scholarly journals Waning Vaccine Effectiveness Against Influenza-Associated Hospitalizations Among Adults, 2015–2016 to 2018–2019, United States Hospitalized Adult Influenza Vaccine Effectiveness Network

Author(s):  
Jill M Ferdinands ◽  
Manjusha Gaglani ◽  
Emily T Martin ◽  
Arnold S Monto ◽  
Donald Middleton ◽  
...  

Abstract We observed decreased effectiveness of influenza vaccine with increasing time since vaccination for prevention of influenza A(H3N2), influenza A(H1N1)pdm09, and influenza B/Yamagata–associated hospitalizations among adults. Maximum vaccine effectiveness (VE) was observed shortly after vaccination, followed by an absolute decline in VE of about 8%–9% per month postvaccination.

Author(s):  
Gee Yen Shin

The vaccines included in the current UK Immunisation Schedule offer protection against the following pathogens: A. Viruses ● Measles ● Mumps ● Rubella ● Polio ● Human Papilloma Virus (certain serotypes) ● Rotavirus ● Influenza virus (flu A and B) ● Varicella zoster virus (shingles) ● Hepatitis B virus B. Bacteria ● Corynebacterium diphtheriae (Diphtheria) ● Clostridium tetani (Tetanus) ● Bordetella pertussis (Pertussis) ● Haemophilus influenzae type B (Hib) ● Neisseria meningitidis (Meningococcal disease—certain serotypes) ● Streptococcus pneumoniae (Pneumococcal disease—certain serotypes) The UK Immunisation Schedule has evolved over several decades and reflects changes in vaccine development and commercial availability, national and sometimes international disease epidemiology, and the latest expert opinion. It is designed to offer optimal protection against infectious diseases of childhood to infants and children at the most appropriate age. The most up-to-date information about the UK Immunisation Schedule is available on the online version of the Department of Health publication commonly known as the ‘Green Book’: Immunisation Against Infectious Disease Handbook (see Further reading. Various chapters of the online version are updated at regular intervals; thus, it is very important to refer to the online version of the Green Book on the website for current guidance. Changes to the UK Immunisation Schedule are made on the recommendation of the independent Joint Committee on Vaccines and Immunisation (JCVI). Several of the UK Immunisation Schedule vaccines are combined vaccines: ● Measles, mumps, and rubella (MMR). ● Hexavalent diphtheria, tetanus, acellular pertussis, inactivated polio virus, Haemophilus influenza type b, hepatitis B (DTaP/IPV/Hib/HepB). ● Diphtheria, tetanus, acellular pertussis, inactivated polio, and Haemophilus influenzae (DTaP/IPV/Hib). ● Diphtheria, tetanus, acellular pertussis, inactivated polio (DTaP/IPV). ● Tetanus, diphtheria, and inactivated polio (Td/IPV). ● Inactivated influenza vaccine: influenza A H1N1, H3N2, influenza B. ● Live attenuated intranasal influenza vaccine: influenza A H1N1, H3N2, influenza B. In the UK, vaccines against single pathogens covered by the MMR vaccine are not recommended and not available in the National Health Service (NHS). There has been some limited demand for single-target vaccines, e.g. measles, due to misguided and unfounded concerns about the alleged risks of autism following MMR.


2019 ◽  
Vol 24 (31) ◽  
Author(s):  
Ainara Mira-Iglesias ◽  
F Xavier López-Labrador ◽  
Víctor Baselga-Moreno ◽  
Miguel Tortajada-Girbés ◽  
Juan Mollar-Maseres ◽  
...  

Introduction Influenza immunisation is recommended for elderly people each season. The influenza vaccine effectiveness (IVE) varies annually due to influenza viruses evolving and the vaccine composition. Aim To estimate, in inpatients ≥ 60 years old, the 2017/18 trivalent IVE, overall, by vaccine type and by strain. The impact of vaccination in any of the two previous seasons (2016/17 and 2015/16) on current (2017/18) IVE was also explored. Methods This was a multicentre prospective observational study within the Valencia Hospital Surveillance Network for the Study of Influenza and Respiratory Viruses Disease (VAHNSI, Spain). The test-negative design was applied taking laboratory-confirmed influenza as outcome and vaccination status as main exposure. Information about potential confounders was obtained from clinical registries and/or by interviewing patients; vaccine information was only ascertained by registries. Results Overall, 2017/18 IVE was 9.9% (95% CI: −15.5 to 29.6%), and specifically, 48.3% (95% CI: 13.5% to 69.1%), −29.9% (95% CI: −79.1% to 5.8%) and 25.7% (95% CI: −8.8% to 49.3%) against A(H1N1)pdm09, A(H3N2) and B/Yamagata lineage, respectively. For the adjuvanted and non-adjuvanted vaccines, overall IVE was 10.0% (95% CI: −24.4% to 34.9%) and 7.8% (95% CI: −23.1% to 31.0%) respectively. Prior vaccination significantly protected against influenza B/Yamagata lineage (IVE: 50.2%; 95% CI: 2.3% to 74.6%) in patients not vaccinated in the current season. For those repeatedly vaccinated against influenza A(H1N1)pdm09, IVE was 46.4% (95% CI: 6.8% to 69.2%). Conclusion Our data revealed low vaccine effectiveness against influenza in hospitalised patients ≥60 years old in 2017/18. Prior vaccination protected against influenza A(H1N1)pdm09 and B/Yamagata-lineage.


2012 ◽  
Vol 141 (3) ◽  
pp. 620-630 ◽  
Author(s):  
R. G. PEBODY ◽  
N. ANDREWS ◽  
D. M. FLEMING ◽  
J. McMENAMIN ◽  
S. COTTRELL ◽  
...  

SUMMARYAn analysis was undertaken to measure age-specific vaccine effectiveness (VE) of 2010/11 trivalent seasonal influenza vaccine (TIV) and monovalent 2009 pandemic influenza vaccine (PIV) administered in 2009/2010. The test-negative case-control study design was employed based on patients consulting primary care. Overall TIV effectiveness, adjusted for age and month, against confirmed influenza A(H1N1)pdm 2009 infection was 56% (95% CI 42–66); age-specific adjusted VE was 87% (95% CI 45–97) in <5-year-olds and 84% (95% CI 27–97) in 5- to 14-year-olds. Adjusted VE for PIV was only 28% (95% CI −6 to 51) overall and 72% (95% CI 15–91) in <5-year-olds. For confirmed influenza B infection, TIV effectiveness was 57% (95% CI 42–68) and in 5- to 14-year-olds 75% (95% CI 32–91). TIV provided moderate protection against the main circulating strains in 2010/2011, with higher protection in children. PIV administered during the previous season provided residual protection after 1 year, particularly in the <5 years age group.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S68-S68
Author(s):  
Jessie Chung ◽  
Brendan Flannery ◽  
Rodolfo Begue ◽  
Herve Caspard ◽  
Laurie Demarcus ◽  
...  

Abstract Background Quadrivalent live attenuated influenza vaccine (LAIV4) was not recommended for use in the United States for the 2016–2017 and 2017–2018 influenza seasons based on US observational studies of vaccine effectiveness (VE) from 2013–2014 to 2015–2016. We pooled individual patient data on children aged 2–17 years enrolled in 5 US studies during these 3 influenza seasons to further investigate VE by vaccine type. Methods Analyses included 17,173 children enrolled in the US Department of Defense Global Laboratory-based Influenza Surveillance Program, US Influenza Vaccine Effectiveness Network, Influenza Incidence Surveillance Project, Influenza Clinical Investigation for Children, and a Louisiana State University study. Participants’ specimens were tested for influenza by reverse transcription-polymerase chain reaction (RT-PCR), culture, or a combination of rapid antigen testing and RT-PCR. VE was calculated by comparing odds of vaccination with either inactivated influenza vaccine (IIV) or LAIV4 among influenza-positive cases to test-negative controls and calculated as 100 × (1 − odds ratio) in logistic regression models with age, calendar time, influenza season, and study site (random effect). Patients were stratified by prior season vaccination status in a subanalysis. Results Overall, 38% of patients (N = 6,558) were vaccinated in the current season, of whom 30% (N = 1,979) received LAIV4. Pooled VE of IIV against any influenza virus was 51% (95% CI: 47, 54) versus 26% (95% CI: 15, 36) for LAIV4. Point estimates for pooled VE against any influenza by age group ranged from 45% to 58% for IIV and 19% to 34% for LAIV4 during the 3 seasons (Figures 1 and 2). Pooled VE against influenza A(H1N1)pdm09 was 67% (95% CI: 62, 72) for IIV versus 20% (95% CI: −6, 39) for LAIV4. Pooled VE against influenza A(H3N2) was 29% (95% CI: 14, 42) for IIV versus 7% (95% CI: −11, 23) for LAIV4, and VE against influenza B was 52% (95% CI: 42, 60) for IIV and 66% (95% CI: 47, 77) for LAIV4. VE against influenza A(H1N1)pdm09 was lower for LAIV4 versus IIV across all strata of prior season vaccination (Figure 3). Conclusion Consistent with individual studies, our pooled analyses found that LAIV4 effectiveness was reduced for all age groups against influenza A(H1N1)pdm09 compared with IIV. This result did not vary based on prior vaccination status. Disclosures H. Caspard, AstraZeneca: Employee, Salary.


2016 ◽  
Vol 213 (10) ◽  
pp. 1546-1556 ◽  
Author(s):  
Manjusha Gaglani ◽  
Jessica Pruszynski ◽  
Kempapura Murthy ◽  
Lydia Clipper ◽  
Anne Robertson ◽  
...  

2020 ◽  
Vol 25 (10) ◽  
Author(s):  
Angela Rose ◽  
Esther Kissling ◽  
Hanne-Dorthe Emborg ◽  
Amparo Larrauri ◽  
Jim McMenamin ◽  
...  

Background Influenza A(H1N1)pdm09, A(H3N2) and B viruses were co-circulating in Europe between September 2019 and January 2020. Aim To provide interim 2019/20 influenza vaccine effectiveness (VE) estimates from six European studies, covering 10 countries and both primary care and hospital settings. Methods All studies used the test-negative design, although there were some differences in other study characteristics, e.g. patient selection, data sources, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders. Results There were 31,537 patients recruited across the six studies, of which 5,300 (17%) were cases with 5,310 infections. Most of these (4,466; 84%) were influenza A. The VE point estimates for all ages were 29% to 61% against any influenza in the primary care setting and 35% to 60% in hospitalised older adults (aged 65 years and over). The VE point estimates against A(H1N1)pdm09 (all ages, both settings) was 48% to 75%, and against A(H3N2) ranged from −58% to 57% (primary care) and −16% to 60% (hospital). Against influenza B, VE for all ages was 62% to 83% (primary care only). Conclusions Influenza vaccination is of continued benefit during the ongoing 2019/20 influenza season. Robust end-of-season VE estimates and genetic virus characterisation results may help understand the variability in influenza (sub)type-specific results across studies.


2018 ◽  
Vol 220 (8) ◽  
pp. 1265-1275 ◽  
Author(s):  
Jill M Ferdinands ◽  
Manjusha Gaglani ◽  
Emily T Martin ◽  
Don Middleton ◽  
Arnold S Monto ◽  
...  

Abstract Background Evidence establishing effectiveness of influenza vaccination for prevention of severe illness is limited. The US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) is a multiyear test-negative case-control study initiated in 2015–2016 to estimate effectiveness of vaccine in preventing influenza hospitalization among adults. Methods Adults aged ≥18 years admitted to 8 US hospitals with acute respiratory illness and testing positive for influenza by polymerase chain reaction were cases; those testing negative were controls. Vaccine effectiveness was estimated with logistic regression adjusting for age, comorbidities, and other confounding factors and stratified by frailty, 2-year vaccination history, and clinical presentation. Results We analyzed data from 236 cases and 1231 controls; mean age was 58 years. More than 90% of patients had ≥1 comorbidity elevating risk of influenza complications. Fifty percent of cases and 70% of controls were vaccinated. Vaccination was 51% (95% confidence interval [CI], 29%–65%) and 53% (95% CI, 11%–76%) effective in preventing hospitalization due to influenza A(H1N1)pdm09 and influenza B virus infection, respectively. Vaccine was protective for all age groups. Conclusions During the 2015–2016 US influenza A(H1N1)pdm09–predominant season, we found that vaccination halved the risk of influenza-association hospitalization among adults, most of whom were at increased risk of serious influenza complications due to comorbidity or age.


2019 ◽  
Vol 69 (11) ◽  
pp. 1845-1853 ◽  
Author(s):  
Melissa A Rolfes ◽  
Brendan Flannery ◽  
Jessie R Chung ◽  
Alissa O’Halloran ◽  
Shikha Garg ◽  
...  

Abstract Background The severity of the 2017–2018 influenza season in the United States was high, with influenza A(H3N2) viruses predominating. Here, we report influenza vaccine effectiveness (VE) and estimate the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the 2017–2018 influenza season. Methods We used national age-specific estimates of 2017–2018 influenza vaccine coverage and disease burden. We estimated VE against medically attended reverse-transcription polymerase chain reaction–confirmed influenza virus infection in the ambulatory setting using a test-negative design. We used a compartmental model to estimate numbers of influenza-associated outcomes prevented by vaccination. Results The VE against outpatient, medically attended, laboratory-confirmed influenza was 38% (95% confidence interval [CI], 31%–43%), including 22% (95% CI, 12%–31%) against influenza A(H3N2), 62% (95% CI, 50%–71%) against influenza A(H1N1)pdm09, and 50% (95% CI, 41%–57%) against influenza B. We estimated that influenza vaccination prevented 7.1 million (95% CrI, 5.4 million–9.3 million) illnesses, 3.7 million (95% CrI, 2.8 million–4.9 million) medical visits, 109 000 (95% CrI, 39 000–231 000) hospitalizations, and 8000 (95% credible interval [CrI], 1100–21 000) deaths. Vaccination prevented 10% of expected hospitalizations overall and 41% among young children (6 months–4 years). Conclusions Despite 38% VE, influenza vaccination reduced a substantial burden of influenza-associated illness, medical visits, hospitalizations, and deaths in the United States during the 2017–2018 season. Our results demonstrate the benefit of current influenza vaccination and the need for improved vaccines.


2018 ◽  
Vol 23 (9) ◽  
Author(s):  
Marc Rondy ◽  
Esther Kissling ◽  
Hanne-Dorthe Emborg ◽  
Alin Gherasim ◽  
Richard Pebody ◽  
...  

Between September 2017 and February 2018, influenza A(H1N1)pdm09, A(H3N2) and B viruses (mainly B/Yamagata, not included in 2017/18 trivalent vaccines) co-circulated in Europe. Interim results from five European studies indicate that, in all age groups, 2017/18 influenza vaccine effectiveness was 25 to 52% against any influenza, 55 to 68% against influenza A(H1N1)pdm09, −42 to 7% against influenza A(H3N2) and 36 to 54% against influenza B. 2017/18 influenza vaccine should be promoted where influenza still circulates.


Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1094
Author(s):  
Hyder Mir ◽  
Inaamul Haq ◽  
Parvaiz A. Koul

Influenza vaccine uptake in India is poor, and scant data exist regarding the effectiveness of influenza vaccine against hospitalization. Methods: From October 2019 to March 2020, vaccination status of 1219 patients (males n = 571, aged 5–107 years; median, 50 years) hospitalized with severe acute respiratory illness (SARI) was assessed. The patients were tested for influenza viruses and their subtypes by RT PCR. Sequencing of the HA gene was performed. Vaccine effectiveness (VE) against influenza subtypes was estimated by the test negative design. Results: A total of 336 (27.5%) patients were influenza-positive, with influenza B/Victoria accounting for 49.7% (n = 167), followed by influenza A/H1N1 (47.6%; n = 155) and influenza A/H3N2 (4.4%; n = 15). About 6.8% and 8.6% of the influenza-positive and influenza-negative patients, respectively, had been vaccinated. Adjusted VE for any influenza strain was 13% (95% CI −42 to 47), which for influenza B was 0%. HA sequencing revealed that influenza B samples mainly belonged to subclade V1A.3/133R with deletion of residues 163–165, as against the 2-aa deletion in influenza B/Colorado/06/2017 strain, contained in the vaccine. VE for influenza A/H1N1 was 55%. Conclusions: Poor VE due to a genetic mismatch between the circulating strain and the vaccine strain calls for efforts to reduce the mismatch.


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