Low influenza vaccine effectiveness and the effect of previous vaccination in preventing admission with A(H1N1)pdm09 or B/Victoria-Lineage in patients 60 years old or older during the 2015/2016 influenza season
Low influenza vaccine effectiveness and the effect of previous vaccination in preventing admission with A(H1N1)pdm09 or B/Victoria-Lineage in patients 60 years old or older during the 2015/2016 influenza season
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DOI：
10.1016/j.vaccine.2017.10.100
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发表时间：
2017-12-19
期刊：
影响因子：
5.5
通讯作者：
Diez-Domingo, Javier
中科院分区：
文献类型：
--
作者：
Puig-Barbera, Joan;Guglieri-Lopez, Beatriz;Diez-Domingo, Javier
背景：2015/2016年欧洲流感季节的特点是A(H1N1)pdm09、Glade 6B.1和B/Victoria系流感病毒的传播。巴伦西亚地区当前和过去两个季节使用的疫苗成分类似，但与2015/2016年主要的流感传播毒株不太匹配。我们评估了流感疫苗的有效性(IVE)和以前接种疫苗在这个特殊季节预防A(H1N1)pdm09或B/Victoria血统入院的干扰。方法：巴伦西亚医院流感研究网络进行了一项以医院为基础的积极监测研究，以收集可能与流感有关的连续入院的临床和病毒学数据。用逆转录聚合酶链式反应对鼻咽和咽拭子进行分析，并对阳性流感样本中的血凝素进行测序。疫苗接种是参考人口疫苗信息系统来确定的。结果：在2015-2016赛季，我们招募了1049名符合条件的60岁或以上患者入院，187人流感检测呈阳性。校正后的IVE预防甲型H1N1流感的可信区间为20.2%，95%可信区间为-21.3-47.5%和-33.2%，95%可信区间为-140.1-26.1%。大多数甲型H1N1流感病毒pdm09序列属于新出现的6B.1亚类，由血凝素蛋白的S162N和I216T突变定义。当我们将分析局限于前一年未接种疫苗的人群时，未调整的IVE总体上为84.9%(95%CI9.9~100.0)，预防甲型H1N1流感pdm09的比例为77.9%(-32.7~100.0%)，预防B/Yamagata血统入院的比例为48.8%(-219.5~100.0%)。结论：IVE对预防甲型H1N1流感pdm09的作用较低，与前一季接种疫苗密切相关。未观察到B/Victorialine预防入院的效果。在2015/2016赛季，由于流行病毒和疫苗病毒之间的不匹配和缺乏一致性，IVE较低。(三)2017年提交人(S)。爱思唯尔有限公司出版。
Background: The 2015/2016 influenza season was characterized in Europe by the circulation of A(H1N1) pdm09 Glade 6B.1 and B/Victoria-lineage influenza viruses. The components of the vaccines used in the current and past two seasons in the Valencia region were similar but not well matched to the 2015/2016 dominant influenza-circulating strains. We estimate influenza vaccine effectiveness (IVE) and interference of previous vaccination in preventing admission with A(H1N1)pdm09 or B/Victoria-lineage in this particular season.Methods: The Valencia Hospital Network for the Study of Influenza runs an active surveillance hospital based study to collect clinical and virological data from consecutive admissions possibly related to influenza. Combined nasopharyngeal and pharyngeal swabs are analyzed by reverse transcription polymerase chain reaction, and the hemagglutinin is sequenced in a sample of positive influenza specimens. Vaccination is ascertained consulting a population vaccine information system. We estimate IVE using a test-negative approach.Results: During the 2015-2016 season, we recruited 1049 eligible admissions of patients 60 years or older, and 187 tested positive for influenza. The adjusted IVE in preventing admission with A(H1N1) pdm09 was 20.2%; 95% confidence interval (CI) -21.3-47.5% and -33.2%; 95% CI, -140.1-26.1% in preventing admission with B/Victoria-lineage. The majority of A(H1N1)pdm09 sequenced viruses belonged to the emerging 6B.1 subclade, defined by S162N and I216T mutations in the hemagglutinin protein. When we restricted our analysis to those not vaccinated in the previous year, unadjusted IVE was 84.9% (95% CI 9.9-100.0) overall, 77.9% (-32.7-100.0%) in preventing A(H1N1)pdm09 and 48.8% (-219.5-100.0%) in preventing B/Yamagata-lineage admission.Conclusions: Our findings indicate that IVE was low in preventing A(H1N1)pdm09 and strongly correlated with vaccination in the previous season. No effect in preventing admission with B/Victorialineage was observed. For the 2015/2016 season, IVE was low due to a mismatch and lack of concordance between the circulating and vaccine viruses. (C) 2017 The Author(s). Published by Elsevier Ltd.