tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2023 Feb 1;10(2)
fad033.
doi: 10.1093/ofid/ofad033. eCollection 2023 Feb.
Effectiveness of Maternal Influenza Vaccination in Peru PRIME Cohort
Daniel Owusu[SUP] 1 [/SUP], Fatimah S Dawood[SUP] 1 [/SUP], Eduardo Azziz-Baumgartner[SUP] 1 [/SUP], Yeny Tinoco[SUP] 2 [/SUP], Giselle Soto[SUP] 2 [/SUP], Oswaldo Gonzalez[SUP] 3 [/SUP], Santiago Cabrera[SUP] 4 [/SUP], Richard Florian[SUP] 5 [/SUP], Edwin Llajaruna[SUP] 6 [/SUP], Danielle Rentz Hunt[SUP] 7 [/SUP], Meredith G Wesley[SUP] 1 7 [/SUP], Tat Yau[SUP] 1 [/SUP], Carmen S Arriola[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Few studies have examined influenza vaccine effectiveness (VE) among women during pregnancy in middle-income countries. We used data from a prospective cohort of women who were pregnant in Peru to estimate effectiveness of the 2018 Southern Hemisphere influenza vaccine.
Methods: Women at <28 weeks gestation were enrolled from 4 tertiary level hospitals in Lima, Peru at the start of the 2018 influenza season and followed until the end of their pregnancies. Participants had mid-turbinate nasal swabs collected and tested for influenza by reverse-transcription polymerase chain reaction (RT-PCR) with onset of ≥1 of myalgia, cough, runny nose or nasal congestion, sore throat, or difficulty breathing. Time-varying Cox proportional hazard regression models were used to estimate the risk of RT-PCR-confirmed influenza infection after adjusting for inverse probability treatment weight.
Results: We followed 1896 women for a median of 127 days (interquartile range [IQR], 86-174). Participants had a median age of 29 years (IQR, 24-34). Among the 1896 women, 49% were vaccinated with the 2018 influenza vaccine and 1039 (55%) developed influenza-like illness, 76 (7%) of whom had RT-PCR-confirmed influenza. Incidence rates of RT-PCR-confirmed influenza were 36.6 and 15.3 per 100 000 person-days among women who were unvaccinated and vaccinated, respectively. Adjusted influenza VE was 22% (95% confidence interval, -64.1% to 62.9%).
Conclusions: Participants vaccinated against influenza had more than 50% lower incidence of RT-PCR-confirmed influenza illness. Although the VE estimated through propensity weight-adjusted time-varying Cox regression did not reach statistical significance, our findings provide additional evidence about the value of maternal influenza vaccination in middle-income countries.
Keywords: Peru; influenza; maternal vaccination; pregnant; vaccine effectiveness.
. 2023 Feb 1;10(2)
fad033.doi: 10.1093/ofid/ofad033. eCollection 2023 Feb.
Effectiveness of Maternal Influenza Vaccination in Peru PRIME Cohort
Daniel Owusu[SUP] 1 [/SUP], Fatimah S Dawood[SUP] 1 [/SUP], Eduardo Azziz-Baumgartner[SUP] 1 [/SUP], Yeny Tinoco[SUP] 2 [/SUP], Giselle Soto[SUP] 2 [/SUP], Oswaldo Gonzalez[SUP] 3 [/SUP], Santiago Cabrera[SUP] 4 [/SUP], Richard Florian[SUP] 5 [/SUP], Edwin Llajaruna[SUP] 6 [/SUP], Danielle Rentz Hunt[SUP] 7 [/SUP], Meredith G Wesley[SUP] 1 7 [/SUP], Tat Yau[SUP] 1 [/SUP], Carmen S Arriola[SUP] 1 [/SUP]
Affiliations
- PMID: 36817741
- PMCID: PMC9927556 (available on 2024-02-01)
- DOI: 10.1093/ofid/ofad033
Abstract
Background: Few studies have examined influenza vaccine effectiveness (VE) among women during pregnancy in middle-income countries. We used data from a prospective cohort of women who were pregnant in Peru to estimate effectiveness of the 2018 Southern Hemisphere influenza vaccine.
Methods: Women at <28 weeks gestation were enrolled from 4 tertiary level hospitals in Lima, Peru at the start of the 2018 influenza season and followed until the end of their pregnancies. Participants had mid-turbinate nasal swabs collected and tested for influenza by reverse-transcription polymerase chain reaction (RT-PCR) with onset of ≥1 of myalgia, cough, runny nose or nasal congestion, sore throat, or difficulty breathing. Time-varying Cox proportional hazard regression models were used to estimate the risk of RT-PCR-confirmed influenza infection after adjusting for inverse probability treatment weight.
Results: We followed 1896 women for a median of 127 days (interquartile range [IQR], 86-174). Participants had a median age of 29 years (IQR, 24-34). Among the 1896 women, 49% were vaccinated with the 2018 influenza vaccine and 1039 (55%) developed influenza-like illness, 76 (7%) of whom had RT-PCR-confirmed influenza. Incidence rates of RT-PCR-confirmed influenza were 36.6 and 15.3 per 100 000 person-days among women who were unvaccinated and vaccinated, respectively. Adjusted influenza VE was 22% (95% confidence interval, -64.1% to 62.9%).
Conclusions: Participants vaccinated against influenza had more than 50% lower incidence of RT-PCR-confirmed influenza illness. Although the VE estimated through propensity weight-adjusted time-varying Cox regression did not reach statistical significance, our findings provide additional evidence about the value of maternal influenza vaccination in middle-income countries.
Keywords: Peru; influenza; maternal vaccination; pregnant; vaccine effectiveness.