Potential of the test-negative design for measuring influenza vaccine effectiveness: a systematic review

Sullivan, Sheena G.; Feng, Luzhao; Cowling, Benjamin J.

doi:10.1586/14760584.2014.966695

Cited by 159 publications

(150 citation statements)

References 129 publications

(251 reference statements)

Supporting

Mentioning

146

Contrasting

Unclassified

Order By: Relevance

“…There can be considerable variation in reported IVE estimates due to differences in strain circulation among countries, strain proportion within one region, the vaccines used, age-specific vaccine coverage, the population studied, season definition, case definition, ascertainment of vaccination status, differences in the period of surveillance, the variables included or omitted in the statistical model, how they are modelled, and measured outcome (admission, outpatient contact or infection) [11]. A major caveat are sparse numbers.…”

Section: Discussionmentioning

confidence: 99%

“…Influenza VE estimates generated from surveillance data using the test-negative design have already been presented at the WHO's annual strain selection meeting [11] as a way to improve the vaccine composition. However, variation in the estimates may undermine their credibility and usefulness, particularly early in the season.…”

Section: Discussionmentioning

confidence: 99%

“…Influenza-positive admissions were compared (vaccination odds ratio (OR)) with influenza-negative admissions [10,11]. Adjusted IVE was defined as 100 x (1 -adjusted OR).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results

et al. 2015

View full text Add to dashboard Cite

Preliminary results for the 2014/15 season indicate low to null effect of vaccination against influenza A(H3N2)-related disease. As of week 5 2015, there have been 1,136 hospital admissions, 210 were due to influenza and 98% of subtype A strains were H3. Adjusted influenza vaccine effectiveness was 33% (range: 6-53%) overall and 40% (range: 13% to 59%) in those 65 years and older. Vaccination reduced by 44% (28-68%) the probability of admission with influenza.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results

et al. 2015

View full text Add to dashboard Cite

show abstract

“…We excluded seven children who received their first dose of current season vaccine <14 days before illness onset because vaccine-induced protection may be incomplete. 11 …”

Section: Methodsmentioning

confidence: 99%

Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010–2014

et al. 2017

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE Surveillance for laboratory-confirmed influenza-associated pediatric deaths since 2004 has shown that most deaths occur in unvaccinated children. We assessed whether influenza vaccination reduced the risk of influenza-associated death in children and adolescents. METHODS We conducted a case-cohort analysis comparing vaccination uptake among laboratory-confirmed influenza-associated pediatric deaths with estimated vaccination coverage among pediatric cohorts in the United States. Case vaccination and high-risk status were determined by case investigation. Influenza vaccination coverage estimates were obtained from national survey data or a national insurance claims database. We estimated odds ratios (OR) from logistic regression comparing odds of vaccination among cases with odds of vaccination in comparison cohorts. We used Bayesian methods to compute 95% credible intervals for vaccine effectiveness (VE), calculated as (1 – OR) × 100. RESULTS From August 2010 through July 2014, 358 laboratory-confirmed influenza-associated pediatric deaths were reported among children aged 6 months through 17 years. Vaccination status was determined for 291 deaths; 75 (26%) received vaccine before illness onset. Average vaccination coverage in survey cohorts was 48%. Overall VE against death was 65% (95% credible interval: 54–73). Among 153 deaths in children with underlying high-risk medical conditions, 47 (31%) were vaccinated. VE among children with high-risk conditions was 51% (95% credible interval: 31-67), versus 65% (95% credible interval: 47-78) among children without high-risk conditions. CONCLUSIONS Influenza vaccination was associated with reduced risk of laboratory-confirmed influenza-associated pediatric death. Increasing influenza vaccination could prevent influenza-associated deaths among children and adolescents.

show abstract

“…Furthermore, variability in study methodology and analytical techniques that exist between countries may limit comparability of data. 39,40 For example, differences in inclusion criteria, study setting, influenza sampling type and quality and how confounding factors are adjusted for. That said, VE estimates for IIV, which would be affected by similar factors, have remained generally consistent across studies.…”

Section: (I)variability Between Observational Studies Used To Calculamentioning

confidence: 99%

Urgent challenges in implementing live attenuated influenza vaccine

Singanayagam

Zambon

Lalvani

et al. 2018

The Lancet Infectious Diseases

View full text Add to dashboard Cite

SummaryConflicting reports have emerged about the effectiveness of the live attenuated influenza vaccine (LAIV). LAIV appears to be protecting particularly poorly against currently circulating H1N1 viruses that are derived from the 2009 pandemic H1N1 (pH1N1) viruses. During the 2015/16 influenza season, when pH1N1 was the predominant virus, studies from the United States (US) reported a complete lack of effectiveness of LAIV in children. This led to a critical decision in the US to recommend that LAIV not be used in 2016/17 and to switch to the inactivated influenza vaccine. Other countries, including the UK, Canada and Finland, have continued to recommend use of LAIV. This policy divergence and uncertainty has far reaching implications for the entire global community, given the importance of LAIV production capability for pandemic preparedness. In this Personal View, we discuss possible explanations for the observed reduced effectiveness of LAIV and highlight underpinning scientific questions. Further research to understand the reasons for these observations is essential to enable informed public health policy and commercial decisions about vaccine production and development in coming years. 3 IntroductionInfluenza vaccination remains the main strategy to control the burden of seasonal influenza disease that affects 5-10% of adults and 20-30% of children, resulting in 250,000-500,000 deaths worldwide each year. 1,2 In the US, 140 million doses of vaccine are distributed each year and vaccination is estimated to prevent nearly a quarter of predicted influenza-associated deaths. 3 Vaccination is also the primary public health response to a global influenza pandemic.Influenza vaccines contain a mixture of three or four components designed to protect against the different viruses that circulate contemporaneously as seasonal influenza viruses. Currently, these are two influenza A viruses (H1N1 and H3N2 subtypes) and two influenza B viruses (Victoria and Yamagata lineages). Vaccine components are reviewed and updated regularly by the WHO in line with observed antigenic drift of influenza viruses.The traditional inactivated influenza vaccine (IIV) was introduced in the 1940s. IIV is administered by intramuscular/intradermal injection, is licensed for use in all ages and has a good safety record. However, effectiveness rates vary, averaging around 50-60%. 4,5 More recently, live attenuated influenza vaccine (LAIV) was demonstrated to have greater efficacy than IIV in children, with absolute efficacy rates of 75-80%. [6][7][8] Internal genes of LAIV viruses are derived from a cold-adapted, attenuated strain of virus, either Ann Arbor/1960 (from the US) or Leningrad/1957 (from Russia). Haemagglutinin (HA) and neuraminidase (NA) surface antigens are engineered to be representative of currently circulating strains. LAIV is nasally administered and vaccine viruses replicate only in the air-cooled environment of the human upper respiratory tract. This results in a mild and self-limiting infection; virus cannot replicate at t...

show abstract

Potential of the test-negative design for measuring influenza vaccine effectiveness: a systematic review

Cited by 159 publications

References 129 publications

Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results

Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results

Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010–2014

Urgent challenges in implementing live attenuated influenza vaccine

Contact Info

Product

Resources

About