Partially vaccinated cohort (n=52) vs. Unvaccinated cohort (n=141)* Conclusion: Partially vaccinated children had no significant protection against ILI and visits to physician as compared to unvaccinated children . *Singh H, Gupta G, Tiwari P. Clinical effectiveness of the 2009-2010 seasonal influenza vaccine among healthy Indian children. ISPOR 4 th Asia Pacific Conference, Phuket, Thailand. (Abstract accepted for Presentation on 5 th Sep, 2010). Sr.No Parameters Odds Ratio CI P-value 1 Influenza like illness 1.54 0.77-3.07 0.24 2 Visits to Physician 1.81 0.65-5.27 0.30
  10. 12. *Ritzwoller DP, Bridges CB, Shetterly S, Yamasaki K, Kolczak M, France EK. Effectiveness of the 2003-2004 influenza vaccine among children 6 months to 8 years of age, with 1 vs 2 doses . Pediatrics. 2005;116:153-159. # ILI Parameters Present study Ritzwoller et al* 1 Fully vaccinated vs. Unvaccinated OR (CI) 0.57 (0.32-0.99) 0.77 (0.66-0.90) P value P=0.05 <0.001 VE% 43% 23% 2 Partially vaccinated vs. Unvaccinated OR(CI) 1.54 (0.77-3.07) 0.93 (0.82-1.04) P value 0.24 <0.01 VE% -54% 7%
  11. 14. Cont… <ul><li>Lack of awareness among pediatricians and physicians regarding influenza vaccine </li></ul><ul><li>Lack of awareness in parents/patients </li></ul>
  12. 15. # Knowledge of parents of Vaccinated children Percentage 1 Influenza is a serious problem and influenza vaccine prevents influenza 90% 2 Starting of winters is right time to get influenza vaccine 61% 3 Pediatrician as source of information about influenza vaccine 99% 4 Children and elderly with complications can be given influenza 15% 5 Influenza vaccine is an annual vaccine 76%
  13. 16. # Attitude of parents of Vaccinated children Percentage 1 Influenza vaccine prevents all ailments like cough or cold or runny nose or fever 28% 2 Health of the child was same as before 27% 3 Health of the child was not good after vaccination 28% 4 Health of the child was much better than before 44%
  14. 17. # Practices of parents of Vaccinated children Percentage 1 Parents want to take Influenza vaccine next year also 48% 2 Find that influenza vaccine was not very effective and don’t want to get their child vaccinated next year 16% 3 Parents had not yet decided to get their child vaccinated next year 35% 4 Parents want their pediatrician to spread more awareness about influenza vaccine 64%
  15. 18. * Singh H, Gupta G, Tiwari P. Safety and tolerability of Influenza vaccine in Indian Children. NIPER & Charak Care Clinics. (Data On File)
  16. 19. * Singh H, Gupta G, Tiwari P. Safety and tolerability of Influenza vaccine in Indian Children. NIPER & Charak Care Clinics. (Data on file)
  17. 20. *Delore V, Salamand C, Marsh G, Arnoux S, Pepin S and Saliou P. Long-term clinical trial safety experience with the inactivated split influenza vaccine, Vaxigrip®. Vaccine 2006; 24 : 1586-1592 . Reactions after vaccination The Present Study Delore et al* Local reactions (Inj. site tenderness) >6-35 months 8.5(0) % 6-36 months 8.6(0)% 3-9 years 24.1(1.6)% 3-10 years 32.1(0.6)% >9-18 years 46.6(0)% - - Systemic reaction >6-35 months 26.7(0)% 6-36 months 21.2(2.1)% 3-9 years 13.3(4.1)% 3-10 years 4.3(0)% >9-18 years 6.6(6.6)% - -
  18. 21. Conclusion <ul><li>Flu vaccine is effective in reducing ILI in fully vaccinated children – 43 % reduction in ILI, 57 % reduction in School absenteeism. No effect of partial vaccination </li></ul><ul><li>It is safe & well tolerated by healthy Indian children. </li></ul><ul><li>KAP – Awareness of flu vaccine is present, many parents feel that it is effective and would like to take annual doses. More information needs to be provided by the pediatrician. </li></ul>
  19. 22. Conclusions <ul><li>More studies are needed with larger sample size to establish the efficacy of Seasonal Influenza vaccine </li></ul><ul><li>Identify sub-groups in which it is more effective </li></ul><ul><li>Further research for more effective & single dose Influenza vaccine is needed before it can be universally recommended in our country </li></ul>
  20. 23. <ul><li>Research Team </li></ul><ul><li>Himmat Singh </li></ul><ul><li>Dr. Gaurav Gupta </li></ul><ul><li>Prof. Pramil Tiwari </li></ul>

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