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Uptake and effectiveness of influenza vaccine in those aged 65 years and older in the United Kingdom, influenza seasons 2010/11 to 2016/17
- Richard G Pebody1 , Fiona Warburton1 , Nick Andrews1 , Mary Sinnathamby1 , Ivelina Yonova2,3 , Arlene Reynolds4 , Chris Robertson5 , Simon Cottrell6 , Muhammad Sartaj7 , Rory Gunson8 , Matthew Donati9 , Catherine Moore6 , Joanna Ellis1 , Simon de Lusignan2,3 , Jim McMenamin4 , Maria Zambon1
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View Affiliations Hide AffiliationsAffiliations: 1 Public Health England, London, United Kingdom 2 University of Surrey, Guildford, United Kingdom 3 Royal College of General Practitioners, London, United Kingdom 4 Health Protection Scotland, Glasgow, United Kingdom 5 University of Strathclyde, Glasgow, United Kingdom 6 Public Health Wales, Cardiff, United Kingdom 7 Public Health Agency Northern Ireland, Belfast, United Kingdom 8 West of Scotland Specialist Virology Centre, Glasgow, United Kingdom 9 Public Health England, Bristol, United KingdomRichard Pebodyrichard.pebody phe.gov.uk
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Citation style for this article: Pebody Richard G, Warburton Fiona, Andrews Nick, Sinnathamby Mary, Yonova Ivelina, Reynolds Arlene, Robertson Chris, Cottrell Simon, Sartaj Muhammad, Gunson Rory, Donati Matthew, Moore Catherine, Ellis Joanna, de Lusignan Simon, McMenamin Jim, Zambon Maria. Uptake and effectiveness of influenza vaccine in those aged 65 years and older in the United Kingdom, influenza seasons 2010/11 to 2016/17. Euro Surveill. 2018;23(39):pii=1800092. https://doi.org/10.2807/1560-7917.ES.2018.23.39.1800092 Received: 27 Feb 2018; Accepted: 28 Jun 2018
Abstract
In 2016/17, seasonal influenza vaccine was less effective in those aged 65 years and older in the United Kingdom. We describe the uptake, influenza-associated mortality and adjusted vaccine effectiveness (aVE) in this age group over influenza seasons 2010/11–2016/17. Methods: Vaccine uptake in 2016/17 and five previous seasons were measured using a sentinel general practitioners cohort in England; the test-negative case-control design was used to estimate pooled aVE by subtype and age group against laboratory-confirmed influenza in primary care from 2010–2017. Results: Vaccine uptake was 64% in 65–69-year-olds, 74% in 70–74-year-olds and 80% in those aged 75 and older. Overall aVE was 32.5% (95% CI: 11.6 to 48.5); aVE by sub-type was 60.8% (95% CI: 33.9 to 76.7) and 50.0% (95% CI: 21.6 to 68.1) against influenza A(H1N1)pdm09 and influenza B, respectively, but only 5.6% (95% CI: - 39.2 to 35.9) against A(H3N2). Against all laboratory-confirmed influenza aVE was 45.2% (95% CI: 25.1 to 60.0) in 65–74 year olds; - 26.2% (95% CI: - 149.3 to 36.0) in 75–84 year olds and - 3.2% (95% CI: - 237.8 to 68.5) in those aged 85 years and older. Influenza-attributable mortality was highest in seasons dominated by A(H3N2). Conclusions: Vaccine uptake with non-adjuvanted, normal-dose vaccines remained high, with evidence of effectiveness against influenza A(H1N1)pdm09 and B, though poor against A(H3N2), particularly in those aged 75 years and older. Forthcoming availability of newly licensed vaccines with wider use of antivirals can potentially further improve prevention and control of influenza in this group.

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