Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15-64-year-olds in Europe: exploration by birth cohort
Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15-64-year-olds in Europe: exploration by birth cohort
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DOI：
10.2807/1560-7917.es.2019.24.48.1900604
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发表时间：
2019-11-28
期刊：
影响因子：
19
通讯作者：
Moren, Alain
中科院分区：
文献类型：
--
作者：
Kissling, Esther;Pozo, Francisco;Moren, Alain
简介：甲型流感 (H3N2) 进化枝 3C.2a 和 3C.3a 于 2018/19 年在欧洲共同流行。儿童首次感染流感的免疫印记可能会导致未来出生队列的疫苗有效性（VE）差异。目的：I-MOVE 多中心初级保健检测阴性研究按年龄和遗传亚组评估了 2018/19 甲型 H3N2 流感 VE，以按出生队列探索 VE。方法：我们测量了针对甲型流感 (H3N2) 和（亚）分支的 VE。我们按常见年龄组（0-14、15-64、>= 65 岁）对 VE 进行分层。为了评估疫苗印记调节效应 (I-REV) 假说，我们进一步对中年组进行了分层，特别是包括 32-54 岁 (1964-86) 的人，他们在血凝素第 159 位上具有潜在的童年印记。结果：所有年龄段的甲型流感 (H3N2) VE 为 -1%（95% 置信区间 (CI)：-24 至 18）， 0-14 岁、15-64 岁和 65 岁以上人群中，这一比例分别为 46%（95% CI：8-68）、-26%（95% CI：-66 至 4）和 20%（95% CI：-20 至 46）。在 15-64 岁人群中，针对进化枝 3C.2a1b 和 3C.3a 的 VE 分别为 15%（95% CI：-34 至 50）和 -74%（95% CI：-259 至 16）。 15-31岁（1987-2003年）、32-54岁（1964-86年）和55-64岁人群中VE为-18%（95% CI：-140至41）、-53%（95% CI：-131至-2）和-12%（95% CI：-74至28） (1954-63)，分别。讨论：2018/19 年甲型 (H3N2) 流感 VE 最低的是针对分支 3C.3a 和 1964-86 年出生的人群，与 I-REV 假设相对应。 15-64 岁人群中甲型 (H3N2) VE 较低以及 I-REV 假说对公共卫生的影响值得进一步研究。
Introduction: Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE). Aim: The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort. Methods: We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0-14, 15-64, >= 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32-54-year-olds (1964-86) sharing potential childhood imprinting to serine at haemagglutinin position 159. Results: Influenza A(H3N2) VE among all ages was -1% (95% confidence interval (CI): -24 to 18) and 46% (95% CI: 8-68), -26% (95% CI: -66 to 4) and 20% (95% CI: -20 to 46) among 0-14, 15-64 and >= 65-year-olds, respectively. Among 15-64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: -34 to 50) and -74% (95% CI: -259 to 16), respectively. VE was -18% (95% CI: -140 to 41), -53% (95% CI: -131 to -2) and -12% (95% CI: -74 to 28) among 15-31-year-olds (1987-2003), 32-54-year-olds (1964-86) and 55-64-year-olds (1954-63), respectively. Discussion: The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964-86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15-64-year-olds and the public health impact of the I-REV hypothesis warrant further study.