Public health impact of including two lineages of influenza B in a quadrivalent seasonal influenza vaccine
Public health impact of including two lineages of influenza B in a quadrivalent seasonal influenza vaccine
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DOI：
10.1016/j.vaccine.2011.12.098
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发表时间：
2012-03-02
期刊：
影响因子：
5.5
通讯作者：
Fiore, Anthony
中科院分区：
文献类型：
--
作者：
Reed, Carrie;Meltzer, Martin I.;Fiore, Anthony
年度三价流感疫苗 (TIV) 包括代表三种流感毒株的病毒 - 一种 A/H1N1、一种 A/H3N2 和一种 B，尽管两种抗原不同的 B 型流感谱系（维多利亚和山形）每年在美国共同流行。预测哪个乙型流感谱系将在一个季节中占主导地位具有挑战性，并且通过免疫接种针对其他谱系的交叉保护预计较低。一种提议的替代方案是生产一种四价流感疫苗（QIV），其中包含来自两种流行谱系的乙型流感病毒。我们通过计算十个流感季节（1999/2000-2008/2009）对流感相关健康结果（疾病、住院和死亡）的预期影响，估计了 QIV 与 TIV 相比的额外公共卫生效益。我们纳入了流感相关结果的年发生率、病毒循环、疫苗覆盖率和疫苗有效性的数据。我们还考虑了疫苗的年生产能力，因为可用资源可以生产四种疫苗病毒而不是三种，从而可能导致 QIV 剂量减少。使用 QIV 可以减少美国每年的病例数（范围：2200-970,000）、住院人数（范围：14-8200）和死亡人数（范围：1-485）。在早期季节，调整 QIV 中第四种病毒的生产能力可能会导致流感疫苗总体供应量减少以及流感相关结果的净增加。然而，最近几个季节，QIV 的预期供应量很可能超过实际接种的疫苗剂量。 QIV 对流感相关结果的潜在净影响预计会因季节而异，具体取决于两种 B 型流感谱系引起的流感发病率的年度变化、疫苗覆盖率和有效性。通过纳入乙型流感的第二谱系提供的额外保护可能会导致流感相关结果的适度减少。由爱思唯尔有限公司出版
The annual trivalent influenza vaccine (TIV) includes viruses representing three influenza strains - one A/H1N1, one A/H3N2, and one B, although two antigenically distinct lineages of influenza B (Victoria and Yamagata) co-circulate annually in the United States. Predicting which lineage of influenza B will predominate during a season is challenging, and cross-protection by immunization against the other lineage is expected to be low. One proposed alternative is to produce a quadrivalent influenza vaccine (QIV) including an influenza B virus from each of the two circulating lineages. We estimated the additional public health benefit of QIV compared with TIV by calculating the expected impact on influenza-related health outcomes (illness, hospitalization, and death) over ten influenza seasons (1999/2000-2008/2009). We included data on the annual incidence of influenza-associated outcomes, virologic circulation, vaccine coverage, and vaccine effectiveness. We also considered annual vaccine production capacity, since available resources would have produced four vaccine viruses instead of three, potentially resulting in fewer doses of QIV. Use of QIV could have reduced annual cases (range: 2200-970,000), hospitalizations (range: 14-8200), and deaths (range: 1-485) in the US. During earlier seasons, adjusting production capacity for a fourth virus in QIV could have resulted in reduced overall influenza vaccine availability and net increases in influenza-associated outcomes. However, in recent seasons, the expected supply of QIV is likely to exceed the doses of vaccine actually administered. The potential net impact of QIV on influenza-associated outcomes is expected to vary between seasons, depending on annual variability in the incidence of influenza caused by the two influenza B lineages, vaccine coverage, and effectiveness. The additional protection provided by including a second lineage of influenza B could result in a modest reduction in influenza-associated outcomes. Published by Elsevier Ltd.