1887
Research Open Access
Like 0

Abstract

Background

Most reports of influenza vaccine effectiveness consider current-season vaccination only.

Aim

We evaluated a method to estimate the effect of influenza vaccinations (EIV) considering vaccination history.

Methods

We used a test-negative design with well-documented vaccination history to evaluate the average EIV over eight influenza seasons (2011/12–2018/19; n = 10,356). Modifying effect was considered as difference in effects of vaccination in current and previous seasons and current-season vaccination only. We also explored differences between current-season estimates excluding from the reference category people vaccinated in any of the five previous seasons and estimates without this exclusion or only for one or three previous seasons.

Results

The EIV was 50%, 45% and 38% in people vaccinated in the current season who had previously received none, one to two and three to five doses, respectively, and it was 30% and 43% for one to two and three to five prior doses only. Vaccination in at least three previous seasons reduced the effect of current-season vaccination by 12 percentage points overall, 31 among outpatients, 22 in 9–65 year-olds, and 23 against influenza B. Including people vaccinated in previous seasons only in the unvaccinated category underestimated EIV by 9 percentage points on average (31% vs 40%). Estimates considering vaccination of three or five previous seasons were similar.

Conclusions

Vaccine effectiveness studies should consider influenza vaccination in previous seasons, as it can retain effect and is often an effect modifier. Vaccination status in three categories (current season, previous seasons only, unvaccinated) reflects the whole EIV.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.32.2001099
2021-08-12
2021-09-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.32.2001099
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/26/32/eurosurv-26-32-2.html?itemId=/content/10.2807/1560-7917.ES.2021.26.32.2001099&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). Influenza (seasonal). Geneva: WHO; 2018. Available from: https://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)
  2. Aguilar I, Reyes M, Martínez-Baz I, Guevara M, Albeniz E, Belza M, et al. Use of the vaccination register to evaluate influenza vaccine coverage in seniors in the 2010/11 influenza season, Navarre, Spain. Euro Surveill. 2012;17(17):20154.  https://doi.org/10.2807/ese.17.17.20154-en  PMID: 22551499 
  3. 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):1-14.  https://doi.org/10.1080/14760584.2017.1334554  PMID: 28562111 
  4. Kwong JC, Chung H, Jung JK, Buchan SA, Campigotto A, Campitelli MA, et al. The impact of repeated vaccination using 10-year vaccination history on protection against influenza in older adults: a test-negative design study across the 2010/11 to 2015/16 influenza seasons in Ontario, Canada. Euro Surveill. 2020;25(1):1900245.  https://doi.org/10.2807/1560-7917.ES.2020.25.1.1900245  PMID: 31937397 
  5. Martínez-Baz I, Navascués A, Casado I, Aguinaga A, Ezpeleta C, Castilla J. Remaining effect of influenza vaccines received in prior seasons. J Infect Dis. 2019;220(7):1136-40.  https://doi.org/10.1093/infdis/jiz266  PMID: 31107953 
  6. Martínez-Baz I, Casado I, Navascués A, Díaz-González J, Aguinaga A, Barrado L, et al. Effect of repeated vaccination with the same vaccine component against 2009 pandemic influenza A(H1N1) virus. J Infect Dis. 2017;215(6):847-55.  https://doi.org/10.1093/infdis/jix055  PMID: 28453845 
  7. 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 
  8. Castilla J, Navascués A, Casado I, Díaz-González J, Pérez-García A, Fernandino L, et al. Combined effectiveness of prior and current season influenza vaccination in northern Spain: 2016/17 mid-season analysis. Euro Surveill. 2017;22(7):30465.  https://doi.org/10.2807/1560-7917.ES.2017.22.7.30465  PMID: 28230523 
  9. Sullivan SG, Tchetgen Tchetgen EJ, Cowling BJ. Theoretical basis of the test-negative study design for assessment of influenza vaccine effectiveness. Am J Epidemiol. 2016;184(5):345-53.  https://doi.org/10.1093/aje/kww064  PMID: 27587721 
  10. Foppa IM, Ferdinands JM, Chung J, Flannery B, Fry AM. Vaccination history as a confounder of studies of influenza vaccine effectiveness. Vaccine X. 2019;1:100008.  https://doi.org/10.1016/j.jvacx.2019.100008  PMID: 31384730 
  11. Ainslie KEC, Haber M, Orenstein WA. Challenges in estimating influenza vaccine effectiveness. Expert Rev Vaccines. 2019;18(6):615-28.  https://doi.org/10.1080/14760584.2019.1622419  PMID: 31116070 
  12. Belongia EA, Simpson MD, King JP, Sundaram ME, Kelley NS, Osterholm MT, et al. Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. Lancet Infect Dis. 2016;16(8):942-51.  https://doi.org/10.1016/S1473-3099(16)00129-8  PMID: 27061888 
  13. Ramsay LC, Buchan SA, Stirling RG, Cowling BJ, Feng S, Kwong JC, et al. The impact of repeated vaccination on influenza vaccine effectiveness: a systematic review and meta-analysis. BMC Med. 2019;17(1):9.  https://doi.org/10.1186/s12916-018-1239-8  PMID: 30626399 
  14. World Health Organization (WHO). Evaluation of influenza vaccine effectiveness: a guide to the design and interpretation of observational studies. Geneva: WHO; 2017. Available from: https://apps.who.int/iris/bitstream/handle/10665/255203/9789241512121-eng.pdf;jsessionid=BF8E8B943503324D3B7CF47325EABD46?sequence=1
  15. Castilla J, Morán J, Martínez-Artola V, Fernández-Alonso M, Guevara M, Cenoz MG, et al. Effectiveness of the monovalent influenza A(H1N1)2009 vaccine in Navarre, Spain, 2009-2010: cohort and case-control study. Vaccine. 2011;29(35):5919-24.  https://doi.org/10.1016/j.vaccine.2011.06.063  PMID: 21723358 
  16. Martínez-Baz I, Martínez-Artola V, Reina G, Guevara M, Cenoz MG, Morán J, et al. Effectiveness of the trivalent influenza vaccine in Navarre, Spain, 2010-2011: a population-based test-negative case-control study. BMC Public Health. 2013;13(1):191.  https://doi.org/10.1186/1471-2458-13-191  PMID: 23496887 
  17. Martínez-Baz I, Navascués A, Pozo F, Chamorro J, Albeniz E, Casado I, et al. Influenza vaccine effectiveness in preventing inpatient and outpatient cases in a season dominated by vaccine-matched influenza B virus. Hum Vaccin Immunother. 2015;11(7):1626-33.  https://doi.org/10.1080/21645515.2015.1038002  PMID: 25996366 
  18. Castilla J, Navascués A, Fernández-Alonso M, Reina G, Albéniz E, Pozo F, et al. Effects of previous episodes of influenza and vaccination in preventing laboratory-confirmed influenza in Navarre, Spain, 2013/14 season. Euro Surveill. 2016;21(22):30243.  https://doi.org/10.2807/1560-7917.ES.2016.21.22.30243  PMID: 27277013 
  19. Castilla J, Navascués A, Fernández-Alonso M, Reina G, Pozo F, Casado I, et al. Effectiveness of subunit influenza vaccination in the 2014-2015 season and residual effect of split vaccination in previous seasons. Vaccine. 2016;34(11):1350-7.  https://doi.org/10.1016/j.vaccine.2016.01.054  PMID: 26854911 
  20. Castilla J, Martínez-Baz I, Navascués A, Casado I, Aguinaga A, Díaz-González J, et al. , Primary Health Care Sentinel Network Of Navarre, Network For Influenza Surveillance In Hospitals Of Navarre. Comparison of influenza vaccine effectiveness in preventing outpatient and inpatient influenza cases in older adults, northern Spain, 2010/11 to 2015/16. Euro Surveill. 2018;23(2):16-00780.  https://doi.org/10.2807/1560-7917.ES.2018.23.2.16-00780  PMID: 29338809 
  21. Castilla J, Navascués A, Casado I, Pérez-García A, Aguinaga A, Ezpeleta G, et al. , Primary Health Care Sentinel Network, Network For Influenza Surveillance In Hospitals Of Navarre. Interim effectiveness of trivalent influenza vaccine in a season dominated by lineage mismatched influenza B, northern Spain, 2017/18. Euro Surveill. 2018;23(7):18-00057.  https://doi.org/10.2807/1560-7917.ES.2018.23.7.18-00057  PMID: 29471624 
  22. Martínez-Baz I, Navascués A, Portillo ME, Casado I, Fresán U, Ezpeleta C, et al. Effect of influenza vaccination in preventing laboratory-confirmed influenza hospitalization in patients with diabetes mellitus. Clin Infect Dis. 2021;73(1):107-14.  https://doi.org/10.1093/cid/ciaa564  PMID: 32412600 
  23. Greenland S, Pearce N. Statistical foundations for model-based adjustments. Annu Rev Public Health. 2015;36(1):89-108.  https://doi.org/10.1146/annurev-publhealth-031914-122559  PMID: 25785886 
  24. Valenciano M, Kissling E, Larrauri A, Nunes B, Pitigoi D, O’Donnell J, et al. Exploring the effect of previous inactivated influenza vaccination on seasonal influenza vaccine effectiveness against medically attended influenza: Results of the European I-MOVE multicentre test-negative case-control study, 2011/2012-2016/2017. Influenza Other Respir Viruses. 2018;12(5):567-81.  https://doi.org/10.1111/irv.12562  PMID: 29659149 
  25. Ohmit SE, Thompson MG, Petrie JG, Thaker SN, Jackson ML, Belongia EA, et al. Influenza vaccine effectiveness in the 2011-2012 season: protection against each circulating virus and the effect of prior vaccination on estimates. Clin Infect Dis. 2014;58(3):319-27.  https://doi.org/10.1093/cid/cit736  PMID: 24235265 
  26. Skowronski DM, Janjua NZ, Sabaiduc S, De Serres G, Winter AL, Gubbay JB, et al. Influenza A/subtype and B/lineage effectiveness estimates for the 2011-2012 trivalent vaccine: cross-season and cross-lineage protection with unchanged vaccine. J Infect Dis. 2014;210(1):126-37.  https://doi.org/10.1093/infdis/jiu048  PMID: 24446529 
  27. Ohmit SE, Petrie JG, Malosh RE, Fry AM, Thompson MG, Monto AS. Influenza vaccine effectiveness in households with children during the 2012-2013 season: assessments of prior vaccination and serologic susceptibility. J Infect Dis. 2015;211(10):1519-28.  https://doi.org/10.1093/infdis/jiu650  PMID: 25416812 
  28. Gherasim A, Martínez-Baz I, Castilla J, Pozo F, Larrauri A, cycEVA working group. Effect of previous and current vaccination against influenza A(H1N1)pdm09, A(H3N2), and B during the post-pandemic period 2010-2016 in Spain. PLoS One. 2017;12(6):e0179160.  https://doi.org/10.1371/journal.pone.0179160  PMID: 28614376 
  29. Nichols MK, Andrew MK, Ye L, Hatchette TF, Ambrose A, Boivin G, et al. The impact of prior season vaccination on subsequent influenza vaccine effectiveness to prevent influenza-related hospitalizations over 4 influenza seasons in Canada. Clin Infect Dis. 2019;69(6):970-9.  https://doi.org/10.1093/cid/ciy1009  PMID: 30508064 
  30. Castilla J, Martínez-Baz I, Godoy P, Toledo D, Astray J, García S, et al. Trends in influenza vaccine coverage among primary healthcare workers in Spain, 2008-2011. Prev Med. 2013;57(3):206-11.  https://doi.org/10.1016/j.ypmed.2013.05.021  PMID: 23732251 
  31. Petrie JG, Ohmit SE, Johnson E, Truscon R, Monto AS. Persistence of antibodies to influenza hemagglutinin and neuraminidase following one or two years of influenza vaccination. J Infect Dis. 2015;212(12):1914-22.  https://doi.org/10.1093/infdis/jiv313  PMID: 26014800 
  32. Valenciano M, Kissling E, Ciancio BC, Moren A. Study designs for timely estimation of influenza vaccine effectiveness using European sentinel practitioner networks. Vaccine. 2010;28(46):7381-8.  https://doi.org/10.1016/j.vaccine.2010.09.010  PMID: 20851086 
  33. Sullivan SG, Kelly H. Stratified estimates of influenza vaccine effectiveness by prior vaccination: caution required. Clin Infect Dis. 2013;57(3):474-6.  https://doi.org/10.1093/cid/cit255  PMID: 23619811 
  34. Foppa IM, Ferdinands JM, Chaves SS, Haber MJ, Reynolds SB, Flannery B, et al. The case test-negative design for studies of the effectiveness of influenza vaccine in inpatient settings. Int J Epidemiol. 2016;45(6):2052-9.  https://doi.org/10.1093/ije/dyw022  PMID: 26979985 
/content/10.2807/1560-7917.ES.2021.26.32.2001099
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