Influenza vaccine effectiveness against influenza-related hospitalization during a season with mixed outbreaks of four influenza viruses: a test-negative case-control study in adults in Canada

BMC Infectious Diseases

Research Article

Gael Dos Santos¹  Ardith Ambrose²  Michaela K. Nichols²  Lingyun Ye²  Donna MacKinnon-Cameron²  Scott A. Halperin²  Melissa K. Andrew²  Jason LeBlanc²  Todd Hatchette²  May ElSherif²  Shelly A. McNeil²  Joanne M. Langley²  Sylvie Trottier³  Guy Boivin³  Vivek Shinde⁴  Barbara Ibarguchi⁵  François Haguinet⁶  Janet McElhaney⁷  Ayman Chit⁸  Makeda Semret⁹  Jennie Johnstone^1,10  Mark Loeb^1,10  Jeff Powis^1,11  Karen Green^1,12  Allison McGeer^1,12  Kevin Katz^1,13  Duncan Webster^1,14  Anne McCarthy^1,15  William Bowie^1,16  Grant Stiver^1,16  Louis Valiquette^1,17  David Richardson^1,18 

[1] Business & Decision Life Sciences, Bruxelles, Belgium, on behalf of GSK (Wavre, Belgium), Current affiliation: GSK, Wavre, Belgium;Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, B3K 6R8, Halifax, Nova Scotia, Canada;Centre Hospitalier Universitaire de Québec, 2705 Boulevard Laurier, RC-709, G1V 4G2, Québec, Québec, Canada;GSK, King of Prussia, Current affiliation: Novavax Vaccines, Washington, DC, USA;GSK, Mississauga, Ontario, Canada, Current affiliation: Bayer Inc, Mississauga, Ontario, Canada;GSK, Wavre, Belgium;Health Sciences North Research Institute, 41 Ramsey Lake Rd, P3E 5J1, Sudbury, Ontario, Canada;Leslie Dan Faculty of Pharmacy, University of Toronto, Current affiliation: Sanofi Pasteur, Swiftwater, Pennsylvania, USA;McGill University, McGill University Health Centre, Glen Site, 1001 Decarie Blvd, H4A 3J1, Montreal, Quebec, Canada;McMaster University, Michael G. DeGroote Centre for Learning, 1200 Main Street West, Room 3208, L8S 4K1, Hamilton, Ontario, Canada;Michael Garron Hospital, 825 Coxwell Ave, M4C 3E7, Toronto, Ontario, Canada;Mount Sinai Hospital, 600 University Ave, Room 210, M5G 1X5, Toronto, Ontario, Canada;North York General Hospital, 4001 Leslie St, M2K 1E1, Toronto, Ontario, Canada;Saint John Regional Hospital, Dalhousie University, 400 University Ave, E2L 4L2, Saint John, New Brunswick, Canada;The Ottawa Hospital, Ottawa Hospital Civic Campus, 1053 Carling Ave, K1Y 4E9, Ottawa, Ontario, Canada;University of British Columbia, 452D, Heather Pavilion East, VGH, 2733 Heather Street, V5Z 3J5, Vancouver, British Columbia, Canada;Université de Sherbrooke, 3001 12th Ave North, J1H 5N4, Sherbrooke, Quebec, Canada;William Osler Health System, Department of Infectious Diseases and Medical Microbiology, 2100 Bovaird Dr East, L6R 3J7, Brampton, Ontario, Canada;

关键词: Influenza;    Vaccine;    Effectiveness;    Adults;    Hospitalization;   

DOI  :  10.1186/s12879-017-2905-8

 received in 2017-06-22, accepted in 2017-12-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe Serious Outcomes Surveillance (SOS) Network was established to monitor seasonal influenza complications among hospitalized Canadian adults and to assess the effectiveness of influenza vaccination against severe outcomes. Here we report age- and strain-specific vaccine effectiveness (VE) in preventing severe outcomes during a season characterized by mixed outbreaks of four different influenza strains.MethodsThis prospective, multicentre, test-negative case-control study evaluated the VE of trivalent influenza vaccine (TIV) in the prevention of laboratory-confirmed influenza-hospitalization in adults aged ≥16 years (all adults) and adults aged 16–64 years (younger adults). The SOS Network identified hospitalized patients with diagnoses potentially attributable to influenza during the 2011/12 influenza season. Swabs collected at admission were tested by reverse transcriptase polymerase chain reaction (RT PCR) or viral culture to discriminate influenza cases (positive) from controls (negative). VE was calculated as 1-odds ratio (OR) of vaccination in cases versus controls × 100.ResultsOverall, in all adults, the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 41.8% (95% Confidence Interval [CI]: 26.0, 54.3), and 42.8% (95% CI: 23.8, 57.0), respectively. In younger adults (16–64 years), the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 35.8% (95% CI: 4.5, 56.8) and 33.2% (95% CI: −6.7, 58.2), respectively. In the all adults group, adjusted VE against influenza A/H1N1 was 72.5% (95% CI: 30.5, 89.1), against A/H3N2 was 86.1% (95% CI: 40.1, 96.8), against B/Victoria was 40.5% (95% CI: −28.9, 72.6), and against B/Yamagata was 32.3% (95% CI: −8.3, 57.7). The adjusted estimate of early season VE (from November 1 to March 11) was 54.4% (95% CI: 29.7–70.4), which was higher than late season (from March 11 to May 25) VE estimate (VE: 29.7%, 95% CI: -5.3, 53.1).ConclusionsThese results suggest that TIV was highly effective against A viruses and moderately effective against B viruses during a mild season characterised by co-circulation of four influenza strains in Canada. Findings underscore the need to provide VE assessment by subtype/lineage as well as the timing of vaccination (early season vs late season) to accurately evaluate vaccine performance and thus guide public health decision-making.Trial registrationClinicalTrials.gov Identifier: NCT01517191. Registration was retrospective and the date of registration was January 17, 2012.

【 授权许可】

CC BY   
© The Author(s). 2017