2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals

Rondy, Marc; Launay, Odile; Puig-Barberà, Joan; Gefenaitė, Giedrė; Castilla, Jesús; Donati, Katleen de Gaetano; Galtier, Florence; Guevara, Marcela; Costanzo, Simona; Moren, Alain

doi:10.2807/1560-7917.es2015.20.2.21011

Cited by 32 publications

(35 citation statements)

References 292 publications

(325 reference statements)

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“…Although the influenza diagnoses were not laboratory-confirmed, our study demonstrates that comprehensive population-based patient register data on influenza-specific outcomes, which allow for adjustments of multiple confounders and assessments of potential biases, can and should be used for routine estimates of seasonal influenza IVE and VE. The VEs in our study were in accordance with those from European multicentre studies using the much more laborious test-negative design [25,31,32]. International sentinel surveillance efforts remain vital to gauge circulating types, but are not needed to accurately assess VE across broad populations.…”

Section: Discussionsupporting

confidence: 76%

Real-time real-world analysis of seasonal influenza vaccine effectiveness: method development and assessment of a population-based cohort in Stockholm County, Sweden, seasons 2011/12 to 2014/15

Levál¹,

Hergens

Persson

et al. 2016

Eurosurveillance

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Real-world estimates of seasonal influenza vaccine effectiveness (VE) are important for early detection of vaccine failure. We developed a method for evaluating real-time in-season vaccine effectiveness (IVE) and overall seasonal VE. In a retrospective, register-based, cohort study including all two million individuals in Stockholm County, Sweden, during the influenza seasons from 2011/12 to 2014/15, vaccination status was obtained from Stockholm’s vaccine register. Main outcomes were hospitalisation or primary care visits for influenza (International Classification of Disease (ICD)-10 codes J09-J11). VE was assessed using Cox multivariate stratified and non-stratified analyses adjusting for age, sex, socioeconomic status, comorbidities and previous influenza vaccinations. Stratified analyses showed moderate VE in prevention of influenza hospitalisations among chronically ill adults ≥ 65 years in two of four seasons, and lower but still significant VE in one season; 53% (95% confidence interval (CI): 33–67) in 2012/13, 55% (95% CI: 25–73) in 2013/14 and 18% (95% CI: 3–31) in 2014/15. In conclusion, seasonal influenza vaccination was associated with substantial reductions in influenza-specific hospitalisation, particularly in adults ≥ 65 years with underlying chronic conditions. With the use of population-based patient register data on influenza-specific outcomes it will be possible to obtain real-time estimates of seasonal influenza VE.

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Section: Discussionsupporting

confidence: 76%

Real-time real-world analysis of seasonal influenza vaccine effectiveness: method development and assessment of a population-based cohort in Stockholm County, Sweden, seasons 2011/12 to 2014/15

Levál¹,

Hergens

Persson

et al. 2016

Eurosurveillance

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“…Eighteen studies met the eligibility criteria [4,13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Of these, one study was restricted to hospitalized patients and was therefore excluded from the meta-analysis [31].…”

Section: Resultsmentioning

confidence: 99%

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Belongia

Skowronski

McLean

et al. 2017

Expert Review of Vaccines

221

185

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Introduction: Studies in the 1970s and 1980s signaled concern that repeated influenza vaccination could affect vaccine protection. The antigenic distance hypothesis provided a theoretical framework to explain variability in repeat vaccination effects based on antigenic similarity between successive vaccine components and the epidemic strain. Areas covered: A meta-analysis of vaccine effectiveness studies from 2010-11 through 2014-15 shows substantial heterogeneity in repeat vaccination effects within and between seasons and subtypes. When negative effects were observed, they were most pronounced for H3N2, especially in 2014-15 when vaccine components were unchanged and antigenically distinct from the epidemic strain. Studies of repeated vaccination across multiple seasons suggest that vaccine effectiveness may be influenced by more than one prior season. In immunogenicity studies, repeated vaccination blunts the hemagglutinin antibody response, particularly for H3N2. Expert commentary: Substantial heterogeneity in repeated vaccination effects is not surprising given the variation in study populations and seasons, and the variable effects of antigenic distance and immunological landscape in different age groups and populations. Caution is required in the interpretation of pooled results across multiple seasons, since this can mask important variation in repeat vaccination effects between seasons. Multi-season clinical studies are needed to understand repeat vaccination effects and guide recommendations. ARTICLE HISTORY

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“…84 Given that documenting current year influenza vaccination status is especially challenging in hospital settings, 32,33 it is not surprising that the effect of prior vaccination on IVE was reported in very few articles. 36,41,58 Nonetheless, research that considers the possible modification of current season IVE by prior vaccination history among hospitalized patients is needed, especially when consecutive identical vaccine components are followed by an antigenically distinct circulating strain. This can result in a blunting of IVE as described by Smith et al 85 and observed in 2014–15.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of influenza vaccines in preventing severe influenza illness among adults: A systematic review and meta-analysis of test-negative design case-control studies

Rondy

Omeiri

Thompson

et al. 2017

Journal of Infection

178

128

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Summary Objectives Summary evidence of influenza vaccine effectiveness (IVE) against hospitalized influenza is lacking. We conducted a meta-analysis of studies reporting IVE against laboratory-confirmed hospitalized influenza among adults. Methods We searched Pubmed (January 2009 to November 2016) for studies that used test-negative design (TND) to enrol patients hospitalized with influenza-associated conditions. Two independent authors selected relevant articles. We calculated pooled IVE against any and (sub)type specific influenza among all adults, and stratified by age group (18–64 and 65 years and above) using random-effects models. Results We identified 3411 publications and 30 met our inclusion criteria. Between 2010–11 and 2014–15, the pooled seasonal IVE was 41% (95%CI:34;48) for any influenza (51% (95%CI:44;58) among people aged 18–64y and 37% (95%CI:30;44) among ≥65 years). IVE was 48% (95%CI:37;59), 37% (95%CI:24;50) and 38% (95%CI:23;53) against influenza A(H1N1)pdm09, A(H3N2) and B, respectively. Among persons aged ≥65 year, IVE against A(H3N2) was 43% (95%CI:33;53) in seasons when circulating and vaccine strains were antigenically similar and 14% (95%CI: −3;30) when A(H3N2) variant viruses predominated. Conclusions Influenza vaccines provided moderate protection against influenza-associated hospitalizations among adults. They seemed to provide low protection among elderly in seasons where vaccine and circulating A(H3N2) strains were antigenically variant.

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2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals

Abstract: Binary file ES_Abstracts_Final_ECDC.txt matches

Cited by 32 publications

References 292 publications

Real-time real-world analysis of seasonal influenza vaccine effectiveness: method development and assessment of a population-based cohort in Stockholm County, Sweden, seasons 2011/12 to 2014/15

Real-time real-world analysis of seasonal influenza vaccine effectiveness: method development and assessment of a population-based cohort in Stockholm County, Sweden, seasons 2011/12 to 2014/15

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Effectiveness of influenza vaccines in preventing severe influenza illness among adults: A systematic review and meta-analysis of test-negative design case-control studies

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