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McMenamin ME, Bond HS, Sullivan SG, Cowling BJ. Estimation of Relative Vaccine Effectiveness in Influenza: A Systematic Review of Methodology. Epidemiology 2022; 33:334-345. [PMID: 35213508 PMCID: PMC8983951 DOI: 10.1097/ede.0000000000001473] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/31/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND When new vaccine components or platforms are developed, they will typically need to demonstrate noninferiority or superiority over existing products, resulting in the assessment of relative vaccine effectiveness (rVE). This review aims to identify how rVE evaluation is being performed in studies of influenza to inform a more standardized approach. METHODS We conducted a systematic search on PubMed, Google Scholar, and Web of Science for studies reporting rVE comparing vaccine components, dose, or vaccination schedules. We screened titles, abstracts, full texts, and references to identify relevant articles. We extracted information on the study design, relative comparison made, and the definition and statistical approach used to estimate rVE in each study. RESULTS We identified 63 articles assessing rVE in influenza virus. Studies compared multiple vaccine components (n = 38), two or more doses of the same vaccine (n = 17), or vaccination timing or history (n = 9). One study compared a range of vaccine components and doses. Nearly two-thirds of all studies controlled for age, and nearly half for comorbidities, region, and sex. Assessment of 12 studies presenting both absolute and relative effect estimates suggested proportionality in the effects, resulting in implications for the interpretation of rVE effects. CONCLUSIONS Approaches to rVE evaluation in practice is highly varied, with improvements in reporting required in many cases. Extensive consideration of methodologic issues relating to rVE is needed, including the stability of estimates and the impact of confounding structure on the validity of rVE estimates.
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Affiliation(s)
- Martina E. McMenamin
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Helen S. Bond
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Sheena G. Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Benjamin J. Cowling
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong, China
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Kenzaka T, Yahata S, Goda K, Kumabe A, Kamada M, Okayama M. Effects of Vaccination Day Routine Activities on Influenza Vaccine Efficacy and Vaccination-Induced Adverse Reaction Incidence: A Cohort Study. Vaccines (Basel) 2021; 9:vaccines9070753. [PMID: 34358169 PMCID: PMC8310289 DOI: 10.3390/vaccines9070753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to investigate the effect of vaccination day routine activities on the influenza vaccine efficacy and vaccination-induced adverse reaction incidence. Study participants were workers at three hospitals in the Hyogo Prefecture, Japan, who received the influenza vaccine between October and November, 2018 and 2019. Their data were collected using a questionnaire. The main factors, which were examined for vaccination day routine activities, were personal hygiene (bathing), smoking, alcohol consumption, caffeine intake, and exercise. The main outcome markers included influenza incidence during the winter season and vaccination-induced local or systemic adverse reaction incidence. The risk ratio for the main factors of vaccination day routine activities was calculated against the main outcome markers using the modified Poisson regression. Overall, 3780 people received the influenza vaccination, and 2731 submitted the questionnaire. We found that vaccination day routine activities did not affect the influenza vaccine efficacy, and engaging in strenuous exercise on the vaccination day tended to cause systemic adverse reactions. Moreover, lifestyle-related activities had no impact on the incidence of systemic or local adverse reactions. Therefore, it is advisable to only avoid strenuous physical exercise, and no other lifestyle-related restrictions are necessary on the day of influenza vaccination.
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Affiliation(s)
- Tsuneaki Kenzaka
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Hyogo, Kobe 652-0032, Japan; (K.G.); (A.K.)
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Hyogo, Tamba 669-3495, Japan;
- Correspondence: ; Tel.: +81-78-382-6732
| | - Shinsuke Yahata
- Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Hyogo, Kobe 652-0032, Japan; (S.Y.); (M.O.)
- Department of Internal Medicine, Shiso Municipal Hospital, Hyogo, Shiso 671-2576, Japan
| | - Ken Goda
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Hyogo, Kobe 652-0032, Japan; (K.G.); (A.K.)
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Hyogo, Tamba 669-3495, Japan;
| | - Ayako Kumabe
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Hyogo, Kobe 652-0032, Japan; (K.G.); (A.K.)
- Department of Internal Medicine, Toyooka Public Hospital, Hyogo, Toyooka 668-8501, Japan
| | - Momoka Kamada
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Hyogo, Tamba 669-3495, Japan;
| | - Masanobu Okayama
- Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Hyogo, Kobe 652-0032, Japan; (S.Y.); (M.O.)
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Bohn-Goldbaum E, Pascoe A, Singh MF, Singh N, Kok J, Dwyer DE, Mathieson E, Booy R, Edwards KM. Acute exercise decreases vaccine reactions following influenza vaccination among older adults. Brain Behav Immun Health 2020; 1:100009. [PMID: 38377422 PMCID: PMC8474530 DOI: 10.1016/j.bbih.2019.100009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/13/2019] [Indexed: 11/30/2022] Open
Abstract
Although valuable and effective in decreasing disease burden, influenza vaccination has low rates of efficacy, especially in those at most risk. Studies have shown that acute exercise can improve vaccine responses, most consistently with weaker antigens. Here we examined the effect of resistance exercise on the acute and longer-term responses to influenza vaccination among healthy older adults. Forty-six participants (47.8% male, mean 73.4 ± 6.6 years) were randomised to perform one 45-min moderate-intensity resistance exercise session or sit quietly prior to the receipt of influenza vaccination. Acute exercise reduced vaccine reactions but had no effect on either antibody responses or development of influenza-like symptoms during six months of follow-up. Psychosocial and behavioural characteristics were examined for potential associations with the responses to vaccination. Participants (n = 36) vaccinated in the previous year had higher baseline antibody titres but not follow-up titres nor more frequent experience of influenza-like symptoms over 6 months compared to those unvaccinated in the previous year. These findings provide further support for the ability of acute exercise to reduce vaccine reactions and suggest risk factors for vaccine responses for future exploration.
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Affiliation(s)
- Erika Bohn-Goldbaum
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
| | - April Pascoe
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
| | - Maria Fiatarone Singh
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
- The University of Sydney, Faculty of Health Sciences, Physical Activity, Lifestyle, Ageing and Wellbeing Research Group, Lidcombe, Australia
- Hebrew SeniorLife and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Nalin Singh
- The Centre for STRONG Medicine, Pymble, NSW, Australia
| | - Jen Kok
- Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital and University of Sydney, Sydney, Australia
| | - Dominic E. Dwyer
- Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital and University of Sydney, Sydney, Australia
| | | | - Robert Booy
- The University of Sydney, National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
| | - Kate M. Edwards
- The University of Sydney, Faculty of Health Sciences and Charles Perkins Centre, Sydney, Australia
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Lawrence H, Hunter A, Murray R, Lim WS, McKeever T. Cigarette smoking and the occurrence of influenza - Systematic review. J Infect 2019; 79:401-406. [PMID: 31465780 DOI: 10.1016/j.jinf.2019.08.014] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The association of current smoking with influenza infection is not widely recognised. The aim of this systematic review was to summarise published evidence and quantify the risk of influenza infection in tobacco smokers compared to non-smokers. METHODS We systematically searched MEDLINE, EMBASE, CINAHL, LILACS and Web of Science, from inception to 7 November 2017, to identify relevant randomised control trials, cohort and case-control studies. Study quality was assessed using the Newcastle-Ottawa Scale. We included studies defining influenza as a clinical syndrome and those using confirmatory microbiological tests. Pooled odds ratios (ORs) were estimated by using random effects model. RESULTS The mean quality score across the nine included studies (n = 40,685 participants) was 5.4 of 9 (SD 1.07). Current smokers were over 5 times more likely to develop laboratory-confirmed influenza than non-smokers (pooled OR 5.69 (95% CI 2.79-11.60), 3 studies). For studies reporting the occurrence of an influenza-like illness (ILI), current smokers were 34% more likely to develop ILI than non-smokers (pooled OR 1.34 (95% CI 1.13-1.59), 6 studies). CONCLUSION Current smokers have an increased risk of developing influenza compared to non-smokers. The association was strongest in studies examining cases with laboratory confirmed influenza.
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Affiliation(s)
- H Lawrence
- Nottingham University Hospitals NHS Trust, Clinical Sciences Building, Hucknall Road, Nottingham NG5 1 PB, UK; Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK.
| | - A Hunter
- Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - R Murray
- Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - W S Lim
- Nottingham University Hospitals NHS Trust, Clinical Sciences Building, Hucknall Road, Nottingham NG5 1 PB, UK; Nottingham Biomedical Research Centre NIHR, UK
| | - T McKeever
- Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK; Nottingham Biomedical Research Centre NIHR, UK
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Godoy P, Castilla J, Soldevila N, Mayoral JM, Toledo D, Martín V, Astray J, Egurrola M, Morales-Suarez-Varela M, Domínguez A. Smoking may increase the risk of influenza hospitalization and reduce influenza vaccine effectiveness in the elderly. Eur J Public Health 2017; 28:150-155. [DOI: 10.1093/eurpub/ckx130] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pere Godoy
- Department of Health, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiology and Public Health, Madrid, Spain
- IRBLleida, University of Lleida, Lleida, Spain
| | - Jesús Castilla
- CIBER Epidemiology and Public Health, Madrid, Spain
- Public Health Institute of Navarra, IdiSNA, Pamplona, Spain
| | - Núria Soldevila
- CIBER Epidemiology and Public Health, Madrid, Spain
- University of Barcelona, Barcelona, Spain
| | | | - Diana Toledo
- CIBER Epidemiology and Public Health, Madrid, Spain
- University of Barcelona, Barcelona, Spain
| | - Vicente Martín
- CIBER Epidemiology and Public Health, Madrid, Spain
- University of Leon, Leon, Spain
| | - Jenaro Astray
- CIBER Epidemiology and Public Health, Madrid, Spain
- Area of Epidemiology, Community of Madrid, Madrid, Spain
| | | | | | - Angela Domínguez
- CIBER Epidemiology and Public Health, Madrid, Spain
- University of Barcelona, Barcelona, Spain
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