Using surveillance data to estimate pandemic vaccine effectiveness against laboratory confirmed influenza A(H1N1)2009 infection: two case-control studies, Spain, season 2009-2010

BMC Public Health

Research Article

Ana Martinez¹  Nuria Torner²  Carolina Rodriguez³  Tomas Vega³  Carmen Quiñones⁴  Milagros Perucha⁴  Pilar Pérez Breña⁵  Francisco Pozo⁵  Inmaculada Casas⁵  Salvador de Mateo⁶  Silvia Jiménez-Jorge⁶  Amparo Larrauri⁶  Camelia Savulescu⁷  Jesús Castilla⁸  Manuel García Cenoz⁸  Jose M Arteagoitia⁹  Antonia Galmés^1,10  Juana M Vanrell^1,10  Julián M Ramos^1,11  Maria C Serrano^1,11  Jone M Altzibar^1,12 

[1] Department of Health, Generalitat of Catalonia, C/Roc Boronat 81-95, 08005, Barcelona, Spain;Department of Health, Generalitat of Catalonia, C/Roc Boronat 81-95, 08005, Barcelona, Spain;Consortium for Biomedical Research in Epidemiology & Public Health, Institute of Health Carlos III, Spain;Dirección General de Salud Pública e Investigación, Desarrollo e Innovación. Consejería de Sanidad de Castilla y León, Paseo Zorrilla 1, 47071, Valladolid, Spain;General Directorate of Public Health and Consumption, Consejería de Salud. La Rioja Government, C/Gran Vía del rey D. Juan Carlos, no 18, 26071, Logroño, Spain;Institute of Health Carlos III, National Centre for Microbiology, National Influenza Centre, 28220, Majadahonda, Madrid, Spain;Institute of Health Carlos III, National Centre of Epidemiology, c/Monforte de Lemos no.5, 28029, Madrid, Spain;Consortium for Biomedical Research in Epidemiology & Public Health, Institute of Health Carlos III, Spain;Institute of Health Carlos III, National Centre of Epidemiology, c/Monforte de Lemos no.5, 28029, Madrid, Spain;EpiConcept, 47, rue de Charenton, 75012, Paris, France;Institute of Public Health of Navarra, Leyre 15, 31003, Pamplona, Spain;Consortium for Biomedical Research in Epidemiology & Public Health, Institute of Health Carlos III, Spain;Public Health Service, Department of Health, Basque Government, C/Donostia-San Sebastian 1, 01010, Vitoria-Gasteiz, Spain;Service of Epidemiology, General Directorate of Public Health, Baleares, c/Cecilio Metelo 18, 07003, Palma de Mallorca, Spain;Sub-directorate of Epidemiology, Public Health Directorate, Avda América 2, 06800, Mérida, Badajoz, Spain;Sub-directorate of Public Health, Gipuzkoa, Avda Navarra 4, 20013, Donostia-San Sebastián, Spain;Consortium for Biomedical Research in Epidemiology & Public Health, Institute of Health Carlos III, Spain;

关键词: Influenza;    Influenza Vaccination;    Pandemic Influenza;    Influenza Like Illness;    Influenza Surveillance;   

DOI  :  10.1186/1471-2458-11-899

 received in 2011-06-16, accepted in 2011-11-30,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPhysicians of the Spanish Influenza Sentinel Surveillance System report and systematically swab patients attended to their practices for influenza-like illness (ILI). Within the surveillance system, some Spanish regions also participated in an observational study aiming at estimating influenza vaccine effectiveness (cycEVA study). During the season 2009-2010, we estimated pandemic influenza vaccine effectiveness using both the influenza surveillance data and the cycEVA study.MethodsWe conducted two case-control studies using the test-negative design, between weeks 48/2009 and 8/2010 of the pandemic season. The surveillance-based study included all swabbed patients in the sentinel surveillance system. The cycEVA study included swabbed patients from seven Spanish regions. Cases were laboratory-confirmed pandemic influenza A(H1N1)2009. Controls were ILI patients testing negative for any type of influenza. Variables collected in both studies included demographic data, vaccination status, laboratory results, chronic conditions, and pregnancy. Additionally, cycEVA questionnaire collected data on previous influenza vaccination, smoking, functional status, hospitalisations, visits to the general practitioners, and obesity. We used logistic regression to calculate adjusted odds ratios (OR), computing pandemic influenza vaccine effectiveness as (1-OR)*100.ResultsWe included 331 cases and 995 controls in the surveillance-based study and 85 cases and 351 controls in the cycEVA study. We detected nine (2.7%) and two (2.4%) vaccine failures in the surveillance-based and cycEVA studies, respectively. Adjusting for variables collected in surveillance database and swabbing month, pandemic influenza vaccine effectiveness was 62% (95% confidence interval (CI): -5; 87). The cycEVA vaccine effectiveness was 64% (95%CI: -225; 96) when adjusting for common variables with the surveillance system and 75% (95%CI: -293; 98) adjusting for all variables collected.ConclusionPoint estimates of the pandemic influenza vaccine effectiveness suggested a protective effect of the pandemic vaccine against laboratory-confirmed influenza A(H1N1)2009 in the season 2009-2010. Both studies were limited by the low vaccine coverage and the late start of the vaccination campaign. Routine influenza surveillance provides reliable estimates and could be used for influenza vaccine effectiveness studies in future seasons taken into account the surveillance system limitations.

【 授权许可】

CC BY   
© Savulescu et al; licensee BioMed Central Ltd. 2011