Influenza vaccine failure in the tropics: a retrospective cohort study of waning effectiveness.
Influenza vaccine failure in the tropics: a retrospective cohort study of waning effectiveness.
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DOI：
10.1017/s0950268820002952
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发表时间：
2020-12-02
影响因子：
4.2
通讯作者：
Chen M
中科院分区：
文献类型：
--
作者：
Young BE;Mak TM;Ang LW;Sadarangani S;Ho HJ;Wilder-Smith A;Barkham T;Chen M
流感疫苗的有效性（VE）在温带气候的冬季逐渐减弱，但热带国家全年流感病毒活动的数据很少。在新加坡，对2013年至2017年接种疫苗的成年人进行了一项回顾性队列研究。流感疫苗接种失败定义为接种后2-49周因聚合酶链反应证实的流感感染住院。通过将随访期分为8周发作（Lexis扩展）和接种后前8周（第2-9周）与随后8周相比的流感感染几率，使用多变量logistic回归调整患者因素和流感病毒活性，计算相对VE。分析了19298例流感疫苗接种记录，其中617例（3.2%）流感感染。疫苗接种后前26周，相对VE保持稳定，但随后在第42-49周，所有三种流感类型/亚型的相对VE下降至69%（95%置信区间（CI）52- 92%，P = 0.011）。VE在老年人、慢性肺病患者和过去2年内接种过疫苗的人中下降最快。疫苗接种失败与疫苗接种和观察期之间推荐疫苗株的变化显著相关（校正比值比1.26，95% CI 1.06-1.50，P = 0.010）。
Influenza vaccine effectiveness (VE) wanes over the course of a temperate climate winter season but little data are available from tropical countries with year-round influenza virus activity. In Singapore, a retrospective cohort study of adults vaccinated from 2013 to 2017 was conducted. Influenza vaccine failure was defined as hospital admission with polymerase chain reaction-confirmed influenza infection 2–49 weeks after vaccination. Relative VE was calculated by splitting the follow-up period into 8-week episodes (Lexis expansion) and the odds of influenza infection in the first 8-week period after vaccination (weeks 2–9) compared with subsequent 8-week periods using multivariable logistic regression adjusting for patient factors and influenza virus activity. Records of 19 298 influenza vaccinations were analysed with 617 (3.2%) influenza infections. Relative VE was stable for the first 26 weeks post-vaccination, but then declined for all three influenza types/subtypes to 69% at weeks 42–49 (95% confidence interval (CI) 52–92%, P = 0.011). VE declined fastest in older adults, in individuals with chronic pulmonary disease and in those who had been previously vaccinated within the last 2 years. Vaccine failure was significantly associated with a change in recommended vaccine strains between vaccination and observation period (adjusted odds ratio 1.26, 95% CI 1.06–1.50, P = 0.010).