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Abstract

Background

In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV).

Aim

To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue.

Methods

This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples.

Results

Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15% (95% confidence interval (CI): −6.3 to 32) against all influenza; −16.4% (95% CI: −59.3 to 14.9) against A(H3N2); 24.7% (95% CI: 1.1 to 42.7) against B and 66.3% (95% CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9% (95% CI: −32.6 to 59.7) against all influenza; −75.5% (95% CI: −289.6 to 21) against A(H3N2); 60.8% (95% CI: 8.2 to 83.3) against B and 90.3% (95% CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9% (95% CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds.

Conclusions

Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.

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2019-08-01
2024-04-24
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End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Richard+Pebody&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pebody Richard</a>, <a href="/search?value1=Abdelmajid+Djennad&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Djennad Abdelmajid</a>, <a href="/search?value1=Joanna+Ellis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ellis Joanna</a>, <a href="/search?value1=Nick+Andrews&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Andrews Nick</a>, <a href="/search?value1=Diogo+F+P+Marques&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marques Diogo F P</a>, <a href="/search?value1=Simon+Cottrell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cottrell Simon</a>, <a href="/search?value1=Arlene+J+Reynolds&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reynolds Arlene J</a>, <a href="/search?value1=Rory+Gunson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gunson Rory</a>, <a href="/search?value1=Monica+Galiano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Galiano Monica</a>, <a href="/search?value1=Katja+Hoschler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoschler Katja</a>, <a href="/search?value1=Angie+Lackenby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lackenby Angie</a>, <a href="/search?value1=Chris+Robertson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Robertson Chris</a>, <a href="/search?value1=Mark+O%E2%80%99Doherty&option1=author&noRedirect=true" class="nonDisambigAuthorLink">O’Doherty Mark</a>, <a href="/search?value1=Mary+Sinnathamby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sinnathamby Mary</a>, <a href="/search?value1=Nikolaos+Panagiotopoulos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Panagiotopoulos Nikolaos</a>, <a href="/search?value1=Ivelina+Yonova&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Yonova Ivelina</a>, <a href="/search?value1=Rebecca+Webb&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Webb Rebecca</a>, <a href="/search?value1=Catherine+Moore&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Moore Catherine</a>, <a href="/search?value1=Matthew+Donati&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Donati Matthew</a>, <a href="/search?value1=Muhammad+Sartaj&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sartaj Muhammad</a>, <a href="/search?value1=Samantha+J+Shepherd&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Shepherd Samantha J</a>, <a href="/search?value1=Jim+McMenamin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McMenamin Jim</a>, <a href="/search?value1=Simon+de+Lusignan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Lusignan Simon</a>, <a href="/search?value1=Maria+Zambon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zambon Maria</a></span>. End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(31):pii=1800488. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 31 Aug 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 11 Jun 2019 </span> </p>
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