Influenza Vaccine Effectiveness in the 2011–2012 Season: Protection Against Each Circulating Virus and the Effect of Prior Vaccination on Estimates

Ohmit, Suzanne E.; Thompson, Mark G.; Petrie, Joshua G.; Thaker, Swathi; Jackson, Michael L.; Belongia, Edward A.; Zimmerman, Richard K.; Gaglani, Manjusha; Lamerato, Lois; Spencer, Sarah; Jackson, Lisa A.; Meece, Jennifer K.; Nowalk, Mary Patricia; Song, Juhee; Zervos, Marcus J.; Cheng, Po Yung; Rinaldo, Charles R.; Clipper, Lydia; Shay, David K.; Piedra, Pedro A.; Monto, Arnold S.

doi:10.1093/cid/cit736

Cited by 312 publications

(296 citation statements)

References 22 publications

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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

Self Cite

219

178

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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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Section: Resultsmentioning

confidence: 99%

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Belongia

Skowronski

McLean

et al. 2017

Expert Review of Vaccines

Self Cite

219

178

View full text Add to dashboard Cite

show abstract

“…Consistent with this hypothesis, there is evidence that vaccination history [23,48,49] and recipient age (potentially a proxy for infection history) [57] affect vaccine efficacy. Models that include more realistic features of immunity might demonstrate how interactions between existing immunity and novel responses affect the impact of vaccination on influenza's evolution.…”

Section: Discussionmentioning

confidence: 83%

“…In the United States, up to 68.4% of vaccine recipients get vaccinated every year [46,47]. Consecutive vaccination may also reduce vaccine effectiveness potentially due to interaction with prior immune responses, although the mechanisms underlying these effects are not well understood [23,48,49]. Thus, the effective amount of vaccine-induced immunity in a population is potentially lower than vaccine coverage estimates would suggest.…”

Section: Discussionmentioning

confidence: 99%

“…Vaccination confers a private benefit to vaccinated individuals by directly reducing their risk of infection: the inactivated vaccine reduces the within-season rate of influenza infections in healthy adult recipients by up to 75% [21][22][23][24][25]. Vaccination also confers a social benefit to the host population by reducing the burden of disease, although these effects are infrequently measured.…”

Section: Introductionmentioning

confidence: 99%

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The beneficial effects of vaccination on the evolution of seasonal influenza

Wen

Malani

Cobey

2017

Preprint

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Although vaccines against seasonal influenza are designed to protect against currently circulating strains, they may also affect the emergence of antigenically divergent strains and thereby change the rate of antigenic evolution. Such evolutionary effects could change the benefits that vaccines confer to vaccinated individuals and the host population (i.e. private and social benefits). To investigate vaccinations potential evolutionary impacts, we simulated the dynamics of an influenza-like pathogen in an annually vaccinated host population. On average, vaccination decreased the cumulative amount of antigenic evolution of the viral population and the incidence of disease. Vaccination at a 5% random annual vaccination rate (48% cumulative vaccine coverage after 20 years) decreased cumulative evolution by 56% and incidence by 76%. To understand how the evolutionary effects of vaccination might affect its private and social benefits over multiple seasons, we fit linear panel models to simulated infection and vaccination histories. Including the evolutionary effects of vaccination lowered the private benefits by 14% but increased the social benefits by 30% (at a 5% annual vaccination rate) compared to when evolutionary effects were ignored. Thus, in the long term, vaccines' private benefits may be lower and social benefits may be greater than predicted by current measurements of vaccine impact, which do not capture long-term evolutionary effects. These results suggest that conventional vaccines against seasonal influenza could greatly reduce the burden of disease by slowing antigenic evolution like universal vaccines. Furthermore, vaccination's evolutionary effects compound a collective action problem, highlighting the importance on social policies concerning vaccination.

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“…Indeed, there are still controversies about repeated vaccination. These debates have emerged through data from a study performed in a household cohort during the 2010-2011 season, where reduced VE was demonstrated among individuals vaccinated in the prior year, and other studies subsequently observed similar findings [23][24][25]. These reductions in VE have primarily been associated with outbreaks of A(H3N2) infection.…”

Section: Current Limits Of the Researchmentioning

confidence: 91%

Influenza vaccine response: future perspectives

Mameli

D’Auria

Erba

et al. 2017

Expert Opinion on Biological Therapy

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Influenza Vaccine Effectiveness in the 2011–2012 Season: Protection Against Each Circulating Virus and the Effect of Prior Vaccination on Estimates

Abstract: Vaccine effectiveness in the 2011-2012 season was modest overall, with lower effectiveness against the predominant A (H3N2) virus. This may be related to antigenic drift, but past history of vaccination might also play a role.

Cited by 312 publications

References 22 publications

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

The beneficial effects of vaccination on the evolution of seasonal influenza

Influenza vaccine response: future perspectives

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