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Dose-Dependent Negative Effects of Prior Multiple Vaccinations against Influenza A and Influenza B among School Children: A Study of Kamigoto Island i

tetano

Editor, Senior Moderator
Clin Infect Dis. 2018 Mar 8. doi: 10.1093/cid/ciy202. [Epub ahead of print]
[h=1]Dose-Dependent Negative Effects of Prior Multiple Vaccinations against Influenza A and Influenza B among School Children: A Study of Kamigoto Island in Japan during the 2011/12, 2012/13 and 2013/14 Influenza Seasons.[/h] Saito N[SUP]1,[/SUP][SUP]2[/SUP], Komori K[SUP]3[/SUP], Suzuki M[SUP]1,[/SUP][SUP]2[/SUP], Kishikawa T[SUP]3[/SUP], Yasaka T[SUP]3[/SUP], Ariyoshi K[SUP]1,[/SUP][SUP]2[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]Introduction:[/h] We investigated the negative effects of prior multiple vaccinations on influenza vaccine effectiveness (VE) and analysed the association of VE with prior vaccine doses.
[h=4]Methods:[/h] Patients aged 9-18 years presenting with influenza-like illness at a community hospital on a Japanese remote island during the 2011/12, 2012/13 and 2013/14 seasons were tested for influenza using a rapid diagnostic test (RDT). A test-negative case-control study design was used to estimate the VEs of trivalent inactivated influenza vaccine (TIV). Histories of vaccination and medically-attended influenza (MA-flu) A and B during three previous seasons were collected from registry systems. VE was calculated using multi-level mixed-effects logistic regression models adjusted for the history of RDT-confirmed MA-flu.
[h=4]Result:[/h] During three influenza seasons, 1668 influenza-like illness episodes were analysed, including 421 and 358 episodes of MA-fluA and MA-fluB, respectively. The adjusted VE yielded significant dose-dependent attenuations by prior vaccinations against both MA-fluA [0 doses during previous three seasons: 96% (95% CI: 69%-100%), 1 dose: 48% (-7% to 74%), 2 doses: 52% (11%-74%), 3 doses: 21% (-25% to 51%); P for trend <0.05] and MA-fluB [0 doses: 66% (-5% to 89%), 1 dose: 48% (-14% to 76%), 2 doses: 34% (-33% to 67%), 3 doses: -7% (-83% to 37%); P for trend <0.05]. After excluding episodes of MA-flu during prior three seasons, similar trends were observed.
[h=4]Conclusion:[/h] Repeated previous vaccinations over multiple seasons had significant dose-dependent negative impacts on VE against both MA-fluA and MA-fluB. Further studies to confirm this finding are necessary.


PMID: 29528389 DOI: 10.1093/cid/ciy202
 
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