Moderate influenza vaccine effectiveness with variable effectiveness by match between circulating and vaccine strains in Australian adults aged 20-64 years, 2007-2011
Moderate influenza vaccine effectiveness with variable effectiveness by match between circulating and vaccine strains in Australian adults aged 20-64 years, 2007-2011
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DOI：
10.1111/irv.12018
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发表时间：
2013-09-01
影响因子：
4.4
通讯作者：
Fielding, James E.
中科院分区：
文献类型：
--
作者：
Kelly, Heath A.;Sullivan, Sheena G.;Fielding, James E.
背景流感疫苗每年根据免疫原性研究获得许可。我们使用连续5年的数据来评估流感疫苗的有效性(VE)，这是该领域的关键结果。方法2007年至2011年，我们在澳大利亚维多利亚州哨兵全科诊所招募的20-岁的成年人中进行了年度前瞻性试验阴性病例对照研究。我们使用聚合酶链式反应确认的流感作为终点来估计所有年份的流感VE。结果所有年份(不包括2009年)调整后的VE估计值为62%(95%可信区间43，75)。按类型和亚型划分，按年计算的VE点估计值在季节性甲型H1N1流感的31%和甲型H1N1流感的88%之间。2007年，当评估为不完全匹配的流行毒株时，调整后的VE对所有流感的点估计为58%。2011年，当所有毒株被评估为完全匹配时，点估计为59%。结论三价灭活疫苗对工作年龄的成年人提供了中等程度的预防实验室确认的流感，尽管VE估计对所使用的模型很敏感。根据血凝抑制试验的评估，VE估计与循环菌株匹配的相关性较差，这表明VE研究需要结合抗原特征数据。
Background Influenza vaccines are licensed annually based on immunogenicity studies. We used five sequential years of data to estimate influenza vaccine effectiveness (VE), the critical outcome in the field.Methods Between 2007 and 2011, we performed annual prospective test-negative design case-control studies among adults aged 20-64 years recruited from sentinel general practices in the Australian state of Victoria. We used PCR-confirmed influenza as the endpoint to estimate influenza VE for all years. We compared annual VE estimates with the match between circulating and vaccine strains, determined by haemagglutination inhibition assays.Results The adjusted VE estimate for all years (excluding 2009) was 62% (95% CI 43, 75). By type and subtype, the point estimates of VE by year ranged between 31% for seasonal influenza A(H1N1) and 88% for influenza A(H1N1) pdm09. In 2007, when circulating strains were assessed as incompletely matched, the point estimate of the adjusted VE against all influenza was 58%. The point estimate was 59% in 2011 when all strains were assessed as well matched.Conclusion Trivalent inactivated vaccines provided moderate protection against laboratory-confirmed influenza in adults of working age, although VE estimates were sensitive to the model used. VE estimates correlated poorly with circulating strain match, as assessed by haemagglutination inhibition assays, suggesting a need for VE studies that incorporate antigenic characterization data.