Growing Up Healthy:

Long-Term Benefits of Childhood

Influenza Vaccination
 History : Influenza Pandemic
A year of terror and a century of reflection: perspectives on the great influenza pandemic of 1918–1919; BMC 2019
A Century of Pandemic Influenza
 Pediatric Influenza

• Seasonal influenza is a significant cause of respiratory illness.

• Children, particularly those younger than 5 years of age, are at increased risk of influenza-
related complications, including hospitalization and death.
• Children with underlying medical conditions and children less than 5 years of age,
especially those less than 2 years, are at increased risk of influenza related complications.
• A common complication is otitis media, which may develop in up to 40% of children less
than 3 years of age and in 20% of children 3–6 years of age with influenza.
• Influenza can also exacerbate chronic underlying conditions such as asthma, and influenza
has been associated with an increased risk of asthma-treatment failure.
• Other severe complications include pneumonia and other lower respiratory tract
infections, which can be caused by influenza virus alone or by coinfection with a bacterial
pathogen. Illness may progress rapidly to respiratory failure and acute respiratory distress
syndrome.

Pediatric influenza and illness severity: what is known and what questions remain?; Infectious diseases and immunization 2018
• Children younger
than 5 years can be
a high-risk group
for pneumonia
after an influenza
infection—either
due to primary viral
pneumonia or
secondary bacterial
pneumonia (mainly
associated with
pneumococci)
Global burden of childhood pneumonia and
diarrhoea; The Lancet 2013
Host Factors

• Host factors are also important for influenza disease severity – these
may include underlying medical conditions such as heart disease, lung
disease, or neurologic disorders
 Burden of Pediatric Influenza

• Influenza illness in children causes significant clinical and economic burden.

• It has a significant direct impact on the ill children and an indirect impact on their
siblings and parents

Absenteeism COSTS :
Siblings of children with influenza Cost of laboratory for ILI is 32 % higher than non ILI.
also missed school days due to Cost of hospitalization
subsequent ILI Cost of working days lost of the parents

Health care resource use

Hospitalization, medical visit, medication are higher in children
with influenza

Burden of paediatric influenza in Western Europe: a systematic review; Antonova et al. BMC Public Health 2012
Vaccine Recommendation
 •.

Benefit of Flu Vaccination

• In addition to preventing illness, flu vaccine can prevent severe, life-threatening

complications in children.
• Flu vaccination reduced flu-related hospitalization by 41 percent and flu-related
emergency department visits by half among children (aged 6 months to 17 years
old).
• Flu vaccine reduced children’s risk of flu-related pediatric intensive care unit
(PICU) admission by 74 percent during flu seasons from 2010-2012.

• Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children; Clin Infect Dis 2022
• Vaccine Effectiveness Against Pediatric Influenza Hospitalizations and Emergency Visits; Pediatric 2020
• Effectiveness of Influenza Vaccine Against Life-threatening RT-PCR-confirmed Influenza Illness in US Children, 2010–2012; The Journal of
Infectious Disease 2014
 Vaksin Influenza tersedia dalam 2 jenis vaksin

Vaksin Trivalen
• Terdiri dari 3 subtipe virus Subtype A H1N1
influenza Subtype A H3N2
• Jenis virusnya ditentukan Strain B*
oleh WHO
• Efektivitasnya 75%

Vaksin Kuadrivalen
• Terdiri dari 4 subtipe virus Subtype A H1N1
influenza Subtype A H3N2
• Jenis virusnya ditentukan Strain B/ Victoria
oleh WHO Strain B/ Yamagata
• Efektivitasnya di atas 90%

*Lineage
Proprietary and confidential — doof Strain
not B to be determined by WHO recommendations, either Victoria or Yamagata lineage.
distribute
Influenza vaccines are categorized into
different types according to their design
Types of influenza vaccine1–3

Inactivated
Live attenuated Contain inactivated viruses or viral
Contain a live virus that has been constituents (antigens)
made less harmful

• Several subtypes of
inactivated, for
example:
• whole virus
• split virion
• subunit
• virosomal
• adjuvanted

HA, haemagglutinin; NA, neuraminidase; RNA, ribonucleic acid

1. Herzog C, et al. Vaccine 2009;27:4381–7;
2. Noh JY, Kim WJ. Infect Chemother 2013;45:375–86;
3. Kon TC, et al. PLoS One 2016;11:e0150700
PERBEDAAN BERBAGAI VAKSIN INFLUENZA

VAKSIN SUB-UNIT
Ketiga jenis vaksin influenza
hanya mengandung surface antigen (Hemagglutinin
(whole unit, split unit, dan
dan Neuraminidase) tanpa partikel virus lain
sub-unit) memiliki efektifitas
sehingga memiliki frekuensi adverse reaction yang
yang sama1 VIROSOMES
lebih rendah dari vaksin split & whole unit .1, 2

FRAGMENTAS FRAGMENTAS
I I

WHOLE UNIT SPLIT UNIT SUB-UNIT

Referensi: 1. Beyer WE, Palache AM, Osterhaus AD. Comparison of serology and reactogenicity between influenza subunit vaccines and whole virus or split vaccines: A review and meta-analysis of the literature. Clin Drug
Invest 1998; 15:1–12. 2. Wood JM, Williams MS. History of inactivated influenza vaccines. In: Nicholson KG, Webster RG, Hay AJ, editors. Textbook of Influenza. Hoboken, Wiley-Blackwell, 1998. 3. Shah R and Prabhu S.
Advantages of Subunit Influenza Vaccine: An Overall Perspective. Asian Journal of Paediatric Practice, 2018; 1(5): 19–28.
Apa itu H & N ?
Bagian penting untuk menimbulkan perlindungan

• H (Hemagglutinin) berperan
penting dalam pengenalan dan
pengikatan virus pada sel target,
dan kemudian menginfeksi sel
dengan RNA-nya.

• N (neuraminidase) sangat penting

untuk pelepasan partikel virus
yang dibuat di dalam sel yang
terinfeksi sehingga mereka dapat
menyebar ke sel lain.
Thank You