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dc.contributor.authorShibata, Natsumien
dc.contributor.authorKimura, Shinyaen
dc.contributor.authorHoshino, Takahiroen
dc.contributor.authorTakeuchi, Masatoen
dc.contributor.authorUrushihara, Hisashien
dc.contributor.alternative竹内, 正人ja
dc.description.abstractBackground: To date, few large-scale comparative effectiveness studies of influenza vaccination have been conducted in Japan, since marketing authorization for influenza vaccines in Japan has been granted based only on the results of seroconversion and safety in small-sized populations in clinical trial phases not on the vaccine effectiveness. We evaluated the clinical effectiveness of influenza vaccination for children aged 1–15 years in Japan throughout four influenza seasons from 2010 to 2014 in the real world setting. Methods: We conducted a cohort study using a large-scale claims database for employee health care insurance plans covering more than 3 million people, including enrollees and their dependents. Vaccination status was identified using plan records for the influenza vaccination subsidies. The effectiveness of influenza vaccination in preventing influenza and its complications was evaluated. To control confounding related to influenza vaccination, odds ratios (OR) were calculated by applying a doubly robust method using the propensity score for vaccination. Results: Total study population throughout the four consecutive influenza seasons was over 116, 000. Vaccination rate was higher in younger children and in the recent influenza seasons. Throughout the four seasons, the estimated ORs for influenza onset were statistically significant and ranged from 0.797 to 0.894 after doubly robust adjustment. On age stratification, significant ORs were observed in younger children. Additionally, ORs for influenza complication outcomes, such as pneumonia, hospitalization with influenza and respiratory tract diseases, were significantly reduced, except for hospitalization with influenza in the 2010/2011 and 2012/2013 seasons. Conclusions: We confirmed the clinical effectiveness of influenza vaccination in children aged 1–15 years from the 2010/2011 to 2013/2014 influenza seasons. Influenza vaccine significantly prevented the onset of influenza and was effective in reducing its secondary complications.en
dc.publisherElsevier BVen
dc.rights© 2018 The Authors. Published by Elsevier Ltd. This is an openaccess article under the CC BY-NC-ND license(
dc.subjectInfluenza vaccinesen
dc.subjectVaccine effectivenessen
dc.subjectPropensity scoreen
dc.subjectDoubly robust methoden
dc.titleEffectiveness of influenza vaccination for children in Japan: Four-year observational study using a large-scale claims databaseen
dc.typejournal article-
dc.type.niitypeJournal Article-
dc.addressDepartment of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio Universityen
dc.addressJapan Medical Data Center Co., Ltd.en
dc.addressDepartment of Economics, Faculty of Economics, Keio Universityen
dc.addressDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto Universityen
dc.addressDepartment of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio Universityen
dcterms.accessRightsopen access-
jpcoar.funderName.alternativeJapan Society for the Promotion of Science (JSPS)en
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