Effectiveness of trivalent and pandemic influenza vaccines in England and Wales 2008-2010: Results from a cohort study in general practice
Effectiveness of trivalent and pandemic influenza vaccines in England and Wales 2008-2010: Results from a cohort study in general practice
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DOI：
10.1016/j.vaccine.2011.12.038
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发表时间：
2012-02-08
期刊：
影响因子：
5.5
通讯作者：
Pebody, Richard
中科院分区：
文献类型：
--
作者：
Hardelid, Pia;Fleming, Douglas M.;Pebody, Richard
流感疫苗有效性（VE）的评估因每个季节流行毒株和疫苗毒株之间不同程度的不匹配而变得复杂。我们进行了一项队列研究，以评估2008年至2010年期间英格兰和威尔士全科医生（GP）患者中三价（TIV）和大流行性流感疫苗（PIV）预防各种呼吸系统结局的VE。流感样疾病（ILI）、急性呼吸道感染（阿尔蒂）、下呼吸道感染（LRTI）和鼻咽拭子的咨询日期从国家GP网络中招募的100个实践的患者水平电子记录中获得。还提取了TIV和Ply疫苗接种日期。混杂因素包括年龄、时间段和咨询频率通过Poisson回归模型进行调整。2008/9年冬季，TIV预防ILI的调整VE为22.3%（95%CI 13.5%，30.2%）。在2009/10冬季，Ply预防ILI的VE为21.0%（5.3%，34.0%）。PIV预防PCR证实的甲型H1N1流感（2009年）的VE为63.7%（-6.1%，87.6%）。2008/9年流感流行期间的TIV和2009/10年冬季的Ply有效预防了全科医生对ILI的咨询。队列研究设计可用于每个季节估计VE：然而，尽管调整了咨询倾向，但适应症的剩余混杂仍可能存在问题。(C)2011爱思唯尔有限公司保留所有权利。
Estimation of influenza vaccine effectiveness (VE) is complicated by various degrees of mismatch between circulating and vaccine strains each season. We carried out a cohort study to estimate VE of trivalent (TIV) and pandemic influenza vaccines (PIV) in preventing various respiratory outcomes among general practice (GP) patients in England and Wales between 2008 and 2010. Dates of consultations for influenza-like illness (ILI), acute respiratory tract infection (ARTI), lower respiratory tract infection (LRTI) and nasopharyngeal swabs were obtained from the patient-level electronic records of the 100 practices enrolled in a national GP network. Dates of vaccination with TIV and Ply were also extracted. Confounders including age, time period and consultation frequency were adjusted for through Poisson regression models. In the winter of 2008/9, adjusted VE of TIV in preventing ILI was 22.3% (95% CI 13.5%, 30.2%). During the 2009/10 winter VE for Ply in preventing ILI was 21.0% (5.3%, 34.0%). The VE for PIV in preventing PCR-confirmed influenza A/H1N1 (2009) was 63.7% (-6.1%, 87.6%). TIV during the period of influenza circulation of 2008/9 and Ply in the winter of 2009/10 were effective in preventing GP consultations for ILI. The cohort study design could be used each season to estimate VE: however, residual confounding by indication could still present issues, despite adjustment for propensity to consult. (C) 2011 Elsevier Ltd. All rights reserved.