TY  - JOUR
A1  - Rose, Markus A.
A1  - Damm, Oliver
A1  - Greiner, Wolfgang
A1  - Knuf, Markus
A1  - Wutzler, Peter
A1  - Liese, Johannes G.
A1  - Krüger, Hagen
A1  - Wahn, Ulrich
A1  - Schaberg, Tom
A1  - Schwehm, Markus
A1  - Kochmann, Thomas F.
A1  - Eichner, Martin
T1  - The epidemiological impact of childhood influenza vaccination using live-attenuated influenza vaccine (LAIV) in Germany: predictions of a simulation study
JF  - BMC Infectious Diseases
N2  - Background: Routine annual influenza vaccination is primarily recommended for all persons aged 60 and above and for people with underlying chronic conditions in Germany. Other countries have already adopted additional childhood influenza immunisation programmes. The objective of this study is to determine the potential epidemiological impact of implementing paediatric influenza vaccination using intranasally administered live-attenuated influenza vaccine (LAIV) in Germany.
Methods: A deterministic age-structured model is used to simulate the population-level impact of different vaccination strategies on the transmission dynamics of seasonal influenza in Germany. In our base-case analysis, we estimate the effects of adding a LAIV-based immunisation programme targeting children 2 to 17 years of age to the existing influenza vaccination policy. The data used in the model is based on published evidence complemented by expert opinion. 
Results: In our model, additional vaccination of children 2 to 17 years of age with LAIV leads to the prevention of 23.9 million influenza infections and nearly 16 million symptomatic influenza cases within 10 years. This reduction in burden of disease is not restricted to children. About one third of all adult cases can indirectly be prevented by LAIV immunisation of children. 
Conclusions: Our results demonstrate that vaccinating children 2-17 years of age is likely associated with a significant reduction in the burden of paediatric influenza. Furthermore, annual routine childhood vaccination against seasonal influenza is expected to decrease the incidence of influenza among adults and older people due to indirect effects of herd protection. In summary, our model provides data supporting the introduction of a paediatric influenza immunisation programme in Germany.
KW  - vaccination
KW  - live-attenuated influenza vaccine
KW  - children
KW  - transmission model
KW  - metanalysis
KW  - recommendations
KW  - hospitalizations
KW  - burden
KW  - infection
KW  - young children
KW  - seasonal influenza
KW  - United States
KW  - disease
KW  - efficacy
KW  - Germany
KW  - influenza
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-117563
SN  - 1471-2334
VL  - 14
IS  - 40
ER  - 
TY  - JOUR
A1  - Grabenhenrich, Linus B.
A1  - Reich, Andreas
A1  - Fischer, Felix
A1  - Zepp, Fred
A1  - Forster, Johannes
A1  - Schuster, Antje
A1  - Bauer, Carl-Peter
A1  - Bergmann, Renate L.
A1  - Bergmann, Karl E.
A1  - Wahn, Ulrich
A1  - Keil, Thomas
A1  - Lau, Susanne
T1  - The Novel 10-Item Asthma Prediction Tool: External Validation in the German MAS Birth Cohort
JF  - PLOS ONE
N2  - Background: A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at age 8 years based on 10 predictors assessed in early childhood, including current respiratory symptoms, eczema, and parental history of asthma. 
Objective: We aimed to externally validate the proposed asthma prediction method in a German birth cohort. 
Methods: The MAS-90 study (Multicentre Allergy Study) recorded details on allergic diseases prospectively in about yearly follow-up assessments up to age 20 years in a cohort of 1,314 children born 1990. We replicated the scoring method from the Leicester cohort and assessed prediction, performance and discrimination. The primary outcome was defined as the combination of parent-reported wheeze and asthma drugs (both in last 12 months) at age 8. Sensitivity analyses assessed model performance for outcomes related to asthma up to age 20 years. Results: For 140 children parents reported current wheeze or cough at age 3 years. Score distribution and frequencies of later asthma resembled the Leicester cohort: 9% vs. 16% (MAS-90 vs. Leicester) of children at low risk at 3 years had asthma at 8 years, at medium risk 45% vs. 48%. Performance of the asthma prediction tool in the MAS-90 cohort was similar (Brier score 0.22 vs. 0.23) and discrimination slightly better than in the original cohort (area under the curve, AUC 0.83 vs. 0.78). Prediction and discrimination were robust against changes of inclusion criteria, scoring and outcome definitions. The secondary outcome 'physicians' diagnosed asthma at 20 years' showed the highest discrimination (AUC 0.89). 
Conclusion: The novel asthma prediction tool from the Leicester cohort, UK, performed well in another population, a German birth cohort, supporting its use and further development as a simple aid to predict asthma risk in clinical settings.
KW  - disease
KW  - models
KW  - symptoms
KW  - risk
KW  - early-life
KW  - young children
KW  - preschool children
KW  - sample
KW  - wheeze
KW  - age
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-114202
SN  - 1932-6203
VL  - 9
IS  - 12
ER  -