Effects of Influenza Vaccination in the United States During the 2018-2019 Influenza Season
Effects of Influenza Vaccination in the United States During the 2018-2019 Influenza Season
复制标题
DOI：
10.1093/cid/ciz1244
复制
发表时间：
2020-10-15
影响因子：
11.8
通讯作者：
Reed, Carrie
中科院分区：
文献类型：
--
作者：
Chung, Jessie R.;Rolfes, Melissa A.;Reed, Carrie
背景。多价流感疫苗产品可针对甲型（H1N1）pdm09、甲型（H3N2）和乙型流感病毒谱系病毒提供保护。美国2018-2019年流感季节包括与疫苗株良好匹配的A(H1N1)pdm09病毒和大部分与疫苗不匹配的A(H3N2)病毒的长期传播。我们估计了该季节疫苗预防的流感相关疾病、就诊、住院和死亡的人数。方法。我们使用数学模型和蒙特卡罗算法来估计美国通过疫苗接种预防的流感相关结果的数量和 95% 不确定区间 (Uls)。该模型纳入了对 2018-2019 年全国流感疫苗覆盖率的特定年龄估计、美国流感疫苗有效性网络的流感病毒特异性疫苗有效性以及通过流感住院监测网络根据基于人群的流感相关住院率估计的疾病负担。结果。据估计，流感疫苗预防了 440 万人次（95%UI，340 万至 710 万人次）患病、230 万人次（95%UI，180 万至 380 万人次）就诊、58 000 人次住院（95%UI，30 000 至 156 000 人次）住院以及 3500 人次死亡（95%UI，1000 至 13 000 人次死亡）由于美国 2018-2019 流感季节期间的流感病毒。疫苗接种总体上可预防 14% 的与 A(H1N1)pdm09 相关的预计住院治疗，在 6 个月至 4 岁的儿童中可预防 43%。结论。在美国，流感疫苗接种可避免大量与流感相关的疾病，包括住院和死亡，这主要是因为它对 A(H1N1)pdm09 有效。我们的研究结果强调了流感疫苗接种的价值，强调即使在疫苗成分与流行病毒不匹配的季节，疫苗也可以显着减少疾病和相关的医疗保健利用率。
Background. Multivalent influenza vaccine products provide protection against influenza A(H1N1)pdm09, A(H3N2), and B lineage viruses. The 2018-2019 influenza season in the United States included prolonged circulation of A(H1N1)pdm09 viruses well-matched to the vaccine strain and A(H3N2) viruses, the majority of which were mismatched to the vaccine. We estimated the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the season.Methods. We used a mathematical model and Monte Carlo algorithm to estimate numbers and 95% uncertainty intervals (Uls) of influenza-associated outcomes prevented by vaccination in the United States. The model incorporated age-specific estimates of national 2018-2019 influenza vaccine coverage, influenza virus-specific vaccine effectiveness from the US Influenza Vaccine Effectiveness Network, and disease burden estimated from population-based rates of influenza-associated hospitalizations through the Influenza Hospitalization Surveillance Network.Results. Influenza vaccination prevented an estimated 4.4 million (95%UI, 3.4 million-7.1 million) illnesses, 2.3 million (95%UI, 1.8 million-3.8 million) medical visits, 58 000 (95%UI, 30 000-156 000) hospitalizations, and 3500 (95%UI, 1000-13 000) deaths due to influenza viruses during the US 2018-2019 influenza season. Vaccination prevented 14% of projected hospitalizations associated with A(H1N1)pdm09 overall and 43% among children aged 6 months-4 years.Conclusions. Influenza vaccination averted substantial influenza-associated disease including hospitalizations and deaths in the United States, primarily due to effectiveness against A(H1N1)pdm09. Our findings underscore the value of influenza vaccination, highlighting that vaccines measurably decrease illness and associated healthcare utilization even in a season in which a vaccine component does not match to a circulating virus.