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

1. Flu Vaccine – Does it work for Indian Children? Dr. Gaurav Gupta, Practising Pediatrician DCH, DNB, Member AAP, IAP Charak Clinics, Mohali, Punjab

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

8. Methodology-Clinical Effectiveness Study

9. Methodology-Clinical Effectiveness Study Continued…..

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

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

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%

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%

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%

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%

18. * Singh H, Gupta G, Tiwari P. Safety and tolerability of Influenza vaccine in Indian Children. NIPER & Charak Care Clinics. (Data On File)

19. * Singh H, Gupta G, Tiwari P. Safety and tolerability of Influenza vaccine in Indian Children. NIPER & Charak Care Clinics. (Data on file)

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)% - -