Influenza vaccine effectiveness against influenza-related hospitalization during a season with mixed outbreaks of four influenza viruses: a test-negative case-control study ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-12

AUTHORS

Melissa K. Andrew, Vivek Shinde, Todd Hatchette, Ardith Ambrose, Guy Boivin, William Bowie, Ayman Chit, Gael Dos Santos, May ElSherif, Karen Green, François Haguinet, Scott A. Halperin, Barbara Ibarguchi, Jennie Johnstone, Kevin Katz, Joanne M. Langley, Jason LeBlanc, Mark Loeb, Donna MacKinnon-Cameron, Anne McCarthy, Janet McElhaney, Allison McGeer, Michaela K. Nichols, Jeff Powis, David Richardson, Makeda Semret, Grant Stiver, Sylvie Trottier, Louis Valiquette, Duncan Webster, Lingyun Ye, Shelly A. McNeil, on behalf of the Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) Serious Outcomes Surveillance Network and the Toronto Invasive Bacterial Diseases Network (TIBDN)

ABSTRACT

BACKGROUND: The 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. METHODS: This 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. RESULTS: Overall, 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). CONCLUSIONS: These 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 REGISTRATION: ClinicalTrials.gov Identifier: NCT01517191. Registration was retrospective and the date of registration was January 17, 2012. More... »

PAGES

805

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12879-017-2905-8

DOI

http://dx.doi.org/10.1186/s12879-017-2905-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1100105411

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29284435


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463 https://www.grid.ac/institutes/grid.417181.a schema:alternateName Toronto East General Hospital
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478 https://www.grid.ac/institutes/grid.498791.a schema:alternateName William Osler Health System
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482 schema:name Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, B3K 6R8, Halifax, Nova Scotia, Canada
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484 https://www.grid.ac/institutes/grid.86715.3d schema:alternateName Université de Sherbrooke
485 schema:name Université de Sherbrooke, 3001 12th Ave North, J1H 5N4, Sherbrooke, Quebec, Canada
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