What is the Knowledge Hub?
Explore the VoICE Knowledge Hub—a searchable database featuring the latest peer-reviewed research on immunization benefits, especially in low- and middle-income countries. Browse the Knowledge Hub using a variety of different filters to find vaccine evidence based on country, region, topic, or disease. Click on a tag to find more evidence on a specific area, such as the return on investment of vaccines or impacts of infectious disease outbreaks.
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A school-based flu vaccination program in California led to higher vaccination rates, fewer absences, and less flu transmission
A school-located influenza vaccination program implemented in 95 preschools and elementary schools in California was associated with increased influenza vaccination coverage, decreased school absences due to illness, and lower influenza transmission across the community. The 11% increase in flu vaccination in children enrolled in target schools was associated with fewer flu hospitalizations in the community, including 160 fewer influenza hospitalizations per 100,000 among people aged 65 and older.
Benjamin-Chung J, Arnold BF, Kennedy CJ et al.. 2020. Evaluation of a city-wide school-located influenza vaccination program in Oakland, California, with respect to vaccination coverage, school absences, and laboratory-confirmed influenza: A matched cohort study. PLoS Medicine. 17(8).
Immunizing pregnant women protects infants from influenza, with 56% efficacy in the first 2 months of life
A pooled analysis of three randomized controlled trials conducted in Nepal, Mali, and South Africa between 2011 and 2014 found that immunization during pregnancy provided protection against influenza to young infants from birth through 4 months of age. Protection against infant influenza was greatest in the first 2 months of life, with 56% efficacy, and the pooled efficacy of maternal vaccination to prevent infant laboratory-confirmed influenza up to 6 months of age was 35%.
Omer SB, Clark DR, Madhi SA et al.. 2020. Efficacy, duration of protection, birth outcomes, and infant growth associated with influenza vaccination in pregnancy: a pooled analysis of three randomised controlled trials. The Lancet Respiratory Medicine. 8(6).
Influenza vaccination for healthcare workers reduced sick days during flu seasons
Healthcare workers who received an influenza vaccine missed fewer days of work compared to non-vaccinated peers (1.74 vs 2.71 days/person). The study took place at a large Italian hospital that employed approximately 5,300 healthcare workers. The researchers examined a severe influenza season (2017/2018) as well as three moderate flu seasons (2010-2013).
Gianino MM, Kakaa O, Politano G et al.. 2021. Severe and moderate seasonal influenza epidemics among Italian healthcare workers: A comparison of the excess of absenteeism. Influenza and Other Respiratory Viruses. 15(1).
Increasing influenza vaccination coverage by 10% leads to a 65% decrease in antibiotic use
A retrospective analysis of influenza vaccination coverage and antibiotic prescribing rates from 2010 to 2017 across states in the United States, controlling for differences in health infrastructure and yearly vaccine effectiveness, found that a 10-percentage point increase in influenza vaccination coverage was associated with a 6.5% decrease in antibiotic use across all age groups, equivalent to 14.2 fewer antibiotic prescriptions per 1000 individuals.
Klein EY, Schueller E, Tseng KK et al.. 2020. The Impact of Influenza Vaccination on Antibiotic Use in the United States, 2010–2017. Open Forum Infectious Diseases. 7(7).
Influenza vaccination in patients with diabetes reduces the risk of death and complications
In patients with diabetes, influenza vaccination was associated with a reduced risk of all-cause death, cardiovascular death, and death from acute myocardial infarction (heart attacks) or stroke. The analysis included medical records from 241,551 adult patients in Denmark across nine consecutive influenza seasons (2007 to 2016). Influenza vaccination was associated with a reduced risk for being admitted to the hospital with diabetes-related complications, like diabetic ketoacidosis, hypoglycemia, or coma.
Modin D, Claggett B, Køber L et al.. 2020. Influenza Vaccination Is Associated With Reduced Cardiovascular Mortality in Adults With Diabetes: A Nationwide Cohort Study. Diabetes Care. 43(9).
Influenza vaccination reduces absenteeism among healthcare workers
In a retrospective cohort study among healthcare workers (HCWs) of an Italian academic healthcare trust during the 2017–2018 influenza season, non-vaccinated HCWs lost 2.47/100 person-days of work compared to 1.92/100 person-days of work among vaccinated HCWs (p < 0.001). This adds further evidence that absenteeism among HCWs is negatively correlated with influenza vaccination.
Antinolfi F, Battistella C, Brunelli L et al.. 2020. Absences from work among healthcare workers: are they related to influenza shot adherence?. BMC Health Services Research. 20(1).
Immunization against influenza and pneumococcus can reduce healthcare visits and antibiotic use, improving overall health
This systematic review suggests that vaccination against influenza and pneumococcus can reduce overall healthcare visits and antimicrobial consumption. Of the 26 studies included in the review, 23 found significant reductions in antimicrobial use in vaccinated individuals or groups. This evidence indicates that improved coverage with existing vaccines may significantly reduce antimicrobial demand.
Doherty TM, Hausdorff WP, Kristinsson KG. 2020. Effect of vaccination on the use of antimicrobial agents: a systematic literature review. Annals of Medicine. 52(6).
Increasing influenza vaccine uptake can help manage respiratory outbreaks and reduce strain on healthcare systems during COVID-19
The potential for a spike in COVID-19 concurrent with influenza season could threaten to overwhelm healthcare systems, particularly in resource-limited contexts. A double burden of influenza and COVID-19 cases could also increase risk of cross-infection and transmission in hospital settings. This mathematical modeling study found that increasing influenza vaccine uptake would help manage respiratory outbreaks coinciding with peak flu season and thus reduce the potential strain on healthcare systems responding to COVID-19.
Li Q, Tang B, Bragazzi NL et al.. 2020. Modeling the impact of mass influenza vaccination and public health interventions on COVID-19 epidemics with limited detection capability. Mathematical Biosciences. 325.
Influenza vaccination reduces antibiotic prescriptions and helps fight against antibiotic resistance
A study led by researchers from the U.S. Centers for Disease Control and Prevention found that across five winter influenza seasons (2013-2018), vaccination against influenza averted 1 in 25 antibiotic prescriptions among outpatients with acute respiratory illness (ARI). The study population included 37,487 ARI outpatients 6 months or older treated at over 50 healthcare facilities across the United States. The authors conclude that influenza vaccination may curb unnecessary antibiotic use and help reduce the global threat of antibiotic resistance.
Smith ER, Fry AM, Hicks LA et al.. 2020. Reducing Antibiotic Use in Ambulatory Care Through Influenza Vaccination. Clinical Infectious Diseases. 71(11).
A study in Germany found that vaccinating children against influenza reduces infections in the general population
A modelling simulation study in Germany found that routine influenza vaccination coverage of 55% in children of 6 months to 17 years indirectly reduces influenza infections by 26% in the general population through pronounced herd effects. The study authors conclude that targeting children in influenza vaccination campaigns may not only reduce their individual disease burden, but also that of non-vaccinated individuals.
Schmidt-Ott R, Molnar D, Anastassopoulou A et al.. 2020. Assessing direct and indirect effects of pediatric influenza vaccination in Germany by individual-based simulations. Human Vaccines & Immunotherapeutics. 16(4).