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Emami A, Pirbonyeh N, Moattari A, Javanmardi F. A decade genetic diversity in Circulating influenza B virus in Iran (2010-2019): Divergence from WHO-recommended vaccine strains. Vopr Virusol 2023; 68:385-393. [PMID: 38156573 DOI: 10.36233/0507-4088-180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 10/15/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Data on the disease burden and circulation patterns of influenza B virus lineages for Iran are limited. OBJECTIVE This review aims to describe the pattern of influenza B occurrence in Iran, comparing it with the proposed vaccine strains and determining the match and mismatch with the prescribed vaccine annually. METHODS Various sources were used to retrieve information of the data; such as information from an online search of databases such as FluNet, GISAID, and NCBI. After extracting protein sequence records in GISAID, sequence alignment with vaccine strain and construction of a phylogenetic tree were performed. Subsequently, categories of the registered circulating strains were evaluated for matching with the vaccine strains. RESULTS Of the total registered influenza-positive samples, 20.21% were related to influenza B virus. The phylogenic tree was designed based on 43 samples registered in the GISAID database; 76.74 and 23.25% sequences were of Yamagata and Victoria lineages, respectively. The most prevalent influenza B virus strains circulating during the study years belonged to the Yamagata lineage. In general, the match of the influenza B virus predominant circulating strains with administrated vaccines was observed in Iran. However, a high level of mismatch between the vaccine strain and Iranian isolates was identified in 2016‒2017. CONCLUSION The review of match and mismatch in influenza vaccine in order to improve the composition of the prescribed vaccine in each region is very important because the vaccine efficacy decreased when the strain included in vaccine did not match the circulating epidemic strain.
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Affiliation(s)
- A Emami
- Shiraz University of medical sciences
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2
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Imran M, Puig-Barbera J, Ortiz JR, Lopez-Gonzalez L, Dean A, Bonafede M, Haag M. Relative Effectiveness of the Cell-Based Quadrivalent Influenza Vaccine in Preventing Cardiorespiratory Hospitalizations in Adults Aged 18-64 Years During the 2019-2020 US Influenza Season. Open Forum Infect Dis 2023; 10:ofad304. [PMID: 37496602 PMCID: PMC10368203 DOI: 10.1093/ofid/ofad304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 07/28/2023] Open
Abstract
Background The mammalian cell-based quadrivalent inactivated influenza vaccine (IIV4c) has advantages over egg-based quadrivalent inactivated influenza vaccine (IIV4e), as production using cell-derived candidate viruses eliminates the opportunity for egg adaptation. This study estimated the relative vaccine effectiveness (rVE) of IIV4c versus IIV4e in preventing cardiorespiratory hospitalizations during the 2019-2020 US influenza season. Methods We conducted a retrospective cohort study using electronic medical records linked to claims data of US individuals aged 18-64 years. We assessed rVE against cardiorespiratory hospitalizations and against subcategories of this outcome, including influenza, pneumonia, myocardial infarction and ischemic stroke, and respiratory hospitalizations. We used a doubly robust inverse probability of treatment weighting and logistic regression model to obtain odds ratios (ORs; odds of outcome among IIV4c recipients/odds of outcome among IIV4e recipients) adjusted for age, sex, race, ethnicity, geographic region, vaccination week, health status, frailty, and healthcare resource utilization. rVE was calculated as 100(1 - ORadjusted). Results In total, 1 491 097 individuals (25.2%) received IIV4c, and 4 414 758 (74.8%) received IIV4e. IIV4c was associated with lower odds of cardiorespiratory (rVE, 2.5% [95% confidence interval, 0.9%-4.1%]), respiratory (3.7% [1.5%-5.8%]), and influenza (9.3% [0.4%-17.3%]) hospitalizations among adults 18-64 years of age. No difference was observed for the other outcomes. Conclusions This real-world study conducted for the 2019-2020 season demonstrated that vaccination with IIV4c was associated with fewer cardiorespiratory, respiratory, and influenza hospitalizations compared with IIV4e.
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Affiliation(s)
- Mahrukh Imran
- Correspondence: Mahrukh Imran, MScPH, CSL Seqirus, Ste 504, 16766 TransCanada Hwy, Kirkland, QC H9H 4M7, Canada ()
| | | | - Justin R Ortiz
- University of Maryland School of Medicine, Baltimore, Maryland, USA
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Vaikutyte R, Kuliese M, Mickiene A, Jancoriene L, Zablockiene B, Gefenaite G. Influenza vaccine effectiveness in patients hospitalized with severe acute respiratory infection in Lithuania during the 2019-2020 influenza season: a test negative case - control study. Virol J 2023; 20:67. [PMID: 37046288 PMCID: PMC10091321 DOI: 10.1186/s12985-023-02015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/20/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Influenza is a contagious viral airborne disease that adds to the clinical and economic burden on the healthcare system. It could be prevented substantially by seasonal influenza vaccination. Seasonal influenza vaccine effectiveness (SIVE) varies a lot and should therefore be monitored. This report aims to update age-stratified SIVE estimates among patients hospitalized due to severe acute respiratory infection (SARI) during the 2019-2020 influenza season. METHODS We performed a test-negative case-control study between December 2019 and April 2020 influenza season. We estimated SIVE and its 95% confidence intervals (95% CI) with logistic regression as (1-odds ratio)*100%. The models were adjusted for covariates that changed the unadjusted SIVE by ≥ 10%. RESULTS Among 84 participants, 32 (38.1%) were influenza positive, mostly with A(H1N1)pdm09 (25 cases; 78.1%). SIVE against any influenza adjusted for age and heart disease was 39.2% (95% CI: -119.3%, 83.1%). Age-stratified point estimates adjusted for heart diseases indicated different SIVE, and were 64.0% (95% CI: -309.2%, 96.8%) and 21.6% (95% CI: -252.2%, 82.6%) for 18-64 and ≥ 65 year-old participants, respectively. CONCLUSIONS The point estimates suggested low to moderate SIVE against any influenza among hospitalized 18-64-year-old SARI participants, while low estimates were found in the ≥ 65-year-old group. Although broad SIVE confidence intervals indicate a small sample size and therefore the results can serve only as indicatory, they are in line with the estimates reported by other studies during the 2019-2020 season.
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Affiliation(s)
- Roberta Vaikutyte
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, Kaunas, 47116, Lithuania.
| | - Monika Kuliese
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, Kaunas, 47116, Lithuania
| | - Aukse Mickiene
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, Kaunas, 47116, Lithuania
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu street 14, Vilnius, 08406, Lithuania
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Santariskiu Street 14, Vilnius, 08406, Lithuania
| | - Birute Zablockiene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariskiu street 14, Vilnius, 08406, Lithuania
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Santariskiu Street 14, Vilnius, 08406, Lithuania
| | - Giedre Gefenaite
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, Kaunas, 47116, Lithuania
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund, 22100, Sweden
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MADE: A Computational Tool for Predicting Vaccine Effectiveness for the Influenza A(H3N2) Virus Adapted to Embryonated Eggs. Vaccines (Basel) 2022; 10:vaccines10060907. [PMID: 35746515 PMCID: PMC9227319 DOI: 10.3390/vaccines10060907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 01/29/2023] Open
Abstract
Seasonal Influenza H3N2 virus poses a great threat to public health, but its vaccine efficacy remains suboptimal. One critical step in influenza vaccine production is the viral passage in embryonated eggs. Recently, the strength of egg passage adaptation was found to be rapidly increasing with time driven by convergent evolution at a set of functionally important codons in the hemagglutinin (HA1). In this study, we aim to take advantage of the negative correlation between egg passage adaptation and vaccine effectiveness (VE) and develop a computational tool for selecting the best candidate vaccine virus (CVV) for vaccine production. Using a probabilistic approach known as mutational mapping, we characterized the pattern of sequence evolution driven by egg passage adaptation and developed a new metric known as the adaptive distance (AD) which measures the overall strength of egg passage adaptation. We found that AD is negatively correlated with the influenza H3N2 vaccine effectiveness (VE) and ~75% of the variability in VE can be explained by AD. Based on these findings, we developed a computational package that can Measure the Adaptive Distance and predict vaccine Effectiveness (MADE). MADE provides a powerful tool for the community to calibrate the effect of egg passage adaptation and select more reliable strains with minimum egg-passaged changes as the seasonal A/H3N2 influenza vaccine.
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Review of Analyses Estimating Relative Vaccine Effectiveness of Cell-Based Quadrivalent Influenza Vaccine in Three Consecutive US Influenza Seasons. Vaccines (Basel) 2022; 10:vaccines10060896. [PMID: 35746504 PMCID: PMC9228909 DOI: 10.3390/vaccines10060896] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/13/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
The adaptation of influenza seed viruses in egg culture can result in a variable antigenic vaccine match each season. The cell-based quadrivalent inactivated influenza vaccine (IIV4c) contains viruses grown in mammalian cell lines rather than eggs. IIV4c is not subject to egg-adaptive changes and therefore may offer improved protection relative to egg-based vaccines, depending on the degree of match with circulating influenza viruses. We summarize the relative vaccine effectiveness (rVE) of IIV4c versus egg-based quadrivalent influenza vaccines (IIV4e) to prevent influenza-related medical encounters (IRMEs) from three retrospective observational cohort studies conducted during the 2017–2018, 2018–2019, and 2019–2020 US influenza seasons using the same underlying electronic medical record dataset for all three seasons—with the addition of linked medical claims for the latter two seasons. We identified IRMEs using diagnostic codes specific to influenza disease (ICD J09*-J11*) from the records of over 10 million people. We estimated rVE using propensity score methods adjusting for age, sex, race, ethnicity, geographic location, week of vaccination, and health status. Subgroup analyses included specific age groups. IIV4c consistently had higher relative effectiveness than IIV4e across all seasons assessed, which were characterized by different dominant circulating strains and variable antigenic drift or egg adaptation.
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Tadakuma K, Maruyama T, Mori K, Fujiki N. Effectiveness of seasonal influenza vaccine in adult Japanese workers, 2017-2020. Vaccine 2021; 40:621-626. [PMID: 34952756 DOI: 10.1016/j.vaccine.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous studies have not estimated vaccine effectiveness (VE) against influenza in the working-age Japanese population. In this study, we determined VE in adult workers at a Japanese company. METHODS We estimated VE based on self-reported data regarding influenza infections and vaccinations in employees of an auto parts manufacturing company during three influenza seasons from 2017 to 2020. VE was estimated as 100% × [1 - odds ratio (the ratio of the odds of being diagnosed with influenza among enrollees with and without influenza vaccination)]. Odds ratios were estimated using logistic regression. RESULTS We included 11,347 worker records [3,592 (2017-18), 3,663 (2018-19), and 4,092 (2019-20)] from employees who had worked with the company throughout each influenza season. The adjusted VE was moderate and significant in the 2019-20 season (VE = 53%; 95% confidence interval [CI] = 30% to 69%) but low or negative and non-significant during the 2017-18 (VE = 28%; 95% CI = -5% to 50%) and 2018-19 (VE = -11%; 95% CI = - 42% to 14%) seasons. CONCLUSIONS Influenza vaccines were moderately effective during the 2019-20 season but showed low or negative effectiveness during the 2017-18 and 2018-19 seasons. Self-reports from worker records can successfully help determine VE against influenza.
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Affiliation(s)
- Kiyoshi Tadakuma
- Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Takashi Maruyama
- Department of Physiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koji Mori
- Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nobuhiro Fujiki
- Department of Ergonomics, Institute of Industrial and Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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Talbot HK, Martin ET, Gaglani M, Middleton DB, Ghamande S, Silveira FP, Murthy K, Zimmerman RK, Trabue CH, Olson SM, Petrie JG, Ferdinands JM, Patel MM, Monto AS. Coronavirus disease 2019 (COVID-19) Versus Influenza in Hospitalized Adult Patients in the United States: Differences in Demographic and Severity Indicators. Clin Infect Dis 2021; 73:2240-2247. [PMID: 34050659 PMCID: PMC8195096 DOI: 10.1093/cid/ciab123] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Novel coronavirus disease 2019 (COVID-19) is frequently compared with influenza. The Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) conducts studies on the etiology and characteristics of U.S. hospitalized adults with influenza. It began enrolling patients with COVID-19 hospitalizations in March 2020. Patients with influenza were compared with those with COVID-19 in the first months of the U.S. epidemic. METHODS Adults aged ≥ 18 years admitted to hospitals in 4 sites with acute respiratory illness were tested by real-time reverse transcription polymerase chain reaction for influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing COVID-19. Demographic and illness characteristics were collected for influenza illnesses during 3 seasons 2016-2019. Similar data were collected on COVID-19 cases admitted before June 19, 2020. RESULTS Age groups hospitalized with COVID-19 (n = 914) were similar to those admitted with influenza (n = 1937); 80% of patients with influenza and 75% of patients with COVID-19 were aged ≥50 years. Deaths from COVID-19 that occurred in younger patients were less often related to underlying conditions. White non-Hispanic persons were overrepresented in influenza (64%) compared with COVID-19 hospitalizations (37%). Greater severity and complications occurred with COVID-19 including more ICU admissions (AOR = 15.3 [95% CI: 11.6, 20.3]), ventilator use (AOR = 15.6 [95% CI: 10.7, 22.8]), 7 additional days of hospital stay in those discharged alive, and death during hospitalization (AOR = 19.8 [95% CI: 12.0, 32.7]). CONCLUSIONS While COVID-19 can cause a respiratory illness like influenza, it is associated with significantly greater severity of illness, longer hospital stays, and higher in-hospital deaths.
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Affiliation(s)
- H Keipp Talbot
- Department of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Emily T Martin
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Manjusha Gaglani
- Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas, USA
- Department of Medical Education at Texas A&M University COM, Texas, USA
| | - Donald B Middleton
- Department of Medicine, Division of Infectious Diseases, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Shekhar Ghamande
- Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas, USA
- Department of Medical Education at Texas A&M University COM, Texas, USA
| | - Fernanda P Silveira
- Department of Medicine, Division of Infectious Diseases, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Kempapura Murthy
- Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Richard K Zimmerman
- Department of Medicine, Division of Infectious Diseases, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Christopher H Trabue
- Department of Medicine, University of Tennessee Health Science Center, Saint Thomas Health, Nashville, Tennessee, USA
| | - Samantha M Olson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joshua G Petrie
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jill M Ferdinands
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manish M Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Arnold S Monto
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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8
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Boikos C, Fischer L, O'Brien D, Vasey J, Sylvester GC, Mansi JA. Relative Effectiveness of the Cell-derived Inactivated Quadrivalent Influenza Vaccine Versus Egg-derived Inactivated Quadrivalent Influenza Vaccines in Preventing Influenza-related Medical Encounters During the 2018-2019 Influenza Season in the United States. Clin Infect Dis 2021; 73:e692-e698. [PMID: 33400775 PMCID: PMC8326580 DOI: 10.1093/cid/ciaa1944] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/01/2021] [Indexed: 12/13/2022] Open
Abstract
Background The cell-propagated inactivated quadrivalent influenza vaccine (ccIIV4) may offer improved protection in seasons where egg-derived influenza viruses undergo mutations that affect antigenicity. This study estimated the relative vaccine effectiveness (rVE) of ccIIV4 versus egg-derived inactivated quadrivalent influenza vaccine (eIIV4) in preventing influenza-related medical encounters in the 2018–2019 US season. Methods A dataset linking primary care electronic medical records with medical claims data was used to conduct a retrospective cohort study among individuals ≥ 4 years old vaccinated with ccIIV4 or eIIV4 during the 2018–2019 season. Adjusted odds ratios (ORs) were derived from a doubly robust inverse probability of treatment-weighted approach adjusting for age, sex, race, ethnicity, geographic region, vaccination week, and health status. rVE was estimated by (1 – OR) × 100 and presented with 95% confidence intervals (CI). Results Following the application of inclusion/exclusion criteria, the study cohort included 2 125 430 ccIIV4 and 8 000 903 eIIV4 recipients. Adjusted analyses demonstrated a greater reduction in influenza-related medical encounters with ccIIV4 versus eIIV4, with the following rVE: overall, 7.6% (95% CI, 6.5–8.6); age 4–17 years, 3.9% (95% CI, .9–7.0); 18–64 years, 6.5% (95% CI, 5.2–7.9); 18–49 years, 7.5% (95% CI, 5.7–9.3); 50–64 years, 5.6% (95% CI, 3.6–7.6); and ≥65 years, –2.2% (95% CI, –5.4 to .9). Conclusions Adjusted analyses demonstrated statistically significantly greater reduction in influenza-related medical encounters in individuals vaccinated with ccIIV4 versus eIIV4 in the 2018–2019 US influenza season. These results support ccIIV4 as a potentially more effective public health measure against influenza than an egg-based equivalent.
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Affiliation(s)
| | | | | | - Joe Vasey
- Veradigm, San Francisco, California, USA
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Chung JR, Rolfes MA, Flannery B, Prasad P, O'Halloran A, Garg S, Fry AM, Singleton JA, Patel M, Reed C. Effects of Influenza Vaccination in the United States During the 2018-2019 Influenza Season. Clin Infect Dis 2021; 71:e368-e376. [PMID: 31905401 DOI: 10.1093/cid/ciz1244] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/02/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Multivalent influenza vaccine products provide protection against influenza A(H1N1)pdm09, A(H3N2), and B lineage viruses. The 2018-2019 influenza season in the United States included prolonged circulation of A(H1N1)pdm09 viruses well-matched to the vaccine strain and A(H3N2) viruses, the majority of which were mismatched to the vaccine. We estimated the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the season. METHODS We used a mathematical model and Monte Carlo algorithm to estimate numbers and 95% uncertainty intervals (UIs) of influenza-associated outcomes prevented by vaccination in the United States. The model incorporated age-specific estimates of national 2018-2019 influenza vaccine coverage, influenza virus-specific vaccine effectiveness from the US Influenza Vaccine Effectiveness Network, and disease burden estimated from population-based rates of influenza-associated hospitalizations through the Influenza Hospitalization Surveillance Network. RESULTS Influenza vaccination prevented an estimated 4.4 million (95%UI, 3.4 million-7.1 million) illnesses, 2.3 million (95%UI, 1.8 million-3.8 million) medical visits, 58 000 (95%UI, 30 000-156 000) hospitalizations, and 3500 (95%UI, 1000-13 000) deaths due to influenza viruses during the US 2018-2019 influenza season. Vaccination prevented 14% of projected hospitalizations associated with A(H1N1)pdm09 overall and 43% among children aged 6 months-4 years. CONCLUSIONS Influenza vaccination averted substantial influenza-associated disease including hospitalizations and deaths in the United States, primarily due to effectiveness against A(H1N1)pdm09. Our findings underscore the value of influenza vaccination, highlighting that vaccines measurably decrease illness and associated healthcare utilization even in a season in which a vaccine component does not match to a circulating virus.
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Affiliation(s)
- Jessie R Chung
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa A Rolfes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Pragati Prasad
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Alissa O'Halloran
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alicia M Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James A Singleton
- Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carrie Reed
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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10
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Boikos C, Imran M, Nguyen VH, Ducruet T, Sylvester GC, Mansi JA. Effectiveness of the Cell-Derived Inactivated Quadrivalent Influenza Vaccine in Individuals at High Risk of Influenza Complications in the 2018-2019 United States Influenza Season. Open Forum Infect Dis 2021; 8:ofab167. [PMID: 34327253 PMCID: PMC8314952 DOI: 10.1093/ofid/ofab167] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/30/2021] [Indexed: 12/25/2022] Open
Abstract
Background Higher rates of influenza-related morbidity and mortality occur in individuals with underlying medical conditions. To improve vaccine effectiveness, cell-based technology for influenza vaccine manufacturing has been developed. Cell-derived inactivated quadrivalent influenza vaccines (cIIV4) may improve protection in seasons in which egg-propagated influenza viruses undergo mutations that affect antigenicity. This study aimed to estimate the relative vaccine effectiveness (rVE) of cIIV4 versus egg-derived inactivated quadrivalent influenza vaccines (eIIV4) in preventing influenza-related medical encounters in individuals with underlying medical conditions putting them at high risk of influenza complications during the 2018-2019 US influenza season. Methods An integrated dataset, linking primary care electronic medical records with claims data, was used to conduct a retrospective cohort study among individuals aged ≥4 years, with ≥1 health condition, vaccinated with cIIV4 or eIIV4 during the 2018-2019 season. Adjusted odds ratios (ORs) were derived using a doubly robust inverse probability of treatment-weighting (IPTW) model, adjusting for age, sex, race, ethnicity, geographic region, vaccination week, and health status. Relative vaccine effectiveness was estimated by (1 - OR) × 100 and presented with 95% confidence intervals (CIs). Results The study cohort included 471 301 cIIV4 and 1 641 915 eIIV4 recipients. Compared with eIIV4, cIIV4 prevented significantly more influenza-related medical encounters among individuals with ≥1 health condition (rVE, 13.4% [95% CI, 11.4%-15.4%]), chronic pulmonary disease (rVE, 18.7% [95% CI, 16.0%-21.3%]), and rheumatic disease (rVE, 11.8% [95% CI, 3.6%-19.3%]). Conclusions Our findings support the use of cIIV4 in individuals ≥4 years of age at high risk of influenza complications and provide further evidence supporting improved effectiveness of cIIV4 compared with eIIV4.
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Thangarajah D, Malo JA, Field E, Andrews R, Ware RS, Lambert SB. Effectiveness of quadrivalent influenza vaccination in the first year of a funded childhood program in Queensland, Australia, 2018. Vaccine 2020; 39:729-737. [PMID: 33358414 DOI: 10.1016/j.vaccine.2020.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/31/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Following high influenza activity in 2017, the state of Queensland, Australia, funded a quadrivalent inactivated influenza vaccination program for children aged 6 months to <5 years in 2018. We calculated influenza vaccine effectiveness (VE) among children eligible for this program. METHODS A matched case-control study was conducted. Cases were identified using Queensland 2018 influenza notification data among children age-eligible for funded vaccination. Controls were drawn from Australian Immunisation Register records of Queensland resident children age-eligible for funded influenza vaccine. Up to 10 controls per case were matched for location and birthdate. First dose vaccination was valid if received ≥14 days prior to specimen collection; a second dose was valid if received ≥28 days after first dose receipt. VE was calculated for vaccine doses and adherence to national recommendations for two doses in the first season (schedule completeness) and adjusted (VEadj) for sex and First Nations status. RESULTS There were 1,125 cases and 10,645 matched controls analysed. Overall VEadj against laboratory-confirmed influenza was 51% (95% confidence interval (CI) 41-60). VEadj was 60% (95% CI 46-70) for children who received two doses in 2018, and 60% (95% CI 48-69) for children vaccinated appropriately according to schedule completeness. VE increased with age. CONCLUSIONS Moderate vaccine effectiveness was observed for children eligible for the funded program in Queensland in 2018, adding to the sparse evidence for influenza vaccine use in Australian children. Adhering to the national first season two dose schedule for influenza vaccine receipt in children ensures maximum protection.
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Affiliation(s)
- Dharshi Thangarajah
- Communicable Diseases Branch, Queensland Health, Brisbane, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia.
| | - Jonathan A Malo
- Communicable Diseases Branch, Queensland Health, Brisbane, Australia.
| | - Emma Field
- National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia; Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
| | - Ross Andrews
- National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia; Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
| | - Stephen B Lambert
- Communicable Diseases Branch, Queensland Health, Brisbane, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra Australia.
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Ferdinands JM, Gaglani M, Ghamande S, Martin ET, Middleton D, Monto AS, Silveira F, Talbot HK, Zimmerman R, Smith ER, Patel M. Vaccine Effectiveness Against Influenza-Associated Hospitalizations Among Adults, 2018-2019, US Hospitalized Adult Influenza Vaccine Effectiveness Network. J Infect Dis 2020; 224:151-163. [PMID: 33336702 DOI: 10.1093/infdis/jiaa772] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/14/2020] [Indexed: 01/18/2023] Open
Abstract
We estimated vaccine effectiveness (VE) for prevention of influenza-associated hospitalizations among adults during the 2018-2019 influenza season. Adults admitted with acute respiratory illness to 14 hospitals of the US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) and testing positive for influenza were cases; patients testing negative were controls. VE was estimated using logistic regression and inverse probability of treatment weighting. We analyzed data from 2863 patients with a mean age of 63 years. Adjusted VE against influenza A(H1N1)pdm09-associated hospitalization was 51% (95% confidence interval [CI], 25%-68%). Adjusted VE against influenza A(H3N2) virus-associated hospitalization was -2% (95% CI, -65% to 37%) and differed significantly by age, with VE of -130% (95% CI, -374% to -27%) among adults 18 to ≤56 years of age. Although vaccination halved the risk of influenza A(H1N1)pdm09-associated hospitalizations, it conferred no protection against influenza A(H3N2)-associated hospitalizations. We observed negative VE for young and middle-aged adults but cannot exclude residual confounding as a potential explanation.
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Affiliation(s)
- Jill M Ferdinands
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Donald Middleton
- University of Pittsburgh Medical Center; Pittsburgh, Pennsylvania, USA
| | - Arnold S Monto
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Fernanda Silveira
- University of Pittsburgh Medical Center; Pittsburgh, Pennsylvania, USA
| | - Helen K Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Richard Zimmerman
- University of Pittsburgh Medical Center; Pittsburgh, Pennsylvania, USA
| | - Emily R Smith
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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13
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Wong J, Tai CM, Hurt AC, Tan HX, Kent SJ, Wheatley AK. Sequencing B cell receptors from ferrets (Mustela putorius furo). PLoS One 2020; 15:e0233794. [PMID: 32470013 PMCID: PMC7259655 DOI: 10.1371/journal.pone.0233794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/12/2020] [Indexed: 12/16/2022] Open
Abstract
The domestic ferret (Mustela putorius furo) provides a critical animal model to study human respiratory diseases. However immunological insights are restricted due to a lack of ferret-specific reagents and limited genetic information about ferret B and T cell receptors. Here, variable, diversity and joining genes within the ferret kappa, lambda and heavy chain immunoglobulin loci were annotated using available genomic information. A multiplex PCR approach was derived that facilitated the recovery of paired heavy and light chain immunoglobulin sequences from single sorted ferret B cells, allowing validation of predicted germline gene sequences and the identification of putative novel germlines. Eukaryotic expression vectors were developed that enabled the generation of recombinant ferret monoclonal antibodies. This work advances the ferret as an informative immunological model for viral diseases by allowing the in-depth interrogation of antibody-based immunity.
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Affiliation(s)
- Julius Wong
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Celeste M. Tai
- World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Aeron C. Hurt
- World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Hyon-Xhi Tan
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Stephen J. Kent
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre and Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
- ARC Centre for Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Parkville, Victoria, Australia
- * E-mail: (AKW); (SJK)
| | - Adam K. Wheatley
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- ARC Centre for Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Parkville, Victoria, Australia
- * E-mail: (AKW); (SJK)
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Navarro Alonso JA. La gripe: 76 años de vacuna antigripal… ¡y de la hemaglutinina! REVISTA MADRILEÑA DE SALUD PÚBLICA 2020. [DOI: 10.36300/remasp.2020.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Se revisa someramente la historia de los virus gripales y los pasos dados desde que se utilizó masivamente la primera vacuna de virus completos, hasta la descripción de las distintas vías de vehiculizar o de administrar la hemaglutinina de las que disponemos en
la actualidad, en aras de mejorar la respuesta inmune y por tanto la protección clínica de toda la población.
Se exponen brevemente los requisitos que debería cumplir una futura vacuna “universal” para que pudiera ser usada con carácter sistemático y los distintos proyectos en marcha.
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Affiliation(s)
- José Antonio Navarro Alonso
- Dirección General de Salud Pública y Adicciones Consejería de Salud. Comunidad Autónoma de la Región de Murcia
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15
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Glatman-Freedman A, Pando R, Sefty H, Omer I, Rosenberg A, Drori Y, Nemet I, Mendelson E, Keinan-Boker L, Mandelboim M. Predominance of a Drifted Influenza A (H3N2) Clade and its Association with Age-specific Influenza Vaccine Effectiveness Variations, Influenza Season 2018-2019. Vaccines (Basel) 2020; 8:vaccines8010078. [PMID: 32050460 PMCID: PMC7157661 DOI: 10.3390/vaccines8010078] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/24/2020] [Accepted: 01/29/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Influenza A (H3N2) clade 3C.3a was the predominant influenza virus in Israel throughout the 2018-2019 season, constituting a drift from the influenza A (H3N2) vaccine. We estimated the end-of season vaccine effectiveness (VE) by age, among community patients with influenza-like illness (ILI), considering the hemagglutinin (HA) gene mutations and amino acid substitutions of influenza A (H3N2) viruses detected. Methods: Nose-throat samples were analyzed for the presence of influenza virus, type/subtype, and HA gene sequence. HA gene sequences and amino acid substitutions were compared to the influenza A/Singapore/INFIMH-16-0019/2016 (H3N2)-like 2018-2019 vaccine virus, and a phylogenetic tree was generated. Influenza VE against influenza A (H3N2) was estimated using the test-negative design. VE was estimated by age group and by 15 year moving age intervals. Results: In total, 90% of the influenza A (H3N2) viruses belonged to the 3C.3a clade, constituting a unique situation in the northern hemisphere. Adjusted all-age influenza A (H3N2) VE was −3.5% (95% CI: −51.2 to 29.1). Although adjusted VEs were very low among infants, children, and young adults, a VE of 45% (95% CI: −19.2 to 74.6) was estimated among adults aged ≥45 years old. Conclusions: The higher VE point estimates among older adults may be related to previous exposure to similar influenza viruses.
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Affiliation(s)
- Aharona Glatman-Freedman
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
- School of Public Health, Tel Aviv University Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence:
| | - Rakefet Pando
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
- Central Virology Laboratory, Sheba Medical Center, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
| | - Hanna Sefty
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
| | - Itay Omer
- School of Public Health, Tel Aviv University Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Alina Rosenberg
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
| | - Yaron Drori
- School of Public Health, Tel Aviv University Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Central Virology Laboratory, Sheba Medical Center, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
| | - Ital Nemet
- Central Virology Laboratory, Sheba Medical Center, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
| | - Ella Mendelson
- School of Public Health, Tel Aviv University Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Central Virology Laboratory, Sheba Medical Center, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
- School of Public Health, University of Haifa, Haifa 3498838, Israel
| | - Michal Mandelboim
- School of Public Health, Tel Aviv University Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Central Virology Laboratory, Sheba Medical Center, Israel Ministry of Health, Tel Hashomer, Ramat Gan 5265601, Israel
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Flannery B, Kondor RJG, Chung JR, Gaglani M, Reis M, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, Monto AS, Martin ET, Belongia EA, McLean HQ, Kim SS, Blanton L, Kniss K, Budd AP, Brammer L, Stark TJ, Barnes JR, Wentworth DE, Fry AM, Patel M. Spread of Antigenically Drifted Influenza A(H3N2) Viruses and Vaccine Effectiveness in the United States During the 2018-2019 Season. J Infect Dis 2020; 221:8-15. [PMID: 31665373 PMCID: PMC7325528 DOI: 10.1093/infdis/jiz543] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Increased illness due to antigenically drifted A(H3N2) clade 3C.3a influenza viruses prompted concerns about vaccine effectiveness (VE) and vaccine strain selection. We used US virologic surveillance and US Influenza Vaccine Effectiveness (Flu VE) Network data to evaluate consequences of this clade. METHODS Distribution of influenza viruses was described using virologic surveillance data. The Flu VE Network enrolled ambulatory care patients aged ≥6 months with acute respiratory illness at 5 sites. Respiratory specimens were tested for influenza by means of reverse-transcriptase polymerase chain reaction and were sequenced. Using a test-negative design, we estimated VE, comparing the odds of influenza among vaccinated versus unvaccinated participants. RESULTS During the 2018-2019 influenza season, A(H3N2) clade 3C.3a viruses caused an increasing proportion of influenza cases. Among 2763 Flu VE Network case patients, 1325 (48%) were infected with A(H1N1)pdm09 and 1350 (49%) with A(H3N2); clade 3C.3a accounted for 977 (93%) of 1054 sequenced A(H3N2) viruses. VE was 44% (95% confidence interval, 37%-51%) against A(H1N1)pdm09 and 9% (-4% to 20%) against A(H3N2); VE was 5% (-10% to 19%) against A(H3N2) clade 3C.3a viruses. CONCLUSIONS The predominance of A(H3N2) clade 3C.3a viruses during the latter part of the 2018-2019 season was associated with decreased VE, supporting the A(H3N2) vaccine component update for 2019-2020 northern hemisphere influenza vaccines.
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Affiliation(s)
- Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jessie R Chung
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manjusha Gaglani
- Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas
| | - Michael Reis
- Baylor Scott & White Health, Texas A&M University College of Medicine, Temple, Texas
| | - Richard K Zimmerman
- University of Pittsburgh Schools of Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Mary Patricia Nowalk
- University of Pittsburgh Schools of Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Michael L Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Lisa A Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Arnold S Monto
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | - Sara S Kim
- Oak Ridge Institute for Science and Education Fellowship Program, Oak Ridge, Tennessee
| | - Lenee Blanton
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Krista Kniss
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia P Budd
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lynnette Brammer
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomas J Stark
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John R Barnes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David E Wentworth
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia M Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manish Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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