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Using a test-negative design, we assessed interim vaccine effectiveness (VE) for the 2017/18 epidemic of co-circulating influenza A(H3N2) and B(Yamagata) viruses. Adjusted VE for influenza A(H3N2), driven by a predominant subgroup of clade 3C.2a viruses with T131K + R142K + R261Q substitutions, was low at 17% (95% confidence interval (CI): −14 to 40). Adjusted VE for influenza B was higher at 55% (95% CI: 38 to 68) despite prominent use of trivalent vaccine containing lineage-mismatched influenza B(Victoria) antigen, suggesting cross-lineage protection.


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  1. Public Health Agency of Canada (PHAC). FluWatch: Influenza weekly reports 2017-18 season. Ottawa: PHAC; 2018. [Accessed 15 January 2018]. Available from: https://www.canada.ca/en/public-health/services/diseases/flu-influenza/influenza-surveillance/weekly-reports-2017-2018-season.html.
  2. European Centre for Disease Prevention and Control (ECDC). Flu New Europe: Joint ECDC-WHO/Europe weekly influenza update. [Accessed 15 January 2018]. Stockholm: ECDC; 2018. Available from: http://flunewseurope.org/.
  3. Centers for Disease Control and Prevention (CDC). FluView: Weekly U.S. influenza surveillance report. Atlanta: CDC; 2018. [Accessed 15 January 2018]. Available from: https://www.cdc.gov/flu/weekly/.
  4. World Health Organization (WHO). WHO recommendations on the composition of influenza virus vaccines. Geneva: WHO. Available from: http://www.who.int/influenza/vaccines/virus/recommendations/en/
  5. Sullivan SG, Chilver MB, Carville KS, Deng YM, Grant KA, Higgins G, et al. Low interim influenza vaccine effectiveness, Australia, 1 May to 24 September 2017. Euro Surveill. 2017;22(43):pii=17-00707
  6. Chambers C, Skowronski DM, Sabaiduc S, Winter AL, Dickinson JA, De Serres G, et al. Interim estimates of 2015/16 vaccine effectiveness against influenza A(H1N1)pdm09, Canada, February 2016. Euro Surveill. 2016;21(11):30168.  https://doi.org/10.2807/1560-7917.ES.2016.21.11.30168  PMID: 27020673 
  7. Skowronski D, Chambers C, Sabaiduc S, De Serres G, Dickinson J, Winter A, et al. Interim estimates of 2013/14 vaccine effectiveness against influenza A(H1N1)pdm09 from Canada s sentinel surveillance network, January 2014. Euro Surveill. 2014;19(5):20690.  https://doi.org/10.2807/1560-7917.ES2014.19.5.20690  PMID: 24524234 
  8. Skowronski DM, Chambers C, Sabaiduc S, De Serres G, Dickinson JA, Winter AL, et al. Interim estimates of 2014/15 vaccine effectiveness against influenza A(H3N2) from Canada’s Sentinel Physician Surveillance Network, January 2015. Euro Surveill. 2015;20(4):21022.  https://doi.org/10.2807/1560-7917.ES2015.20.4.21022  PMID: 25655053 
  9. Skowronski DM, Chambers C, Sabaiduc S, Dickinson JA, Winter AL, De Serres G, et al. Interim estimates of 2016/17 vaccine effectiveness against influenza A(H3N2), Canada, January 2017. Euro Surveill. 2017;22(6):30460.  https://doi.org/10.2807/1560-7917.ES.2017.22.6.30460  PMID: 28205503 
  10. Neher RA, Bedford T. nextflu: real-time tracking of seasonal influenza virus evolution in humans. Bioinformatics. 2015;31(21):3546-8. . Available from: http://nextflu.org/h3n2/3y/ https://doi.org/10.1093/bioinformatics/btv381  PMID: 26115986 
  11. European Centre for Disease Prevention and Control (ECDC). Influenza virus characterization, summary Europe, December 2017. Stockholm: ECDC; 2017. Available from: https://ecdc.europa.eu/en/publications-data/influenza-virus-characterisation-summary-europe-december-2017
  12. Flannery B, Chung JR, Thaker SN, Monto AS, Martin ET, Belongia EA, et al. Interim estimates of 2016-17 seasonal influenza vaccine effectiveness - United States, February 2017. MMWR Morb Mortal Wkly Rep. 2017;66(6):167-71.  https://doi.org/10.15585/mmwr.mm6606a3  PMID: 28207689 
  13. Kissling E, Rondy MI-MOVE/I-MOVE+ study team. Early 2016/17 vaccine effectiveness estimates against influenza A(H3N2): I-MOVE multicentre case control studies at primary care and hospital levels in Europe. Euro Surveill. 2017;22(7):30464.  https://doi.org/10.2807/1560-7917.ES.2017.22.7.30464  PMID: 28230524 
  14. British Columbia Centre for Disease Control (BCCDC). Canadian Sentinel Practitioner Surveillance Network (SPSN) vaccine effectiveness (VE) estimates (95%CI), 2004-05 to 2016-17 seasons. Vancouver: BCCDC. [Accessed: 15 Jan 2018]. Available from: http://www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Publications/Epid/Influenza%20and%20Respiratory/SPSN_VE_By_Year_Table_2017-12-01.pdf
  15. Ferdinands J. Influenza vaccine effectiveness 2016-17. Advisory Committee on Immunization Practices (ACIP) meeting, Atlanta, 21-22 June 2017. Available from: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2017-06/flu-03-ferdinands.pdf
  16. Belongia EA, Simpson MD, King JP, Sundaram ME, Kelley NS, Osterholm M,, et al. Variable influenza vaccine effectiveness by subtype: a meta-analysis of test negative design studies. Lancet Infect Dis. 2016;16:942-51.  https://doi.org/10.1016/S1473-3099(16)00129-8  PMID: 27061888 
  17. Skowronski DM, Janjua NZ, De Serres G, Sabaiduc S, Eshaghi A, Dickinson JA, et al. Low 2012-13 influenza vaccine effectiveness associated with mutation in the egg-adapted H3N2 vaccine strain not antigenic drift in circulating viruses. PLoS One. 2014;9(3):e92153.  https://doi.org/10.1371/journal.pone.0092153  PMID: 24667168 
  18. Zost SJ, Parkhouse K, Gumina ME, Kim K, Diaz Perez S, Wilson PC, et al. Contemporary H3N2 influenza viruses have a glycosylation site that alters binding of antibodies elicited by egg-adapted vaccine strains. Proc Natl Acad Sci USA. 2017;114(47):12578-83.  https://doi.org/10.1073/pnas.1712377114  PMID: 29109276 
  19. Dugan VG, Blanton L, Elal AIA, Alabi N, Barnes J, Brammer L, et al. Update: influenza activity - United States, October 1-November 25, 2017. MMWR Morb Mortal Wkly Rep. 2017;66(48):1318-26.  https://doi.org/10.15585/mmwr.mm6648a2  PMID: 29216030 
  20. Tricco AC, Chit A, Soobiah C, Hallett D, Meier G, Chen MH, et al. Comparing influenza vaccine efficacy against mismatched and matched strains: a systematic review and meta-analysis. BMC Med. 2013;11(1):153.  https://doi.org/10.1186/1741-7015-11-153  PMID: 23800265 
  21. Skowronski DM, Chambers C, Sabaiduc S, De Serres G, Winter AL, Dickinson JA, et al. Beyond antigenic match: possible agent-host and immuno-epidemiological influences on influenza vaccine effectiveness during the 2015-16 season in Canada. J Infect Dis. 2017;216(12):1487-500.  https://doi.org/10.1093/infdis/jix526  PMID: 29029166 
  22. Allen UD, Aoki FY, Evans GA, Laverdiere M, Skowronski DM, Stiver HG. Guidance on use of antiviral drugs given potential low vaccine effectiveness for the 2017-18 season. Ottawa: Association of Medical Microbiology and Infectious Disease Canada. [Accessed: 15 Jan 2018]. Available from: https://www.ammi.ca/Update/79.ENG.pdf

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