Impact of Repeated Vaccination on Vaccine Effectiveness Against Influenza A(H3N2) and B During 8 Seasons
Impact of Repeated Vaccination on Vaccine Effectiveness Against Influenza A(H3N2) and B During 8 Seasons
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DOI：
10.1093/cid/ciu680
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发表时间：
2014-11-15
影响因子：
11.8
通讯作者：
Belongia, Edward A.
中科院分区：
文献类型：
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作者：
McLean, Huong Q.;Thompson, Mark G.;Belongia, Edward A.
背景。最近的研究表明，在前一个季节接种流感疫苗可能会影响当前季节接种疫苗的有效性，但这尚未在多年的单一人群中进行评估。在2004-2005年至2012-2013年流感季节期间前瞻性纳入急性呼吸道疾病患者。对呼吸道拭子进行流感检测，并从经过验证的登记处获得疫苗接种日期。确定当前、过去和前5个季节的疫苗接种状况。使用具有疫苗接种史交互项的logistic回归模型计算年龄为bb0 = 9岁的参与者的疫苗有效性（VE）。8个季节共登记7315人；甲型流感（H3N2）和乙型流感（H3N2）分别为1056例（14%）和650例（9%）。仅在当前、以前或两个季节接种疫苗对H3N2（调整后的VE范围为31%-36%）和B（52%-66%）产生相似的保护作用。在对5年历史疫苗接种数据的分析中，与有频繁疫苗接种史的疫苗接种者（24%,95% CI, 3%-41%, P = 0.01）相比，无既往疫苗接种史的疫苗接种者（65%，95%置信区间[CI]， 36%-80%）当前季节对H3N2的VE显著高于有频繁疫苗接种史的疫苗接种者（24%,95% CI, 3%-41%, P = 0.01）。对B的VE分别为75% （95% CI, 50% ~ 87%）和48% (95% CI, 29% ~ 62%) （P = 0.05）。当分析仅限于18-49岁的成年人时，也观察到类似的结果。当前和前一个季节的疫苗接种产生了相似的保护水平，疫苗诱导的保护对于在前5年内未接种疫苗的个体是最大的。需要进一步的研究来了解每年接种疫苗的长期影响。
Background. Recent studies suggest that influenza vaccination in the previous season may influence the effectiveness of current-season vaccination, but this has not been assessed in a single population over multiple years.Methods. Patients presenting with acute respiratory illness were prospectively enrolled during the 2004-2005 through 2012-2013 influenza seasons. Respiratory swabs were tested for influenza and vaccination dates obtained from a validated registry. Vaccination status was determined for the current, previous, and prior 5 seasons. Vaccine effectiveness (VE) was calculated for participants aged >= 9 years using logistic regression models with an interaction term for vaccination history.Results. There were 7315 enrollments during 8 seasons; 1056 (14%) and 650 (9%) were positive for influenza A (H3N2) and B, respectively. Vaccination during current only, previous only, or both seasons yielded similar protection against H3N2 (adjusted VE range, 31%-36%) and B (52%-66%). In the analysis using 5 years of historical vaccination data, current season VE against H3N2 was significantly higher among vaccinated individuals with no prior vaccination history (65%; 95% confidence interval [CI], 36%-80%) compared with vaccinated individuals with a frequent vaccination history (24%; 95% CI, 3%-41%; P = .01). VE against B was 75% (95% CI, 50%-87%) and 48% (95% CI, 29%-62%), respectively (P = .05). Similar findings were observed when analysis was restricted to adults 18-49 years.Conclusions. Current-and previous-season vaccination generated similar levels of protection, and vaccine-induced protection was greatest for individuals not vaccinated during the prior 5 years. Additional studies are needed to understand the long-term effects of annual vaccination.