Component-Specific Effectiveness of Trivalent Influenza Vaccine as Monitored through a Sentinel Surveillance Network in Canada, 2006-2007
Component-Specific Effectiveness of Trivalent Influenza Vaccine as Monitored through a Sentinel Surveillance Network in Canada, 2006-2007
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DOI：
10.1086/595862
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发表时间：
2009-01-15
影响因子：
6.4
通讯作者：
Li, Yan
中科院分区：
文献类型：
--
作者：
Skowronski, Danuta M.;De Serres, Gaston;Li, Yan
背景每年重新配制三价灭活流感疫苗（TIV），以包含2种甲型流感亚型（H1 N1和H3 N2）和1种B谱系（Yamagata或维多利亚）的代表性毒株。我们描述了一种哨点监测方法，将流感病毒变异检测与特定成分疫苗有效性（VE）估计联系起来。2006-2007年TIV包括A/NewCaledonia/20/1999（H1N1）样、A/威斯康星州/67/2005（H3 N2）样和B/Malaysia/2506/2004（维多利亚）样组分。纳入的受试者是2006年11月至2007年4月期间在流感样疾病发作后1周内向哨点医生就诊的≥ 9岁的个体。通过实时逆转录聚合酶链反应和/或培养鉴定流感。用血凝抑制试验（HI）和HA 1基因测序对分离株进行鉴定。VE估计为1-[接种疫苗与未接种疫苗人群流感的比值比]。共有841名参与者提供了资料：69名（8%）年龄≥ 65岁; 166名（20%）接受了2006-2007年的TIV。在337例受试者（40%）中检测到流感，分布如下：A/H3 N2，242例（72%）; A/H1N1，55例（16%）;和B，36例（11%）。除1个分离株外，所有A/H1N1分离株均匹配良好，一半A/H3 N2分离株为毒株错配，所有B分离株均与疫苗在谱系水平错配。A/H1N1、A/H3 N2和B组分的经校正估计VE分别为92%（95% CI，40%-91%）、41%（95% CI，6%-63%）和19%（95% CI，-112%至69%），总体VE估计值为47%（95% CI，18%-65%）。限制分析仅包括工作年龄的成年人导致较低的VE估计值，置信区间较宽，但类似的组件特定的趋势。哨点监测提供了一个广泛的平台，将新的变异检测和循环病毒的组合与特定成分VE的年度监测联系起来。
Background. Trivalent inactivated influenza vaccine (TIV) is reformulated annually to contain representative strains of 2 influenza A subtypes (H1N1 and H3N2) and 1 B lineage ( Yamagata or Victoria). We describe a sentinel surveillance approach to link influenza variant detection with component-specific vaccine effectiveness (VE) estimation.Methods. The 2006-2007 TIV included A/NewCaledonia/20/1999( H1N1)-like, A/Wisconsin/67/2005(H3N2) like, and B/Malaysia/2506/2004(Victoria)-like components. Included participants were individuals >= 9 years of age who presented within 1 week after influenzalike illness onset to a sentinel physician between November 2006 and April 2007. Influenza was identified by real-time reverse-transcriptase polymerase chain reaction and/or culture. Isolates were characterized by hemagglutination inhibition assay (HI) and HA1 gene sequence. VE was estimated as 1-[odds ratio for influenza in vaccinated versus nonvaccinated persons].Results. A total of 841 participants contributed: 69 (8%) were >= 65 years of age; 166 (20%) received the 2006-2007 TIV. Influenza was detected in 337 subjects (40%), distributed as follows: A/H3N2, 242 (72%); A/H1N1, 55 (16%); and B, 36 (11%). All but 1 of the A/H1N1 isolates were well matched, half of A/H3N2 isolates were strain mismatched, and all B isolates were lineage-level mismatched to vaccine. Age-adjusted estimated VE for A/H1N1, A/H3N2, and B components was 92% (95% CI, 40%-91%), 41% (95% CI, 6%-63%), and 19% (95% CI, -112% to 69%), respectively, with an overall VEestimate of 47% (95% CI, 18%-65%). Restriction of the analysis to include only working- age adults resulted in lowerVE estimates with wide confidence intervals but similar component-specific trends.Conclusions. Sentinel surveillance provides a broad platform to link new variant detection and the composite of circulating viruses to annual monitoring of component-specific VE.