tetano
Editor, Senior Moderator
Vaccine X. 2019 Sep 17;3:100042. doi: 10.1016/j.jvacx.2019.100042. eCollection 2019 Dec 10. [h=1]Effectiveness of influenza vaccine against influenza A in Europe in seasons of different A(H1N1)pdm09 and the same A(H3N2) vaccine components (2016-17 and 2017-18).[/h]
Kissling E[SUP]1[/SUP], Pozo F[SUP]2[/SUP], Buda S[SUP]3[/SUP], Vilcu AM[SUP]4[/SUP], Rizzo C[SUP]5,[/SUP][SUP]6[/SUP], Gherasim A[SUP]7,[/SUP][SUP]8[/SUP], Horv?th JK[SUP]9[/SUP], Brytting M[SUP]10[/SUP], Domegan L[SUP]11[/SUP], Meijer A[SUP]12[/SUP], Paradowska-Stankiewicz I[SUP]13[/SUP], Machado A[SUP]14[/SUP], Vučina VV[SUP]15[/SUP], Lazar M[SUP]16[/SUP], Johansen K[SUP]17[/SUP], D?rrwald R[SUP]18[/SUP], van der Werf S[SUP]19,[/SUP][SUP]20[/SUP], Bella A[SUP]5[/SUP], Larrauri A[SUP]7,[/SUP][SUP]8[/SUP], Ferenczi A[SUP]9[/SUP], Zakikhany K[SUP]10[/SUP], O'Donnell J[SUP]11[/SUP], Dijkstra F[SUP]12[/SUP], Bogusz J[SUP]13[/SUP], Guiomar R[SUP]21[/SUP], Filipović SK[SUP]15[/SUP], Pitigoi D[SUP]22[/SUP], Penttinen P[SUP]17[/SUP], Valenciano M[SUP]1[/SUP]; I-MOVE/I-MOVE+ study team.
[h=3]Author information[/h] 1 Epidemiology Department, Epiconcept, 47 rue de Charenton, 75012 Paris, France. 2 National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain. 3 Robert Koch Institute, Department of Infectious Disease Epidemiology, Respiratory Infections Unit, Seestrasse 10, 13353 Berlin, Germany. 4 Sorbonne Universit?, INSERM, Institut Pierre Louis d'?pid?miologie et de Sant? Publique (IPLESP UMRS 1136), F-75012, Paris, France. 5 Department of Infectious Diseases, National Institute of Health, Rome, Italy. 6 Bambino Ges? Children's Hospital, Rome, Italy. 7 National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain. 8 CIBER de Epidemiolog?a y Salud P?blica (CIBERESP), Institute of Health Carlos III, Madrid Spain. 9 Office of the Chief Medical Officer, Budapest, Hungary. 10 Public Health Agency of Sweden, Stockholm, Sweden. 11 Health Service Executive-Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 D01 A4A3, Ireland. 12 National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. 13 National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland. 14 Departamento de Epidemiologia, Instituto Nacional de Sa?de Dr. Ricardo Jorge, Lisbon, Portugal. 15 Croatian Institute of Public Health, Zagreb, Croatia. 16 "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania. 17 European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73 Solna, Sweden. 18 Robert Koch Institute, National Reference Center for Influenza, Seestrasse 10, 13353 Berlin, Germany. 19 Unit? de G?n?tique Mol?culaire des Virus ? ARN, Institut Pasteur, CNRS UMR3569, Universit? Paris Diderot SPC, France. 20 CNR des Virus des Infections Respiratoires, WHO National Influenza Center, Institut Pasteur, France. 21 Departamento de Doen?as Infeciosas, Instituto Nacional de Sa?de Dr. Ricardo Jorge, Portugal. 22 Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
[h=3]Abstract[/h] [h=4]Introduction:[/h] Influenza A(H3N2) viruses predominated in Europe in 2016-17. In 2017-18 A(H3N2) and A(H1N1)pdm09 viruses co-circulated. The A(H3N2) vaccine component was the same in both seasons; while the A(H1N1)pdm09 component changed in 2017-18. In both seasons, vaccine seed A(H3N2) viruses developed adaptations/alterations during propagation in eggs, impacting antigenicity.
[h=4]Methods:[/h] We used the test-negative design in a multicentre primary care case-control study in 12 European countries to measure 2016-17 and 2017-18 influenza vaccine effectiveness (VE) against laboratory-confirmed influenza A(H1N1)pdm09 and A(H3N2) overall and by age group.
[h=4]Results:[/h] During the 2017-18 season, the overall VE against influenza A(H1N1)pdm09 was 59% (95% CI: 47-69). Among those aged 0-14, 15-64 and ≥65 years, VE against A(H1N1)pdm09 was 64% (95% CI: 37-79), 50% (95% CI: 28-66) and 66% (95% CI: 42-80), respectively. Overall VE against influenza A(H3N2) was 28% (95% CI: 17-38) in 2016-17 and 13% (95% CI: -15 to 34) in 2017-18. Among 0-14-year-olds VE against A(H3N2) was 28% (95%CI: -10 to 53) and 29% (95% CI: -87 to 73), among 15-64-year-olds 34% (95% CI: 18-46) and 33% (95% CI: -3 to 56) and among those aged ≥65 years 15% (95% CI: -10 to 34) and -9% (95% CI: -74 to 32) in 2016-17 and 2017-18, respectively.
[h=4]Conclusions:[/h] Our study suggests the new A(H1N1)pdm09 vaccine component conferred good protection against circulating strains, while VE against A(H3N2) was <35% in 2016-17 and 2017-18. The egg propagation derived antigenic mismatch of the vaccine seed virus with circulating strains may have contributed to this low effectiveness. A(H3N2) seed viruses for vaccines in subsequent seasons may be subject to the same adaptations; in years with lower than expected VE, recommendations of preventive measures other than vaccination should be given in a timely manner.
? 2019 The Authors.
[h=4]KEYWORDS:[/h] Case-control study; Europe; Influenza; Influenza vaccine; Multicentre study; Vaccine effectiveness
PMID: 31660536 PMCID: PMC6807025 DOI: 10.1016/j.jvacx.2019.100042
Free PMC Article
Kissling E[SUP]1[/SUP], Pozo F[SUP]2[/SUP], Buda S[SUP]3[/SUP], Vilcu AM[SUP]4[/SUP], Rizzo C[SUP]5,[/SUP][SUP]6[/SUP], Gherasim A[SUP]7,[/SUP][SUP]8[/SUP], Horv?th JK[SUP]9[/SUP], Brytting M[SUP]10[/SUP], Domegan L[SUP]11[/SUP], Meijer A[SUP]12[/SUP], Paradowska-Stankiewicz I[SUP]13[/SUP], Machado A[SUP]14[/SUP], Vučina VV[SUP]15[/SUP], Lazar M[SUP]16[/SUP], Johansen K[SUP]17[/SUP], D?rrwald R[SUP]18[/SUP], van der Werf S[SUP]19,[/SUP][SUP]20[/SUP], Bella A[SUP]5[/SUP], Larrauri A[SUP]7,[/SUP][SUP]8[/SUP], Ferenczi A[SUP]9[/SUP], Zakikhany K[SUP]10[/SUP], O'Donnell J[SUP]11[/SUP], Dijkstra F[SUP]12[/SUP], Bogusz J[SUP]13[/SUP], Guiomar R[SUP]21[/SUP], Filipović SK[SUP]15[/SUP], Pitigoi D[SUP]22[/SUP], Penttinen P[SUP]17[/SUP], Valenciano M[SUP]1[/SUP]; I-MOVE/I-MOVE+ study team.
[h=3]Author information[/h] 1 Epidemiology Department, Epiconcept, 47 rue de Charenton, 75012 Paris, France. 2 National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain. 3 Robert Koch Institute, Department of Infectious Disease Epidemiology, Respiratory Infections Unit, Seestrasse 10, 13353 Berlin, Germany. 4 Sorbonne Universit?, INSERM, Institut Pierre Louis d'?pid?miologie et de Sant? Publique (IPLESP UMRS 1136), F-75012, Paris, France. 5 Department of Infectious Diseases, National Institute of Health, Rome, Italy. 6 Bambino Ges? Children's Hospital, Rome, Italy. 7 National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain. 8 CIBER de Epidemiolog?a y Salud P?blica (CIBERESP), Institute of Health Carlos III, Madrid Spain. 9 Office of the Chief Medical Officer, Budapest, Hungary. 10 Public Health Agency of Sweden, Stockholm, Sweden. 11 Health Service Executive-Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 D01 A4A3, Ireland. 12 National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. 13 National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland. 14 Departamento de Epidemiologia, Instituto Nacional de Sa?de Dr. Ricardo Jorge, Lisbon, Portugal. 15 Croatian Institute of Public Health, Zagreb, Croatia. 16 "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania. 17 European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73 Solna, Sweden. 18 Robert Koch Institute, National Reference Center for Influenza, Seestrasse 10, 13353 Berlin, Germany. 19 Unit? de G?n?tique Mol?culaire des Virus ? ARN, Institut Pasteur, CNRS UMR3569, Universit? Paris Diderot SPC, France. 20 CNR des Virus des Infections Respiratoires, WHO National Influenza Center, Institut Pasteur, France. 21 Departamento de Doen?as Infeciosas, Instituto Nacional de Sa?de Dr. Ricardo Jorge, Portugal. 22 Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
[h=3]Abstract[/h] [h=4]Introduction:[/h] Influenza A(H3N2) viruses predominated in Europe in 2016-17. In 2017-18 A(H3N2) and A(H1N1)pdm09 viruses co-circulated. The A(H3N2) vaccine component was the same in both seasons; while the A(H1N1)pdm09 component changed in 2017-18. In both seasons, vaccine seed A(H3N2) viruses developed adaptations/alterations during propagation in eggs, impacting antigenicity.
[h=4]Methods:[/h] We used the test-negative design in a multicentre primary care case-control study in 12 European countries to measure 2016-17 and 2017-18 influenza vaccine effectiveness (VE) against laboratory-confirmed influenza A(H1N1)pdm09 and A(H3N2) overall and by age group.
[h=4]Results:[/h] During the 2017-18 season, the overall VE against influenza A(H1N1)pdm09 was 59% (95% CI: 47-69). Among those aged 0-14, 15-64 and ≥65 years, VE against A(H1N1)pdm09 was 64% (95% CI: 37-79), 50% (95% CI: 28-66) and 66% (95% CI: 42-80), respectively. Overall VE against influenza A(H3N2) was 28% (95% CI: 17-38) in 2016-17 and 13% (95% CI: -15 to 34) in 2017-18. Among 0-14-year-olds VE against A(H3N2) was 28% (95%CI: -10 to 53) and 29% (95% CI: -87 to 73), among 15-64-year-olds 34% (95% CI: 18-46) and 33% (95% CI: -3 to 56) and among those aged ≥65 years 15% (95% CI: -10 to 34) and -9% (95% CI: -74 to 32) in 2016-17 and 2017-18, respectively.
[h=4]Conclusions:[/h] Our study suggests the new A(H1N1)pdm09 vaccine component conferred good protection against circulating strains, while VE against A(H3N2) was <35% in 2016-17 and 2017-18. The egg propagation derived antigenic mismatch of the vaccine seed virus with circulating strains may have contributed to this low effectiveness. A(H3N2) seed viruses for vaccines in subsequent seasons may be subject to the same adaptations; in years with lower than expected VE, recommendations of preventive measures other than vaccination should be given in a timely manner.
? 2019 The Authors.
[h=4]KEYWORDS:[/h] Case-control study; Europe; Influenza; Influenza vaccine; Multicentre study; Vaccine effectiveness
PMID: 31660536 PMCID: PMC6807025 DOI: 10.1016/j.jvacx.2019.100042
Free PMC Article