Influenza vaccine effectiveness: Maintained protection throughout the duration of influenza seasons 2010–2011 through 2013–2014

Radin, Jennifer M; Hawksworth, Anthony W.; Myers, Christopher A.; Ricketts, Michelle N; Hansen, Erin; Brice, Gary T.

doi:10.1016/j.vaccine.2016.05.034

Cited by 42 publications

(40 citation statements)

References 18 publications

(44 reference statements)

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“…In North America, influenza A H3N2 viruses reappeared 1 year sooner than in Europe, i.e. in 2010/11 [159] followed by an unusually 'light' season with few or late cases during the winter of 2011/12 [160]. Public health agencies in the UK reported a particularly 'severe' season in 2010/11 [161,162], whereas Australia reported increased rates of severe influenza disease in 2014 [163][164][165], similar to Mexico during 2013/14.…”

Section: Discussionmentioning

confidence: 99%

Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials

Rath

Conrad

Myles

et al. 2017

Expert Review of Anti-infective Therapy

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Influenza-Like Illness is a leading cause of hospitalization in children. Disease burden due to influenza and other respiratory viral infections is reported on a population level, but clinical scores measuring individual changes in disease severity are urgently needed. Areas covered: We present a composite clinical score allowing individual patient data analyses of disease severity based on systematic literature review and WHO-criteria for uncomplicated and complicated disease. The 22-item ViVI Disease Severity Score showed a normal distribution in a pediatric cohort of 6073 children aged 0-18 years (mean age 3.13; S.D. 3.89; range: 0 to 18.79). Expert commentary: The ViVI Score was correlated with risk of antibiotic use as well as need for hospitalization and intensive care. The ViVI Score was used to track children with influenza, respiratory syncytial virus, human metapneumovirus, human rhinovirus, and adenovirus infections and is fully compliant with regulatory data standards. The ViVI Disease Severity Score mobile application allows physicians to measure disease severity at the point-of care thereby taking clinical trials to the next level.

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Section: Discussionmentioning

confidence: 99%

Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials

Rath

Conrad

Myles

et al. 2017

Expert Review of Anti-infective Therapy

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“…But vaccine effectiveness may be lost during the latter six months of the season 57 . The data reported here demonstrates that annual influenza vaccination boosts HI titers toward strains represented in the vaccine formulation.…”

Section: Discussionmentioning

confidence: 99%

Different Repeat Annual Influenza Vaccinations Improve the Antibody Response to Drifted Influenza Strains

Plant

Fredell

Hatcher³

et al. 2017

Sci Rep

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Seasonal influenza vaccine formulas change almost every year yet information about how this affects the antibody repertoire of vaccine recipients is inadequate. New vaccine virus strains are selected, replacing older strains to better match the currently circulating strains. But even while the vaccine is being manufactured the circulating strains can evolve. The ideal response to a seasonal vaccine would maintain antibodies toward existing strains that might continue to circulate, and to generate crossreactive antibodies, particularly towards conserved influenza epitopes, potentially limiting infections caused by newly evolving strains. Here we use the hemagglutination inhibition assay to analyze the antibody repertoire in subjects vaccinated two years in a row with either identical vaccine virus strains or with differing vaccine virus strains. The data indicates that changing the vaccine formulation results in an antibody repertoire that is better able to react with strains emerging after the vaccine virus strains are selected. The effect is observed for both influenza A and B strains in groups of subjects vaccinated in three different seasons. Analyses include stratification by age and sex.Influenza causes widespread seasonal disease and vaccination has been shown to reduce illness among the population [1][2][3][4] . Several studies have demonstrated that vaccination confers protection against virologically confirmed influenza 5 . However, understanding vaccination effectiveness is complicated because a large portion of the population is asymptomatically infected 6 . The circulating strains evolve from season to season leading to changes in vaccine formulation which further complicates comparisons between seasons.Vaccine effectiveness can be measured by controlled clinical trials but comparisons between trials is complicated by factors such as the prevalence of the circulating virus and the closeness of virus match each season 7 . Observational studies, used in places where universal vaccination recommendations make it unethical to perform trials with placebos, are an increasingly common way of measuring vaccine effectiveness among the general population. Test-negative studies are a widely used method but the estimates for vaccine effectiveness vary widely depending on the study design and often have overlapping confidence intervals [8][9][10] . Correlates of protection, such as the hemagglutination inhibition (HI) titer, are widely used to assess vaccine efficacy. HI titers are associated with reduced risk of disease but there is significant variation in the protective titer depending on factors such as the age of the recipient and the severity of the influenza season [11][12][13] . It has also been reported that factors not detected in HI assays are associated with reduced risk of infection 14,15 .Changes in the annual vaccine formulation are compelled by the antigenic drift associated with seasonal influenza viruses. Despite the best efforts of a group of experts in selecting the candidate vaccine virus (CV...

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“…Based on previous studies that showed persistent antibody levels against influenza for 360 days post‐vaccination, we considered our patients to be vaccinated for 360 days after receiving the vaccine. However, another study showed seroprotection antibody levels greatly diminish after 180 days post‐vaccination . We performed the same Cox regression analysis using this 180‐day window and again found that there was no effect of post‐transplant vaccination status on any of the outcomes considered.…”

Section: Discussionmentioning

confidence: 81%

“…However, another study showed seroprotection antibody levels greatly diminish after 180 days postvaccination. 19 We performed the same Cox regression analysis using this 180-day window and again found that there was no effect of posttransplant vaccination status on any of the outcomes considered.…”

Section: Discussionmentioning

confidence: 98%

Effects of the influenza vaccine on pediatric kidney transplant outcomes

Camerino

Jackson

Chinnakotla

et al. 2019

Pediatric Transplantation

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The influenza vaccine is critical for preventing influenza‐related complications in transplant patients. Previous studies demonstrated de novo donor‐specific antibody formation and rejection following the influenza vaccination. This risk has not been adequately assessed in the pediatric population. We performed a single‐center retrospective analysis of 187 unique pediatric kidney transplant recipients, transplanted from January 1, 2006, to December 31, 2015, assessing for an association of the influenza vaccination with various transplant outcomes. The influenza vaccine was received by 125 of 187 patients within the first year post‐transplant. Using log‐rank tests and Kaplan‐Meier curves, vaccinated patients had a significantly lower risk of mortality (P = 0.048). There were no differences in death‐censored graft survival (P = 0.253), graft survival (P = 0.098), or rejection (P = 0.195) between vaccinated and unvaccinated groups. To address the problem of multiple exposures for a yearly vaccine, Cox proportional hazards regression was utilized with post‐transplant vaccination status considered as a time‐dependent covariate; analyses were performed using both a 360‐ and 180‐day vaccination period following any post‐transplant influenza vaccination. In this model, being vaccinated did not result in a significant difference in mortality (HR 0.90 [0.16, 5.15], P = 0.91), death‐censored graft survival (HR 0.70 [0.31, 1.58], P = 0.39), graft survival (HR 0.69 [0.32, 1.49], P = 0.34), or rejection (HR 0.67 [0.37, 1.19], P = 0.17). Eight patients developed de novo donor‐specific antibodies following the first post‐transplant influenza vaccination; three then developed biopsy‐proven rejection. These results suggest influenza vaccination is safe in pediatric kidney transplant recipients, and larger prospective studies are required to conclusively confirm our findings.

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Influenza vaccine effectiveness: Maintained protection throughout the duration of influenza seasons 2010–2011 through 2013–2014

Abstract: Our study found moderate VE up to 6months postvaccination. Since the influenza season starts at different times each year, optimal timing is difficult to predict. Consequently, early influenza vaccination may still offer the best overall protection.

Cited by 42 publications

References 18 publications

Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials

Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials

Different Repeat Annual Influenza Vaccinations Improve the Antibody Response to Drifted Influenza Strains

Effects of the influenza vaccine on pediatric kidney transplant outcomes

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