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The disease burden of seasonal influenza in young children is substantial. And yet only the USA, Canada, Finland and one state in Australia currently have a routine influenza vaccine policy in place for young children. Few countries seem keen to follow their lead. This paper reviews the evidence required to inform a policy of universal paediatric vaccination; key features include protective effect, economic impacts and the safety of influenza vaccination in this age group. We found that i. there is insufficient data on the protective effect of vaccinating infants aged 6-23 months, ii. there are very few economic evaluations and most of the current published economic evaluations involve modelling and were performed using data from a variety of sources which are not setting specific, and iii. safety data have not been specifically addressed by an in-depth separate systematic review. To better inform relevant policy making, we suggest that interdisciplinary research, (combining epidemiology and health economics at least), is required to fully examine the protective effect, economic impacts and safety of influenza vaccination in children aged 6-59 months. We also suggest that the safety data on influenza vaccination in this age group should be assessed specifically by an in-depth separate systematic review, using published and grey literature. [ABSTRACT FROM AUTHOR]

Introduction: Influenza is a major contributor to the preventable health burden of Australians each year. The National Immunisation Program provides influenza vaccine for those at highest risk of severe disease. This review of influenza epidemiology examines current data on influenza disease burden in Australia, in the context of several comparable countries having programs with much broader eligibility for influenza vaccine in children., Methods: Influenza notifications (2006-2015), hospitalisations, and deaths (2006-2013) were sourced and age-specific rates calculated. Comparisons were made across age groups in the pre-pandemic, pandemic, and post-pandemic periods and by Indigenous and non-Indigenous status., Results: The 2009 pandemic year and the 2012 non-pandemic season resulted in the highest rates of notification, hospitalisation and death. Influenza notification rates were 4.0 times higher and hospitalisation rates 2.1 times higher during 2011-2013 compared with 2006-2008. Death rates varied widely, but peaks corresponded to high-activity seasons. Influenza hospitalisation rates were highest among those aged <5 and ≥65 years, but influenza-attributable deaths were identified primarily in those aged ≥75 years. Significantly higher notification and hospitalisation rates were seen for all Indigenous people, but higher death rates were largely restricted to the 2009 pandemic year., Conclusions: Based on notifications, hospitalisations and deaths, burden of disease from influenza is highest at the extremes of life and is significantly higher among Indigenous people of all ages. This pattern of disease burden warrants consideration of widened eligibility for influenza vaccine under the National Immunisation Program to all Indigenous people and all children less than 5 years of age.

Influenza is an acute respiratory illness that remains an important cause of excessive morbidity and mortality with substantial economic cost to the population. Influenza, being a virus that frequently mutates, is not amenable to elimination. Vaccination remains the most effective preventive measure. This review summarises the latest developments in the fields of biology and epidemiology relating to clinical and economic impacts of influenza disease, and vaccination. We suggest that future efforts should focus on developing safer, more effective, and cost-effective prophylactic vaccines for influenza.

People with dementia are at a greater risk of complications from respiratory infections therefore can benefit from vaccinations against influenza, pneumococcal disease and pertussis. This review aimed to evaluate the uptake and impact of vaccination in older adults with dementia against respiratory infections and identify knowledge gaps. Key databases were explored, search results were assessed, relevant studies identified, and data were synthesised and summarised. Most available data suggest that older adults with dementia are less likely to receive influenza or pneumococcal vaccine while a few studies indicate an increase in vaccination uptake but poor immunogenicity. Among dementia patients, community dwellers have a lower vaccination rate than home care residents. However, vaccinations against influenza and pneumococcal disease can benefit individuals with dementia by reducing both mortality and morbidity. Health professionals caring for patients with dementia could play a role in fostering vaccination of these individuals.