Effectiveness of Influenza Vaccines in the HIVE Household Cohort Over 8 Years: Is There Evidence of Indirect Protection?
Effectiveness of Influenza Vaccines in the HIVE Household Cohort Over 8 Years: Is There Evidence of Indirect Protection?
复制标题
DOI：
10.1093/cid/ciab395
复制
发表时间：
2021-10-05
期刊：
影响因子：
--
通讯作者：
Monto AS
中科院分区：
文献类型：
--
作者：
Malosh RE;Petrie JG;Callear A;Truscon R;Johnson E;Evans R;Bazzi L;Cheng C;Thompson MS;Martin ET;Monto AS
缺乏流感疫苗接种计划定期为社区未接种疫苗的个人提供保护（即间接影响）的证据。我们试图在家庭流感疫苗评价（HIVE）队列中确定流感疫苗的直接、间接和总效应。使用2010-11年至2017-18年HIVE队列的纵向数据，我们使用调整后的混合效应泊松回归模型估计了流感疫苗的直接、间接和总有效性（VE）以及流感病毒感染的发病率比。通过比较全部或部分接种疫苗的家庭中接种疫苗的成员与完全未接种疫苗的家庭中未接种疫苗的个人来确定总有效性。对任何流感的合并直接VE为30.2%（14.0-43.4）。甲型H1 N1流感病毒的直接VE为43.9%（3.9至63.5）和B流感病毒的直接VE为46.7%（17.2至57.5），高于甲型H3 N2流感病毒的直接VE 31.7%（10.5至47.8），幼儿的直接VE为42.4%（10.1至63.0），高于成人的直接VE 18.6%（-6.3至37.7）。流感发病率在完全未接种疫苗的家庭中最高（每100人-季节10.6人），在所有其他家庭疫苗接种覆盖率水平下较低。在调整潜在的混杂因素后，我们几乎没有发现间接VE的证据。低覆盖率家庭的总VE为56.4%（30.1-72.9），中等覆盖率为43.2%（19.5-59.9），完全接种家庭为33.0%（12.1 - 49.0）。流感疫苗可能具有超出直接效果的益处，但在这项研究中，这种效果很小。尽管可能有例外，但全球疫苗建议的目标仍应侧重于为接种疫苗的人提供有记录的直接保护。我们估计了8个季节的家庭队列研究中流感疫苗的直接、间接和总有效性。在这一人群中，我们发现接种疫苗对轻度流感疾病具有一致的中度直接保护作用，但我们几乎没有发现间接保护作用的证据。
The evidence that influenza vaccination programs regularly provide protection to unvaccinated individuals (ie, indirect effects) of a community is lacking. We sought to determine the direct, indirect, and total effects of influenza vaccine in the Household Influenza Vaccine Evaluation (HIVE) cohort. Using longitudinal data from the HIVE cohort from 2010–11 through 2017–18, we estimated direct, indirect, and total influenza vaccine effectiveness (VE) and the incidence rate ratio of influenza virus infection using adjusted mixed-effect Poisson regression models. Total effectiveness was determined through comparison of vaccinated members of full or partially vaccinated households to unvaccinated individuals in completely unvaccinated households. The pooled, direct VE against any influenza was 30.2% (14.0–43.4). Direct VE was higher for influenza A/H1N1 43.9% (3.9 to 63.5) and B 46.7% (17.2 to 57.5) than A/H3N2 31.7% (10.5 to 47.8) and was higher for young children 42.4% (10.1 to 63.0) than adults 18.6% (−6.3 to 37.7). Influenza incidence was highest in completely unvaccinated households (10.6 per 100 person-seasons) and lower at all other levels of household vaccination coverage. We found little evidence of indirect VE after adjusting for potential confounders. Total VE was 56.4% (30.1–72.9) in low coverage, 43.2% (19.5–59.9) in moderate coverage, and 33.0% (12.1 to 49.0) in fully vaccinated households. Influenza vaccines may have a benefit above and beyond the direct effect but that effect in this study was small. Although there may be exceptions, the goal of global vaccine recommendations should remain focused on provision of documented, direct protection to those vaccinated. We estimate direct, indirect, and total influenza vaccine effectiveness in a household cohort study over 8 seasons. In this population we found consistent, moderate direct protection of mild influenza illness by vaccination but we found little evidence of indirect protection.
登录
查看更多内容
影响因子：
6.4
作者：
MONTO, AS;DAVENPORT, FM;FRANCIS, T
通讯作者：
FRANCIS, T
影响因子：
4.3
作者：
Eames KT;Tilston NL;Brooks-Pollock E;Edmunds WJ
通讯作者：
Edmunds WJ
影响因子：
8
作者：
Piedra, Pedro A.;Gaglani, Manjusha J.;Glezen, W. Paul
通讯作者：
Glezen, W. Paul
影响因子：
6.4
作者：
Flannery, Brendan;Zimmerman, Richard K.;Fry, Alicia M.
通讯作者：
Fry, Alicia M.
影响因子：
11.8
作者：
Diallo, Aldiouma;Diop, Ousmane M.;Victor, John C.
通讯作者：
Victor, John C.