1887
Research Open Access
Like 0

Abstract

Introduction

Influenza immunisation is recommended for elderly people each season. The influenza vaccine effectiveness (IVE) varies annually due to influenza viruses evolving and the vaccine composition.

Aim

To estimate, in inpatients ≥ 60 years old, the 2017/18 trivalent IVE, overall, by vaccine type and by strain. The impact of vaccination in any of the two previous seasons (2016/17 and 2015/16) on current (2017/18) IVE was also explored.

Methods

This was a multicentre prospective observational study within the Valencia Hospital Surveillance Network for the Study of Influenza and Respiratory Viruses Disease (VAHNSI, Spain). The test-negative design was applied taking laboratory-confirmed influenza as outcome and vaccination status as main exposure. Information about potential confounders was obtained from clinical registries and/or by interviewing patients; vaccine information was only ascertained by registries.

Results

Overall, 2017/18 IVE was 9.9% (95% CI: −15.5 to 29.6%), and specifically, 48.3% (95% CI: 13.5% to 69.1%), −29.9% (95% CI: −79.1% to 5.8%) and 25.7% (95% CI: −8.8% to 49.3%) against A(H1N1)pdm09, A(H3N2) and B/Yamagata lineage, respectively. For the adjuvanted and non-adjuvanted vaccines, overall IVE was 10.0% (95% CI: −24.4% to 34.9%) and 7.8% (95% CI: −23.1% to 31.0%) respectively. Prior vaccination significantly protected against influenza B/Yamagata lineage (IVE: 50.2%; 95% CI: 2.3% to 74.6%) in patients not vaccinated in the current season. For those repeatedly vaccinated against influenza A(H1N1)pdm09, IVE was 46.4% (95% CI: 6.8% to 69.2%).

Conclusion

Our data revealed low vaccine effectiveness against influenza in hospitalised patients ≥60 years old in 2017/18. Prior vaccination protected against influenza A(H1N1)pdm09 and B/Yamagata-lineage.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2019.24.31.1800461
2019-08-01
2024-11-05
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.31.1800461
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/24/31/eurosurv-24-31-2.html?itemId=/content/10.2807/1560-7917.ES.2019.24.31.1800461&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). Vaccines against influenza WHO position paper – November 2012. Wkly Epidemiol Rec. 2012;87(47):461-76. PMID: 23210147 
  2. Simonsen L, Clarke MJ, Schonberger LB, Arden NH, Cox NJ, Fukuda K. Pandemic versus epidemic influenza mortality: a pattern of changing age distribution. J Infect Dis. 1998;178(1):53-60.  https://doi.org/10.1086/515616  PMID: 9652423 
  3. Simonsen L, Reichert TA, Viboud C, Blackwelder WC, Taylor RJ, Miller MA. Impact of influenza vaccination on seasonal mortality in the US elderly population. Arch Intern Med. 2005;165(3):265-72.  https://doi.org/10.1001/archinte.165.3.265  PMID: 15710788 
  4. Webster RG, Bean WJ, Gorman OT, Chambers TM, Kawaoka Y. Evolution and ecology of influenza A viruses. Microbiol Rev. 1992;56(1):152-79. PMID: 1579108 
  5. World Health Organization (WHO). Composition recommandée des vaccins antigrippaux pour la saison grippale 2017-2018 dans l’hémisphère Nord. [Recommended composition of influenza virus vaccines for use in the 2017–2018 northern hemisphere influenza season]. Wkly Epidemiol Rec. 2017;92(11):117-28. PMID: 28303704 
  6. Rondy M, Gherasim A, Casado I, Launay O, Rizzo C, Pitigoi D, et al. Low 2016/17 season vaccine effectiveness against hospitalised influenza A(H3N2) among elderly: awareness warranted for 2017/18 season. Euro Surveill. 2017;22(41):17-00645.  https://doi.org/10.2807/1560-7917.ES.2017.22.41.17-00645  PMID: 29043961 
  7. European Centre for Disease Prevention and Control (ECDC)/World Health Organization (WHO) Regional Office for Europe. Flu News Europe, Joint ECDC–WHO weekly influenza update, week 20/2018. Geneva: WHO; Stockholm: ECDC. [Accessed 5 Feb 2019]. Available from: https://flunewseurope.org/Archives
  8. Adlhoch C, Snacken R, Melidou A, Ionescu S, Penttinen PThe European Influenza Surveillance Network. Dominant influenza A(H3N2) and B/Yamagata virus circulation in EU/EEA, 2016/17 and 2017/18 seasons, respectively. Euro Surveill. 2018;23(13):1800146.  https://doi.org/10.2807/1560-7917.ES.2018.23.13.18-00146  PMID: 29616611 
  9. European Centre for Disease Prevention and Control (ECDC)/World Health Organization (WHO) Regional Office for Europe. Flu News Europe, Joint ECDC–WHO weekly influenza update, week 18/2018. Geneva: WHO; Stockholm: ECDC. [Accessed 5 Feb 2019]. Available from: https://flunewseurope.org/Archives
  10. Castilla J, Navascués A, Casado I, Pérez-García A, Aguinaga A, Ezpeleta G, et al. Interim effectiveness of trivalent influenza vaccine in a season dominated by lineage mismatched influenza B, northern Spain, 2017/18. Euro Surveill. 2018;23(7):1800057.  https://doi.org/10.2807/1560-7917.ES.2018.23.7.18-00057  PMID: 29471624 
  11. Rondy M, Kissling E, Emborg HD, Gherasim A, Pebody R, Trebbien R, et al. Interim 2017/18 influenza seasonal vaccine effectiveness: combined results from five European studies. Euro Surveill. 2018;23(9):1800086.  https://doi.org/10.2807/1560-7917.ES.2018.23.9.18-00086  PMID: 29510782 
  12. Belongia EA, Skowronski DM, McLean HQ, Chambers C, Sundaram ME, De Serres G. Repeated annual influenza vaccination and vaccine effectiveness: review of evidence. Expert Rev Vaccines. 2017;16(7): 723-36.  https://doi.org/10.1080/14760584.2017.1334554  PMID: 28562111 
  13. Skowronski DM, Chambers C, De Serres G, Sabaiduc S, Winter AL, Dickinson JA, et al. Serial vaccination and the antigenic distance hypothesis: Effects on influenza vaccine effectiveness during A(H3N2) epidemics in Canada, 2010-11 to 2014-15. J Infect Dis. 2017;215(7):1059-99.  https://doi.org/10.1093/infdis/jix074  PMID: 28180277 
  14. Rondy M, Launay O, Castilla J, Costanzo S, Puig-Barberà J, Gefenaite G, et al. Repeated seasonal influenza vaccination among elderly in Europe: Effects on laboratory confirmed hospitalised influenza. Vaccine. 2017;35(34):4298-306.  https://doi.org/10.1016/j.vaccine.2017.06.088  PMID: 28709555 
  15. Zhang L, Yang P, Thompson MG, Pan Y, Ma C, Wu S, et al. Influenza vaccine effectiveness in preventing influenza illness among children during school-based outbreaks in the 2014-2015 season in Beijing, China. Pediatr Infect Dis J. 2017;36(3):e69-75.  https://doi.org/10.1097/INF.0000000000001434  PMID: 27902651 
  16. McLean HQ, Thompson MG, Sundaram ME, Meece JK, McClure DL, Friedrich TC, et al. Impact of repeated vaccination on vaccine effectiveness against influenza A(H3N2) and B during 8 seasons. Clin Infect Dis. 2014;59(10):1375-85.  https://doi.org/10.1093/cid/ciu680  PMID: 25270645 
  17. Shim E, Smith KJ, Nowalk MP, Raviotta JM, Brown ST, DePasse J, et al. Impact of seasonal influenza vaccination in the presence of vaccine interference. Vaccine. 2018;36(6):853-8.  https://doi.org/10.1016/j.vaccine.2017.12.067  PMID: 29329684 
  18. Cheng AC, Macartney KK, Waterer GW, Kotsimbos T, Kelly PM, Blyth CC, et al. Repeated Vaccination Does Not Appear to Impact Upon Influenza Vaccine Effectiveness Against Hospitalization With Confirmed Influenza. Clin Infect Dis. 2017;64(11):1564-72.  https://doi.org/10.1093/cid/cix209  PMID: 28329167 
  19. Casado I, Domínguez Á, Toledo D, Chamorro J, Astray J, Egurrola M, et al. Repeated influenza vaccination for preventing severe and fatal influenza infection in older adults: a multicentre case-control study. CMAJ. 2018;190(1):E3-12.  https://doi.org/10.1503/cmaj.170910  PMID: 29311098 
  20. Puig-Barberà J, Arnedo-Pena A, Pardo-Serrano F, Tirado-Balaguer MD, Pérez-Vilar S, Silvestre-Silvestre E, et al. Effectiveness of seasonal 2008-2009, 2009-2010 and pandemic vaccines, to prevent influenza hospitalizations during the autumn 2009 influenza pandemic wave in Castellón, Spain. A test-negative, hospital-based, case-control study. Vaccine. 2010;28(47):7460-7.  https://doi.org/10.1016/j.vaccine.2010.09.042  PMID: 20875486 
  21. Puig-Barberà J, García-de-Lomas J, Díez-Domingo J, Arnedo-Pena A, Ruiz-García M, Limón-Ramírez R, et al. Influenza vaccine effectiveness in preventing influenza A(H3N2)-related hospitalizations in adults targeted for vaccination by type of vaccine: a hospital-based test-negative study, 2011-2012 A(H3N2) predominant influenza season, Valencia, Spain. PLoS One. 2014;9(11):e112294.  https://doi.org/10.1371/journal.pone.0112294  PMID: 25392931 
  22. Puig-Barberà J, Mira-Iglesias A, Tortajada-Girbes M, López-Labrador FX, Belenguer-Varea A, Carballido-Fernández M, et al. Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results. Euro Surveill. 2015;20(8):21044.  https://doi.org/10.2807/1560-7917.ES2015.20.8.21044  PMID: 25742432 
  23. European Commission. Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (notified under document C(2012) 5538). Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 27.9.2012:L 262/16. [Accessed 5 Feb 2019]. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32012D0506&qid=1428573336660&from=EN#page=16
  24. Puig-Barberà J, Natividad-Sancho A, Calabuig-Pérez J, Lluch-Rodrigo JA, Pastor-Villalba E, Martínez-Úbeda S, et al. MF59-adjuvanted and virosomal influenza vaccines for preventing influenza hospitalization in older people: comparative effectiveness using the Valencia health care information system. Vaccine. 2013;31(37):3995-4002.  https://doi.org/10.1016/j.vaccine.2013.05.070  PMID: 23731629 
  25. World Health Organization (WHO). Real-time PCR group protocol #2, WHO molecular diagnosis of influenza virus in humans, November 2012 update. November 2012. [Accessed 16 Jan 2014]. Available from: http://www.who.int/influenza/gisrs_laboratory/molecular_diagnosis_influenza_virus_humans_update_201211.pdf
  26. He J, Bose ME, Beck ET, Fan J, Tiwari S, Metallo J, et al. Rapid multiplex reverse transcription-PCR typing of influenza A and B virus, and subtyping of influenza A virus into H1, 2, 3, 5, 7, 9, N1 (human), N1 (animal), N2, and N7, including typing of novel swine origin influenza A (H1N1) virus, during the 2009 outbreak in Milwaukee, Wisconsin. J Clin Microbiol. 2009;47(9):2772-8.  https://doi.org/10.1128/JCM.00998-09  PMID: 19641063 
  27. Suwannakarn K, Payungporn S, Chieochansin T, Samransamruajkit R, Amonsin A, Songserm T, et al. Typing (A/B) and subtyping (H1/H3/H5) of influenza A viruses by multiplex real-time RT-PCR assays. J Virol Methods. 2008;152(1-2):25-31.  https://doi.org/10.1016/j.jviromet.2008.06.002  PMID: 18598722 
  28. World Health Organization (WHO). WHO molecular diagnosis of influenza virus in humans, August 2011 update. August 2011. [Accessed Aug 2014]. Available from: http://www.who.int/influenza/resources/documents/molecular_diagnosis_influenza_virus_humans_update_201108.pdf
  29. Guindon S, Dufayard JF, Lefort V, Anisimova M, Hordijk W, Gascuel O. New algorithms and methods to estimate maximum-likelihood phylogenies: assessing the performance of PhyML 3.0. Syst Biol. 2010;59(3):307-21.  https://doi.org/10.1093/sysbio/syq010  PMID: 20525638 
  30. Jackson ML, Nelson JC. The test-negative design for estimating influenza vaccine effectiveness. Vaccine. 2013;31(17):2165-8.  https://doi.org/10.1016/j.vaccine.2013.02.053  PMID: 23499601 
  31. Sullivan SG, Feng S, Cowling BJ. Potential of the test-negative design for measuring influenza vaccine effectiveness: a systematic review. Expert Rev Vaccines. 2014;13(12):1571-91.  https://doi.org/10.1586/14760584.2014.966695  PMID: 25348015 
  32. Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G. Indicators of socioeconomic position (part 2). J Epidemiol Community Health. 2006;60(2):95-101.  https://doi.org/10.1136/jech.2004.028092  PMID: 16415256 
  33. European Centre for Disease Prevention and Control (ECDC)/World Health Organization (WHO) Regional Office for Europe. Flu News Europe, Joint ECDC–WHO weekly influenza update, week 48/2018. Geneva: WHO; Stockhom: ECDC. [Accessed 5 Feb 2019]. Available from: https://flunewseurope.org/Archives
  34. Mira-Iglesias A, López-Labrador FX, Guglieri-López B, Tortajada-Girbés M, Baselga-Moreno V, Cano L, et al. Influenza vaccine effectiveness in preventing hospitalisation of individuals 60 years of age and over with laboratory-confirmed influenza, Valencia Region, Spain, influenza season 2016/17. Euro Surveill. 2018;23(8):17-00318.  https://doi.org/10.2807/1560-7917.ES.2018.23.8.17-00318  PMID: 29486829 
  35. Puig-Barberà J, Guglieri-López B, Tortajada-Girbés M, López-Labrador FX, Carballido-Fernández M, Mollar-Maseres J, et al. Low influenza vaccine effectiveness and the effect of previous vaccination in preventing admission with A(H1N1)pdm09 or B/Victoria-Lineage in patients 60 years old or older during the 2015/2016 influenza season. Vaccine. 2017;35(52):7331-8.  https://doi.org/10.1016/j.vaccine.2017.10.100  PMID: 29128380 
  36. Skowronski DM, Chambers C, De Serres G, Dickinson JA, Winter AL, Hickman R, et al. Early season co-circulation of influenza A(H3N2) and B(Yamagata): interim estimates of 2017/18 vaccine effectiveness, Canada, January 2018. Euro Surveill. 2018;23(5):1800035.  https://doi.org/10.2807/1560-7917.ES.2018.23.5.18-00035  PMID: 29409570 
  37. Instituto de Salud Carlos III (ISCIII). Informe Semanal del Sistema de Vigilancia de la Gripe en España (SVGE). [Weekly Report of the Influenza Surveillance System in Spain]. Week 17/2018 (23 to 29 April). Published on 3 May 2018 (N. 543). Spanish. [Accessed 10 May 2018]. Available from: http://vgripe.isciii.es/inicio.do
  38. Public Health England (PHE). Weekly National Influenza Report. Week 18 report (up to week 17 data); 3 May 2018. [Accessed 10 May 2018]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/704664/Weekly_national_influenza_report_week_18_2018.pdf
  39. The Francis Crick Institute. Reported prepared for the WHO annual consultation on the composition of influenza vaccine for the Northern Hemisphere 2018-2019. London: The Francis Crick Institute;2018. [Accessed 10 May 2018]. Available from: https://www.crick.ac.uk/media/409431/crick_feb2018_report_for_the_web.pdf
  40. World Health Organization (WHO). Recommended composition of influenza virus vaccines for use in the 2018-2019 northern hemisphere influenza season – full report. Geneva: WHO. [Accessed 19 Jun 2018]. Available from: http://www.who.int/influenza/vaccines/virus/recommendations/201802_recommendation.pdf?ua=1
  41. Mosterín Höpping A, Fonville JM, Russell CA, James S, Smith DJ. Influenza B vaccine lineage selection--an optimized trivalent vaccine. Vaccine. 2016;34(13):1617-22.  https://doi.org/10.1016/j.vaccine.2016.01.042  PMID: 26896685 
  42. van de Sandt CE, Dou Y, Vogelzang-van Trierum SE, Westgeest KB, Pronk MR, Osterhaus ADME, et al. Influenza B virus-specific CD8+ T-lymphocytes strongly cross-react with viruses of the opposing influenza B lineage. J Gen Virol. 2015;96(8):2061-73.  https://doi.org/10.1099/vir.0.000156  PMID: 25900135 
  43. Laurie KL, Horman W, Carolan LA, Chan KF, Layton D, Bean A, et al. Evidence for Viral Interference and Cross-reactive Protective Immunity Between Influenza B Virus Lineages. J Infect Dis. 2018;217(4):548-59.  https://doi.org/10.1093/infdis/jix509  PMID: 29325138 
  44. 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):1700707.  https://doi.org/10.2807/1560-7917.ES.2017.22.43.17-00707  PMID: 29090681 
  45. Pebody R, Warburton F, Ellis J, Andrews N, Potts A, Cottrell S, et al. End-of-season influenza vaccine effectiveness in adults and children, United Kingdom, 2016/17. Euro Surveill. 2017;22(44):1700306.  https://doi.org/10.2807/1560-7917.ES.2017.22.44.17-00306  PMID: 29113630 
  46. Ikonen N, Murtopuro S, Haveri A, Virtanen MJ, Baum U, Isoniemelä Y, et al. Influenssakausi Suomessa, viikot 40/2017-20/2018. Available from: http://www.julkari.fi/bitstream/handle/10024/136791/URN_ISBN_978-952-343-159-1.pdf?sequence=1&isAllowed=y
  47. Butler AM, Layton JB, Krueger WS, Kshirsagar AV, McGrath LJ. Assessing Residual Bias in Estimating Influenza Vaccine Effectiveness: Comparison of High-dose Versus Standard-dose Vaccines. Med Care. 2019;57(1):73-8.  https://doi.org/10.1097/MLR.0000000000001018  PMID: 30422840 
  48. Lund JL, Richardson DB, Stürmer T. The active comparator, new user study design in pharmacoepidemiology: historical foundations and contemporary application. Curr Epidemiol Rep. 2015;2(4):221-8.  https://doi.org/10.1007/s40471-015-0053-5  PMID: 26954351 
  49. Ellis PD. The essential guide to effect sizes: statistical power, meta-analysis, and the interpretation of research results. Cambridge; New York: Cambridge University Press; 2010.
/content/10.2807/1560-7917.ES.2019.24.31.1800461
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error