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Shinjoh M, Yaginuma M, Yamaguchi Y, Tamura K, Furuichi M, Tsumura Y, Itaki R, Iqbal A, Maeda N, Narabayashi A, Kamei A, Shibata A, Yamada G, Nishida M, Kenichiro T, Chiga M, Shimoyamada M, Yoshida M, Fukushima N, Nakata Y, Fukushima H, Kawakami C, Narumi S, Sugaya N. Effectiveness of inactivated influenza vaccine in children during the 2023/24 season: The first season after relaxation of intensive COVID-19 measures. Vaccine 2024; 42:126241. [PMID: 39178768 DOI: 10.1016/j.vaccine.2024.126241] [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: 06/23/2024] [Revised: 07/28/2024] [Accepted: 08/14/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND The annual administration of the influenza vaccine is the most effective method for preventing influenza. We have evaluated the effectiveness of the inactivated influenza vaccine in children aged 6 months to 15 years across the seasons from 2013/2014 to 2022/2023. This study aims to investigate the effectiveness of the inactivated influenza vaccine in the 2023/2024 season, the first year following the easing of strict COVID-19 measures, and possibly the last season when only the inactivated vaccine is available on the market. METHODS Adjusted vaccine effectiveness for the 2023/2024 season was assessed using a test-negative case-control design, with results based on polymerase chain reaction and rapid influenza diagnostic tests. Vaccine effectiveness was calculated by influenza type and patient hospitalization/outpatient status. RESULTS A total of 1832 children were recruited. The inactivated influenza vaccine was effective in preventing both symptomatic influenza A and B in both inpatient and outpatient settings. Overall vaccine effectiveness for influenza A was 51% (95% confidence interval [CI], 23%-69%, n = 930) in inpatient settings and 54% (95%CI, 27%-71%, n = 559) in outpatient settings. For influenza B, effectiveness was 60% (95%CI, 22%-79%, n = 859) in inpatient settings and 56% (95%CI, 26%-74%, n = 558) in outpatient settings. Analysis suggested that administering two doses enhanced effectiveness specifically against influenza B. CONCLUSIONS This is the first study to demonstrate influenza vaccine effectiveness in children after the relaxation of strict COVID-19 measures in Japan (2023/2024). We recommend the current inactivated vaccine for preventing both influenza A and B in children, with consideration for the potential use of two doses to enhance effectiveness against influenza B.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Division of Infectious Diseases and Infection Control, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoshio Yamaguchi
- Department of Clinical Research, Department of Infection and Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomaturi, Utsunomiya-City, Tochigi 320-8580, Japan
| | - Kazuyo Tamura
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1 Koukan-dori, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-0852, Japan
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yuki Tsumura
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai Nishi-ku, Yokohama-shi, Kanagawa 220-8521, Japan
| | - Ryo Itaki
- Department of Pediatrics, Tokyo Metropolitan Otsuka Hospital, 2-8-1 Minamiotsuka, Toshima-ku, Tokyo 170-8476, Japan
| | - Asef Iqbal
- Department of Pediatrics, National Hospital Organization, Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan
| | - Akinobu Kamei
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843, Japan
| | - Go Yamada
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Ohshimacho, Ota City, Gunma 273-8585, Japan
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka-shi, Shizuoka 424-8636, Japan
| | - Tsunematsu Kenichiro
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0062, Japan
| | - Michiko Chiga
- Department of Pediatrics, Tokyo Metropolitan Otsuka Hospital, 2-8-1 Minamiotsuka, Toshima-ku, Tokyo 170-8476, Japan
| | - Motoko Shimoyamada
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-0911, Japan
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-chou, Sano-city, Tochigi 327-8511, Japan
| | - Naoya Fukushima
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1 Koukan-dori, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-0852, Japan
| | - Hiroyuki Fukushima
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano Ichikawa, Chiba 272-0824, Japan
| | - Chiharu Kawakami
- National Center for Global Health and Medicine Research Institute, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Satoshi Narumi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Norio Sugaya
- Keio Pediatric Influenza Research Group, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Shinjoh M, Furuichi M, Tsuzuki S, Iqbal A, Fukushima N, Soen S, Fukushima H, Kobayashi K, Yamada G, Narabayashi A, Tsunematsu K, Maeda N, Shimoyamada M, Yoshida M, Kuramochi Y, Shibata A, Yamaguchi Y, Yaginuma M, Takahashi T, Ishikane M, Sugaya N. Effectiveness of inactivated influenza and COVID-19 vaccines in hospitalized children in 2022/23 season in Japan - The first season of co-circulation of influenza and COVID-19. Vaccine 2023:S0264-410X(23)00785-5. [PMID: 37419851 DOI: 10.1016/j.vaccine.2023.06.082] [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: 06/08/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
We have analyzed the inactivated vaccine effectiveness (VE)for preventing influenza hospitalization by test-negative design in the 2022/23 season. This is the first season of co-circulation of influenza and COVID-19, and a unique period because all inpatients received COVID-19 screening. Among 536 children hospitalized with fever, none were positive for both influenza and SARS-CoV-2. The adjusted VE for preventing influenza A for all children, the 6-12-year-old group, and those with underlying diseases was 34 % (95 %CI, -16 %-61 %, n = 474), 76 % (95 % CI, 21 %-92 %, n = 81), and 92 % (95 % CI, 30 %-99 %, n = 86), respectively. Only 1 out of 35 hospitalized cases with COVID-19, and 42 out of 429 controls, had been immunized with COVID-19 vaccine. This is the first report showing influenza VE by age group in children in this limited season. We still recommend the inactivated influenza vaccine for children based on the significant VE in subgroup analysis.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Division of Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Keio Pediatric Influenza Research Group, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, AMR Clinical Reference Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | - Asef Iqbal
- Department of Pediatrics, National Hospital Organization, Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan.
| | - Naoya Fukushima
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Sachiko Soen
- Department of Pediatrics, Tokyo Metropolitan Otsuka Hospital, 2-8-1 Minamiotsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Hiroyuki Fukushima
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano Ichikawa, Chiba 272-0824, Japan.
| | - Ken Kobayashi
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama, 221-0855 Kanagawa, Japan.
| | - Go Yamada
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0061, Japan.
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
| | - Motoko Shimoyamada
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-0911, Japan.
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-chou, Sano-city, Tochigi 327-8511, Japan.
| | - Yuu Kuramochi
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Ohshimacho, Ota City, Gunma 273-8585, Japan.
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, Department of Infection and Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomaturi, Utsunomiya-City, Tochigi 320-8580, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | - Norio Sugaya
- Keio Pediatric Influenza Research Group, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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Kajiume T, Mukai S, Toyota N, Kanazawa I, Kato A, Akimoto E, Shirakawa T. Effectiveness of seasonal influenza vaccine in elementary and middle schools: a 10-year follow-up investigation. BMC Infect Dis 2022; 22:909. [PMID: 36474168 PMCID: PMC9724312 DOI: 10.1186/s12879-022-07898-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Influenza spreads from schools to the rest of society. Thus, we conducted questionnaire surveys of influenza vaccination in elementary and middle schools in a district for 10 years to determine immunization rates and infection conditions among students who were potential sources of infection at home. METHODS The questionnaire-based survey on influenza vaccine administration, influenza infection, and influenza types contracted, as well as influenza immunization history, was conducted in 10 seasons over a period of 10 years. RESULTS In elementary schools, vaccination was associated with lower morbidity in most years, whereas in middle schools, morbidity increased among students who were vaccinated every year. Our study did not find consistent trends among faculty and staff. In addition, we found that morbidity was significantly higher among elementary (P < 0.001) and middle (P < 0.05) school students who had been vaccinated since infancy than among those who had not been vaccinated since infancy. CONCLUSIONS The results of this study suggest that vaccinating infants for influenza may increase the risk of contracting influenza later in life.
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Affiliation(s)
- Teruyuki Kajiume
- Hiroshima Akichiku Medical Association, 5-13 Sakae-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0043 Japan ,Mukainada Child Clinic, 24-26 Aosaki-naka, Fuchu-cho, Aki-gun, Hiroshima, 735-0016 Japan
| | - Sumera Mukai
- Hiroshima Akichiku Medical Association, 5-13 Sakae-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0043 Japan ,Mukai Clinic of Internal Medicine, 2-2-8 Tahara, Ondo-cho, Kure-city, Hiroshima 737-1216 Japan
| | - Nobutaka Toyota
- Hiroshima Akichiku Medical Association, 5-13 Sakae-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0043 Japan ,Toyota Ladies Clinic, 4-30-1 Kawasumi, Kumano-cho, Aki-gun, Hiroshima, 731-4223 Japan
| | - Ikuo Kanazawa
- Hiroshima Akichiku Medical Association, 5-13 Sakae-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0043 Japan ,Kanazawa Cardiology Clinic, 4-10-18 Yano-nishi, Aki-ku, Hiroshima, 736-0085 Japan
| | - Akiko Kato
- Hiroshima Akichiku Medical Association, 5-13 Sakae-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0043 Japan ,Kato Gastroenterology Clinic, 3-3-14 Nakano-higashi, Aki-ku, Hiroshima, 739-0323 Japan
| | - Etsushi Akimoto
- Hiroshima Akichiku Medical Association, 5-13 Sakae-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0043 Japan ,Akimoto Clinic, 3-34 Inari-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0067 Japan
| | - Toshio Shirakawa
- Hiroshima Akichiku Medical Association, 5-13 Sakae-machi, Kaita-cho, Aki-gun, Hiroshima, 736-0043 Japan ,Senosirakawa Hospital, 1-28-3 Seno, Aki-ku, Hiroshima, 739-0311 Japan
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4
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Influenza vaccine effectiveness against hospitalization during the 2018/2019 season among older persons aged ≥ 75 years in Japan: The LIFE-VENUS Study. Vaccine 2022; 40:5023-5029. [PMID: 35851488 DOI: 10.1016/j.vaccine.2022.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/19/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Older persons are recommended to receive annual influenza vaccinations due to their increased susceptibility to influenza infections and related complications. Routine assessments of influenza vaccine effectiveness (IVE) in older persons may help to improve vaccine development and vaccination strategies, but there is a lack of consistent epidemiological data from Japan. This study aimed to evaluate IVE against hospitalization during the 2018/2019 season among older persons aged ≥ 75 years in Japan. METHODS This cohort study was conducted using insurance claims data and vaccination records provided by the Longevity Improvement & Fair Evidence - Vaccine Effectiveness, Networking, and Universal Safety (LIFE-VENUS) Study. The study cohort comprised older persons aged ≥ 75 years residing in an urban municipality in Japan. Vaccinated participants were identified through vaccination records from October 2018 to January 2019, and were matched with unvaccinated participants using a 1:1 ratio. The IVE against hospitalization was calculated as (1-hazard ratio) × 100% while adjusting for covariates such as age, sex, comorbidities, previous vaccinations, and care needs levels. RESULTS We analyzed 30,881 vaccinated participants matched with 30,881 unvaccinated participants. Among these, 587 (1.9%) vaccinated participants and 644 (2.1%) unvaccinated participants were hospitalized during the 2018/2019 season. The adjusted IVE against hospitalization was estimated to be 28.9% (16.6-39.4%). CONCLUSIONS The influenza vaccine for the 2018/2019 season showed moderate effectiveness among older persons in Japan. The LIFE-VENUS Study represents a potential platform for the continued monitoring of IVE among the older Japanese population.
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Matsuda A, Asayama K, Obara T, Yagi N, Ohkubo T. Effectiveness of Influenza Vaccination among Children in Satellite Cities of a Metropolitan Area in Tokyo, Japan during the 2014/2015-2018/2019 Season. TOHOKU J EXP MED 2022; 258:69-78. [PMID: 35831118 DOI: 10.1620/tjem.2022.j057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ayako Matsuda
- Center for Public Health Informatics, National Institute of Public Health
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Tohoku Institute for Management of Blood Pressure.,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University
| | | | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven
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Shinjoh M, Furuichi M, Kobayashi H, Yamaguchi Y, Maeda N, Yaginuma M, Kobayashi K, Nogayama T, Chiga M, Oshima M, Kuramochi Y, Yamada G, Narabayashi A, Ookawara I, Nishida M, Tsunematsu K, Kamimaki I, Shimoyamada M, Yoshida M, Shibata A, Nakata Y, Taguchi N, Mitamura K, Takahashi T. Trends in effectiveness of inactivated influenza vaccine in children by age groups in seven seasons immediately before the COVID-19 era. Vaccine 2022; 40:3018-3026. [PMID: 35450780 PMCID: PMC8995322 DOI: 10.1016/j.vaccine.2022.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022]
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Hisato Kobayashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, Department of Infection and Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomaturi, Utsunomiya-City, Tochigi 320-8580, Japan.
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Ken Kobayashi
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama 221-0855, Kanagawa, Japan.
| | - Taisuke Nogayama
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Michiko Chiga
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Mio Oshima
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Yuu Kuramochi
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Ohshimacho, Ota City, Gunma 273-8585, Japan.
| | - Go Yamada
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan; Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, 8-2 Outemachi, Aoi-ku, Shizuoka 420-0853, Japan.
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka-shi, Shizuoka 424-8636, Japan.
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0061, Japan.
| | - Isamu Kamimaki
- Department of Pediatrics, National Hospital Organization, Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan.
| | - Motoko Shimoyamada
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-0911, Japan.
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-chou, Sano-city, Tochigi 327-8511, Japan.
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843, Japan.
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1Koukan-Dori, Kawasaki, Kanagawa 210-0852, Japan.
| | - Nobuhiko Taguchi
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8581, Japan.
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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7
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Ando S. Effectiveness of the 2019-2020 Influenza Vaccine and the Effect of Prior Influenza Infection and Vaccination in Children during the First Influenza Season Overlapping with the COVID-19 Epidemic. J NIPPON MED SCH 2021; 88:524-532. [PMID: 33692300 DOI: 10.1272/jnms.jnms.2022_89-102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Behavioral changes among Japanese, along with the coronavirus disease 2019 (COVID-19) epidemic, may affect the seasonal influenza epidemic in Japan and change influenza vaccine effectiveness (VE). METHODS This single-center, test-negative case-control (TNCC) study estimated influenza VE in children for the first influenza season (2019/20) to overlap the COVID-19 epidemic in. Effects of prior influenza infection and vaccination in children were assessed for the 2019-2020 season. RESULTS Among 386 children, adjusted VE was significant for influenza A/H1N1 (45.5%; 95% confidence interval [CI]: 2.0-69.7) and influenza B (66.7%; 95% CI: 35.9-82.7). Among patients aged 0-6 years, adjusted VE was significant for influenza A (total: A/H1N1+A/H3N2) (65.0%; 95% CI: 22.2-84.3), influenza A/H1N1 (64.8%; 95% CI: 16.9-85.1) and influenza B (87.4%; 95% CI: 50.5-96.8). No VE was observed in patients aged 7-15 years. Administration of two vaccine doses tended to decrease incidences of influenza A (total) and influenza A/H1N1 in patients aged 0-6 years. The adjusted odds ratios (ORs) of influenza B infection in patients, who had influenza during the previous season, were significantly lower among all participants (0.29; 95% CI: 0.11-0.78) and patients aged 7-15 years (0.34; 95% CI: 0.12-0.94). The adjusted ORs of influenza infections were not significant in patients vaccinated during the previous season. CONCLUSIONS TNCC-based estimates of influenza VE were consistent despite the overlapping COVID-19 epidemic.
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8
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Shinjoh M, Furuichi M, Narabayashi A, Kamei A, Yoshida N, Takahashi T. Risk factors in pediatric hospitalization for influenza A and B during the seven seasons immediately before the COVID-19 era in Japan. J Infect Chemother 2021; 27:1735-1742. [PMID: 34454832 DOI: 10.1016/j.jiac.2021.08.020] [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: 04/27/2021] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The risk factors in pediatric influenza immediately before the COVID-19 era are not well understood. This study aims to evaluate the risk factors for hospitalization in pediatric influenza A and B for the recent seasons. METHODS Children with a fever of ≥38 °C and laboratory-confirmed influenza at 20 hospitals in outpatient settings in Japan in the 2013/14 to 2019/20 seasons were retrospectively reviewed. Possible risk factors, including gender, age, comorbidities, nursery school or kindergarten attendance, earlier diagnosis, no immunization, lower regional temperature, earlier season, and period of onset, were evaluated using binary logistic regression methods. RESULTS A total of 13,040 (type A, 8861; B, 4179) children were evaluated. Significant risk factors (p < 0.05) in multivariate analyses were young age, lower regional temperature, earlier season, respiratory illness (adjusted odds ratio [aOR]:2.76, 95% confidence interval [CI]:1.84-4.13), abnormal behavior and/or unusual speech (aOR:2.78, 95% CI:1.61-4.80), and seizures at onset (aOR:16.8, 95% CI:12.1-23.3) for influenza A; and young age, lower regional temperature, respiratory illness (aOR:1.99, 95% CI:1.00-3.95), history of febrile seizures (aOR:1.73, 95% CI:1.01-2.99), and seizures at onset (aOR:9.74, 95% CI:5.44-17.4) for influenza B. CONCLUSIONS In addition to previously known factors, including young age, seizures, and respiratory illness, abnormal behavior and/or unusual speech and lower regional temperature are new factors. Negative immunization status was not a risk factor for hospitalization. A better understanding of risk factors may help improve the determination of indications for hospitalization during the future co-circulation of influenza and COVID-19.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawa-dori, Kawasaki-ku, Kawasaki City, Kanagawa, 210-0013, Japan.
| | - Akinobu Kamei
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-ku, Yokohama, Kanagawa, 221-0855, Japan.
| | - Naoko Yoshida
- Department of Tropical Medicine and Parasitology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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9
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Hu W, DeMarcus LS, Sjoberg PA, Robbins AS. Inactivated influenza vaccine effectiveness among department of defense beneficiaries aged 6 months-17 years, 2016-2017 through 2019-2020 influenza seasons. PLoS One 2021; 16:e0256165. [PMID: 34450617 PMCID: PMC8397503 DOI: 10.1371/journal.pone.0256165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/30/2021] [Indexed: 11/18/2022] Open
Abstract
A test-negative case-control study was conducted to assess inactivated influenza vaccine effectiveness (VE) in children aged 6 months-17 years. The database was developed from the US Department of Defense Global Respiratory Pathogen Surveillance Program over four consecutive influenza seasons from 2016 to 2020. A total of 9,385 children including 4,063 medically attended, laboratory-confirmed influenza-positive cases were identified for VE analysis. A generalized linear mixed model with logit link and binomial distribution was used to estimate the VE. The adjusted VE for children was 42% [95% confidence interval (CI): 37-47%] overall, including 55% (95% CI: 47-61%) for influenza A(H1N1)pdm09, 37% (95% CI: 28-45%) for influenza A(H3N2), and 49% (95% CI: 41-55%) for influenza B. The analysis by age groups indicated that the adjusted VE in children aged 6 months-4 years was higher against influenza A(H1N1)pdm09 and influenza B, and comparable against influenza A(H3N2), compared to those in children aged 5-17 years. Further age-stratified analysis showed that the VE against any types of influenza was low and non-significant for children aged 6-11 months (33%; 95% CI:-2-56%), but it was high (54%; 95% CI: 34-67%) in children aged 12-23 months, and then declined linearly with increasing age. In conclusion, the inactivated influenza vaccination was moderately effective against influenza infection, based on the analysis from a large number of children aged 6 months-17 years over multiple influenza seasons.
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MESH Headings
- Adolescent
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/pathogenicity
- Influenza A Virus, H3N2 Subtype/drug effects
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/pathogenicity
- Influenza Vaccines/immunology
- Influenza Vaccines/therapeutic use
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Male
- Seasons
- Vaccination
- Vaccine Efficacy
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Affiliation(s)
- Wenping Hu
- The Department of Defense Global Emerging Infections Surveillance Branch, Armed Forces Health Surveillance Division, WPAFB, OH, United States of America
- JYG Innovations, LLC, Dayton, OH, United States of America
- * E-mail:
| | - Laurie S. DeMarcus
- The Department of Defense Global Emerging Infections Surveillance Branch, Armed Forces Health Surveillance Division, WPAFB, OH, United States of America
- JYG Innovations, LLC, Dayton, OH, United States of America
| | - Paul A. Sjoberg
- The Department of Defense Global Emerging Infections Surveillance Branch, Armed Forces Health Surveillance Division, WPAFB, OH, United States of America
- JYG Innovations, LLC, Dayton, OH, United States of America
| | - Anthony S. Robbins
- The Department of Defense Global Emerging Infections Surveillance Branch, Armed Forces Health Surveillance Division, WPAFB, OH, United States of America
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10
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Shinjoh M, Sugaya N, Yamaguchi Y, Ookawara I, Nakata Y, Narabayashi A, Furuichi M, Yoshida N, Kamei A, Kuramochi Y, Shibata A, Shimoyamada M, Nakazaki H, Maejima N, Yuasa E, Araki E, Maeda N, Ohnishi T, Nishida M, Taguchi N, Yoshida M, Tsunematsu K, Shibata M, Hirano Y, Sekiguchi S, Kawakami C, Mitamura K, Takahashi T. Influenza vaccine effectiveness against influenza A in children based on the results of various rapid influenza tests in the 2018/19 season. PLoS One 2021; 16:e0249005. [PMID: 33770132 PMCID: PMC7997015 DOI: 10.1371/journal.pone.0249005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 03/09/2021] [Indexed: 11/18/2022] Open
Abstract
During influenza epidemics, Japanese clinicians routinely conduct rapid influenza diagnostic tests (RIDTs) in patients with influenza-like illness, and patients with positive test results are treated with anti-influenza drugs within 48 h after the onset of illness. We assessed the vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children (6 months-15 years old, N = 4243), using a test-negative case-control design based on the results of RIDTs in the 2018/19 season. The VE against influenza A(H1N1)pdm and A(H3N2) was analyzed separately using an RIDT kit specifically for detecting A(H1N1)pdm09. The adjusted VE against combined influenza A (H1N1pdm and H3N2) and against A(H1N1)pdm09 was 39% (95% confidence interval [CI], 30%-46%) and 74% (95% CI, 39%-89%), respectively. By contrast, the VE against non-A(H1N1)pdm09 influenza A (presumed to be H3N2) was very low at 7%. The adjusted VE for preventing hospitalization was 56% (95% CI, 16%-77%) against influenza A. The VE against A(H1N1)pdm09 was consistently high in our studies. By contrast, the VE against A(H3N2) was low not only in adults but also in children in the 2018/19 season.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, Kanagawa, Japan
- * E-mail:
| | - Yoshio Yamaguchi
- Institute of Clinical Research & Department of Infection and Allergy, National Hospital Organization Tochigi Hospital, Tochigi, Japan
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, Kanagawa, Japan
| | | | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Naoko Yoshida
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Akinobu Kamei
- Department Pediatrics, Yokohama Municipal Citizen’s Hospital, Kanagawa, Japan
| | - Yuu Kuramochi
- Department of Pediatrics, Subaru Health Insurance Society Ota Memorial Hospital, Gunma, Japan
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | | | - Hisataka Nakazaki
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Naohiko Maejima
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
| | - Erika Yuasa
- Department of Pediatrics, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Eriko Araki
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takuma Ohnishi
- Department of Pediatrics, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, Shizuoka, Japan
| | | | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, Tochigi, Japan
| | | | - Meiwa Shibata
- Department of Pediatrics, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Yasuhiro Hirano
- Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan
| | | | | | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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11
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Schussek S, Bernasconi V, Mattsson J, Wenzel UA, Strömberg A, Gribonika I, Schön K, Lycke NY. The CTA1-DD adjuvant strongly potentiates follicular dendritic cell function and germinal center formation, which results in improved neonatal immunization. Mucosal Immunol 2020; 13:545-557. [PMID: 31959882 PMCID: PMC7223721 DOI: 10.1038/s41385-020-0253-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 02/04/2023]
Abstract
Vaccination of neonates and young infants is hampered by the relative immaturity of their immune systems and the lack of safe and efficacious vaccine adjuvants. Immaturity of the follicular dendritic cells (FDCs), in particular, appears to play a critical role for the inability to stimulate immune responses. Using the CD21mT/mG mouse model we found that at 7 days of life, FDCs exhibited a mature phenotype only in the Peyer´s patches (PP), but our unique adjuvant, CTA1-DD, effectively matured FDCs also in peripheral lymph nodes following systemic, as well as mucosal immunizations. This was a direct effect of complement receptor 2-binding to the FDC and a CTA1-enzyme-dependent enhancing effect on gene transcription, among which CR2, IL-6, ICAM-1, IL-1β, and CXCL13 encoding genes were upregulated. This way we achieved FDC maturation, increased germinal center B-cell- and Tfh responses, and enhanced specific antibody levels close to adult magnitudes. Oral priming immunization of neonates against influenza infection with CTA1-3M2e-DD effectively promoted anti-M2e-immunity and significantly reduced morbidity against a live virus challenge infection. To the best of our knowledge, this is the first study to demonstrate direct effects of an adjuvant on FDC gene transcriptional functions and the subsequent enhancement of neonatal immune responses.
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Affiliation(s)
- Sophie Schussek
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Valentina Bernasconi
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Johan Mattsson
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Ulf Alexander Wenzel
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Anneli Strömberg
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Inta Gribonika
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Karin Schön
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Nils Y Lycke
- Mucosal Immunobiology and Vaccine Center (MIVAC), Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.
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12
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Ando S. Estimation of the Effectiveness of Quadrivalent Influenza Vaccines by Distinguishing Between Influenza A (H1N1) pdm09 and Influenza A (H3N2) Using Rapid Influenza Diagnostic Tests During the 2018-2019 Season. Intern Med 2020; 59:933-940. [PMID: 31787695 PMCID: PMC7184079 DOI: 10.2169/internalmedicine.3616-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To estimate the effectiveness of quadrivalent influenza vaccines during the 2018-2019 season for influenza A (H1N1) pdm09 and A (H3N2) in all age groups. Methods A test-negative case-control study was performed. Patients A total of 1,331 participants were divided into 4 groups (younger children: ≤6 years, older children: 7-15 years, younger adults: 16-64 years, and older adults: ≥65 years). Results For all children, the adjusted vaccine effectiveness (VE) was significant against any influenza [41.3% (95% confidence interval (CI): 19.7-57.2%)], total A [A (H1N1) pdm09 and (H3N2); 38.3% (95% CI: 15.1-55.1%)], and A [H3N2; 39.8% (95% CI: 13.8-57.9%)]. In younger children, the adjusted VE against any influenza was 44.8% (95% CI: 14.1-64.5%) and against total A was 43.8% (95% CI: 12.5-63.9%). For all adults, the adjusted VE was significant against any influenza was 42.3% (95% CI: 17.9-59.5%); total A, 39.3% (95% CI: 13.5-57.4%); A (H1N1) pdm09, 56.7% (95% CI: 19.1-76.8%); and A (H3N2), 33.2% (95% CI: 1.5-54.6%). In younger adults, the adjusted VE against any influenza was 43.4% (95% CI: 17.3-61.2%), total A, 41.7% (95% CI: 14.4-60.3%); A (H1N1) pdm09, 56.2% (95% CI: 14.9-77.5%); and A (H3N2), 34.5% (95% CI: 0.3-56.9%). In both older children and older adults, no significant VE was observed. Conclusion This study is the first to report on the VE against all types of influenza in all age groups using a rapid influenza diagnostic test. The VE varied with both age and influenza subtype.
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13
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Influenza vaccine effectiveness against influenza-associated hospitalization in children: A systematic review and meta-analysis. Vaccine 2020; 38:2893-2903. [PMID: 32113808 DOI: 10.1016/j.vaccine.2020.02.049] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/12/2020] [Accepted: 02/15/2020] [Indexed: 01/20/2023]
Abstract
Vaccination remains the most effective way to prevent influenza infection, albeit vaccine effectiveness (VE) varies by year. Compared to other age groups, children and elderly adults have the highest risk of developing influenza-related complications and requiring hospitalization. During the last years, "test negative design" (TND) studies have been implemented in order to estimate influenza VE. The aim of this systematic review and meta-analysis was to summarize the findings of TND studies reporting influenza VE against laboratory-confirmed influenza-related hospitalization in children aged 6 months to 17 years. We searched the PubMed and Embase databases and identified 2615 non-duplicate studies that required detailed review. Among them, 28 met our inclusion criteria and we performed a random-effects meta-analysis using adjusted VE estimates. In our primary analysis, influenza vaccine offered significant protection against any type influenza-related hospitalization (57.48%; 95% CI 49.46-65.49). When we examined influenza VE per type and strain, VE was higher against H1N1 (74.07%; 95% CI: 54.85-93.30) and influenza B (50.87%; 95% CI: 41.75-59.98), and moderate against H3N2 (40.77%; 95% CI: 25.65-55.89). Notably, influenza vaccination offered higher protection in children who were fully vaccinated (61.79%; 95% CI: 54.45-69.13), compared to those who were partially vaccinated (33.91%; 95% CI: 21.12 - 46.69). Also, influenza VE was high in children less than 5 years old (61.71%; 95% CI: 49.29-74.12) as well as in children 6-17 years old (54.37%; 95% CI: 35.14-73.60). In conclusion, in the pediatric population, influenza vaccination offered significant protection against influenza-related hospitalization and complete annual vaccination should be encouraged.
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14
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Huang KYA, Huang YC, Chiu CH, Tsao KC, Lin TY. Impaired Vaccine-Induced Antibody Response Against Clade 6B H1N1 Viruses in Individuals Before Viral Emergence. Open Forum Infect Dis 2020; 7:ofz513. [PMID: 31950072 PMCID: PMC6954487 DOI: 10.1093/ofid/ofz513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/06/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Clade 6B H1N1 pdm09 influenza viruses cause substantial morbidity and mortality worldwide. Human antibody profiles elicited upon vaccination against the clade 6B virus are largely unclear before viral emergence. METHODS Healthy volunteers, including children aged 3-8 years, adolescents aged 9-17 years, and adults, were enrolled before the clade 6B H1N1 outbreak and received the 2013-2014 inactivated influenza vaccine. We determined antibody responses before and after vaccination. Vaccine-induced plasmablast-derived antibodies were tested against H1N1 pdm09 reference and clade 6B viruses. RESULTS The majority of the subjects generated robust hemagglutination inhibition and neutralizing antibody responses upon vaccination across the different age groups. Nevertheless, a subset of young adults preferentially produced antibodies that failed to neutralize clade 6B viruses that emerged and circulated in 2014-2016. The hemagglutinin K163Q change at the Sa antigenic site, one of the substitutions that define clade 6B viruses, was responsible for resistance to neutralization by both postvaccination sera and vaccine-induced plasmablast-derived antibodies. CONCLUSIONS Vaccine-induced antibody immunity is compromised by the antigenic change of H1N1 pdm09 virus in a subset of adults, and this may warrant the incorporation of human serology in the antigenic characterization of virus and vaccine strain selection.
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Affiliation(s)
- Kuan-Ying A Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Molecular Infectious Disease Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yhu-Chering Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Molecular Infectious Disease Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuo-Chien Tsao
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzou-Yien Lin
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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15
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Chua H, Feng S, Lewnard JA, Sullivan SG, Blyth CC, Lipsitch M, Cowling BJ. The Use of Test-negative Controls to Monitor Vaccine Effectiveness: A Systematic Review of Methodology. Epidemiology 2020; 31:43-64. [PMID: 31609860 PMCID: PMC6888869 DOI: 10.1097/ede.0000000000001116] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The test-negative design is an increasingly popular approach for estimating vaccine effectiveness (VE) due to its efficiency. This review aims to examine published test-negative design studies of VE and to explore similarities and differences in methodological choices for different diseases and vaccines. METHODS We conducted a systematic search on PubMed, Web of Science, and Medline, for studies reporting the effectiveness of any vaccines using a test-negative design. We screened titles and abstracts and reviewed full texts to identify relevant articles. We created a standardized form for each included article to extract information on the pathogen of interest, vaccine(s) being evaluated, study setting, clinical case definition, choices of cases and controls, and statistical approaches used to estimate VE. RESULTS We identified a total of 348 articles, including studies on VE against influenza virus (n = 253), rotavirus (n = 48), pneumococcus (n = 24), and nine other pathogens. Clinical case definitions used to enroll patients were similar by pathogens of interest but the sets of symptoms that defined them varied substantially. Controls could be those testing negative for the pathogen of interest, those testing positive for nonvaccine type of the pathogen of interest, or a subset of those testing positive for alternative pathogens. Most studies controlled for age, calendar time, and comorbidities. CONCLUSIONS Our review highlights similarities and differences in the application of the test-negative design that deserve further examination. If vaccination reduces disease severity in breakthrough infections, particular care must be taken in interpreting vaccine effectiveness estimates from test-negative design studies.
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Affiliation(s)
- Huiying Chua
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shuo Feng
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joseph A Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher C Blyth
- Division of Paediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Marc Lipsitch
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
- Center for Communicable Disease Dynamics, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Benjamin J Cowling
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
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16
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Chua H, Chiu SS, Chan ELY, Feng S, Kwan MYW, Wong JSC, Peiris JSM, Cowling BJ. Effectiveness of Partial and Full Influenza Vaccination Among Children Aged <9 Years in Hong Kong, 2011-2019. J Infect Dis 2019; 220:1568-1576. [PMID: 31290537 PMCID: PMC6782104 DOI: 10.1093/infdis/jiz361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Two doses of influenza vaccination are recommended for previously unvaccinated children aged <9 years, and receipt of 1 dose is sometimes termed "partial vaccination." We assessed the effectiveness of partial and full influenza vaccination in preventing influenza-associated hospitalization among children in Hong Kong. METHODS Using the test-negative design we enrolled 23 187 children aged <9 years admitted to hospitals with acute respiratory illness from September 2011 through March 2019. Vaccination and influenza status were recorded. Fully vaccinated children included those vaccinated with 2 doses or, if previously vaccinated, those vaccinated with 1 dose. Partially vaccinated children included those who should have received 2 doses but only received 1 dose. We estimated vaccine effectiveness (VE) by using conditional logistic regression models matched on epidemiological week. RESULTS Overall VE estimates among fully and partially vaccinated children were 73% (95% confidence interval, 69%-77%) and 31% (95% confidence interval, 8%-48%), respectively. A consistently higher VE was observed in children fully vaccinated against each influenza virus type/subtype. The effectiveness of partial vaccination did not vary by age group. CONCLUSIONS Partial vaccination was significantly less effective than full vaccination. Our study supports the current recommendation of 2 doses of influenza vaccination in previously unvaccinated children <9 years of age.
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Affiliation(s)
- Huiying Chua
- 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, China
| | - Susan S Chiu
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital and Li Ka Shing Faculty of Medicine, The University of Hong Kong, China
| | - Eunice L Y Chan
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital and Li Ka Shing Faculty of Medicine, The University of Hong Kong, China
| | - Shuo Feng
- 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, China
| | - Mike Y W Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
| | - Joshua S C Wong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
| | - J S Malik Peiris
- 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, China
| | - Benjamin J Cowling
- 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, China
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17
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Kuniyoshi Y, Obara T, Ishikuro M, Matsubara H, Nagai M, Murakami K, Noda A, Kikuya M, Kure S, Kuriyama S. Effectiveness of seasonal inactivated influenza vaccination in Japanese schoolchildren: an epidemiologic study at the community level. Hum Vaccin Immunother 2019; 16:295-300. [PMID: 31424311 DOI: 10.1080/21645515.2019.1655833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Influenza vaccination is the most effective method for preventing influenza virus infection. The incidence of influenza is higher in schoolchildren than other age groups. This study evaluated the effectiveness of seasonal inactivated influenza vaccination (IIV) in a community population of schoolchildren during two seasons. This study was a cross-sectional survey of public schoolchildren based on data collected in the 2012/2013 and 2014/2015 seasons. The questionnaire was distributed to all public schoolchildren of target grade in a survey area, and 7945 respondents were included in the analysis. The vaccination status and influenza onset were defined based on the self-reported questionnaire by parents or guardians. Generalized linear mixed models were used to adjust clustering within schools and individual covariates and calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between vaccination status and influenza onset. The influenza incidence was higher in the 2015 than the 2013 survey (25% versus 17%), although the vaccination rates were comparable between the two seasons. Receiving one- or two-dose vaccination was more protective against influenza than non-vaccination in both the 2013 (OR, 0.77; 95%CI, 0.65-0.92) and 2015 (OR, 0.88; 95%CI, 0.75-1.02) surveys. Full vaccination was also more protective in both the 2013 (OR, 0.75; 95%CI, 0.62-0.89) and 2015 (OR, 0.86; 95%CI, 0.74-1.00) surveys. Seasonal IIV was protective against influenza for Japanese schoolchildren in a community-based real-world setting. The difference in clinical effectiveness of IIV between the two seasons was likely due to the antigenic mismatch between the circulating and vaccine strains.
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Affiliation(s)
- Yasutaka Kuniyoshi
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Hiroko Matsubara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Masato Nagai
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Pediatrics, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
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18
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Shinjoh M, Sugaya N, Furuichi M, Araki E, Maeda N, Isshiki K, Ohnishi T, Nakamura S, Yamada G, Narabayashi A, Nishida M, Taguchi N, Nakata Y, Yoshida M, Tsunematsu K, Shibata M, Munenaga T, Hirano Y, Ookawara I, Sekiguchi S, Kobayashi Y, Yamaguchi Y, Yoshida N, Mitamura K, Takahashi T. Effectiveness of inactivated influenza vaccine in children by vaccine dose, 2013-18. Vaccine 2019; 37:4047-4054. [PMID: 31186191 DOI: 10.1016/j.vaccine.2019.05.090] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/19/2019] [Accepted: 05/31/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We assessed the vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) by vaccine dose in children aged 6 months to 12 years for whom two doses are recommended in Japan to ascertain the appropriate vaccine doses. METHODS VE was assessed according to a test-negative case-control design based on rapid influenza diagnostic test (RIDT) results. Children aged 6 months to 12 years with a fever ≥38 °C who had received an RIDT in outpatient clinics of 24 hospitals were enrolled for all five seasons since 2013/14. VE by vaccine dose (none vs. once or twice, and once vs. twice) was analyzed. RESULTS In the dose analysis, 20,033 children were enrolled. Both one- and two-dose regimens significantly reduced cases in preventing any influenza, influenza A, and influenza B, but there was no significant difference in adjusted VE between one- and two-dose regimens overall (adjusted OR, 0.560 [95% CI, 0.505-0.621], 0.550 [95% CI, 0.516-0.586]), 0.549 [95% CI, 0.517-0.583], and 1.014 [95% CI, 0.907-1.135], for none vs. once, none vs. twice, none vs. once or twice, and once vs. twice for any influenza, respectively). Both one- and two-dose regimens significantly reduced cases with any influenza and influenza A every season. Also, both regimens significantly reduced cases of any influenza, influenza A, and influenza B among children aged 1-12 years, especially among those aged 1-5 years. In the 2013/14, 2015/16, and 2016/17 seasons, however, only the two-dose regimen was significantly effective in preventing influenza B. Both one- and two-dose regimens significantly reduced cases involving hospitalization due to any influenza and influenza A. CONCLUSIONS Both one- and two-doses regimens of IIV were effective in preventing influenza for children aged 6 months to 12 years. The two-dose regimen was more effective against influenza B in some seasons.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, 220-0012 Kanagawa, Japan; Department of Infection Control, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, 220-0012 Kanagawa, Japan
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Eriko Araki
- Pediatrics, Yokohama City Municipal Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama-city, Kanagawa 240-8555, Japan
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-0021, Japan
| | - Kyohei Isshiki
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-8522, Japan
| | - Takuma Ohnishi
- Department of Pediatrics, National Hospital Organization Saitama National Hospital, 2-1 Suwa, Wako-shi, Saitama 321-0102, Japan
| | - Shoko Nakamura
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan
| | - Go Yamada
- Pediatrics, Saiseikai Utsunomiya Hospital, #201, 3-9-11 Nishiki, Utsunomiya-shi, Tochigi 321-0967, Japan
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki City, Kanagawa 210-0013, Japan
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka-shi, Shizuoka 424-8636, Japan
| | - Nobuhiko Taguchi
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa 220-8581, Japan
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1 Koukandori, Kawasaki, Kanagawa 210-0852, Japan
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kousei General Hospital, 1728 Horigome-cho, Sano City, Tochigi 327-8511, Japan
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0062, Japan
| | - Meiwa Shibata
- Division of Pediatrics, Yokohama Rosai Hospital, 3211 Kozukue-Cho, Kohoku-ku, Yokohama 222-0036, Japan
| | - Takeshi Munenaga
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Oshima-chou, Ota-shi, Gumma 373-8585, Japan
| | - Yasuhiro Hirano
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka-Shi, Kanagawa 254-0065, Japan
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, 8-2 Outemachi, Aoi-ku, Shizuoka 420-0853, Japan
| | - Shinichiro Sekiguchi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yasuaki Kobayashi
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1, Yobecho, Ashikaga, Tochigi 326-0843, Japan
| | - Yoshio Yamaguchi
- Institute of Clinical Research, Department of Infection & Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomatsuri, Utsunomiya-shi, Tochigi 320-8580, Japan
| | - Naoko Yoshida
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, 2-23-16 Higashi-Ueno, Taito-ku, Tokyo 110-8645, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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19
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Chon I, Saito R, Hibino A, Yagami R, Dapat C, Odagiri T, Kondo H, Sato I, Kimura S, Kawashima T, Kodo N, Masaki H, Asoh N, Tsuchihashi Y, Zaraket H, Shobugawa Y. Effectiveness of the quadrivalent inactivated influenza vaccine in Japan during the 2015-2016 season: A test-negative case-control study comparing the results by real time PCR, virus isolation. Vaccine X 2019; 1:100011. [PMID: 31384733 PMCID: PMC6668230 DOI: 10.1016/j.jvacx.2019.100011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We estimated influenza vaccine effectiveness (VE) in 2015-2016 season against medically attended, laboratory-confirmed influenza, when quadrivalent inactivated vaccine (IIV4) was first introduced in Japan, using test-negative case-control design. Influenza A(H1N1)pdm09 cocirculated with B/Yamagata and B/Victoria during the study period in Japan. METHOD We based our case definition on two laboratory tests, real-time reverse transcription polymerase chain reaction (RT PCR), and virus isolation and compared VEs based on these tests. In addition, VE was evaluated by rapid diagnostic test (RDT). Nasopharyngeal swabs were collected from outpatients who visited clinics with influenza-like illness (ILIs) in Hokkaido, Niigata, Gunma and Nagasaki prefectures. RESULTS Among 713 children and adults enrolled in this study, 578 were influenza positive by RT PCR including, 392 influenza A and 186 influenza B, while 135 were tested negative controls. The adjusted VE by RT PCR for all ages against any influenza was low protection of 36.0% (95% confidence interval [CI], 3.1% to 58.6%), for influenza A was 30.0% (95% CI: -10.0% to 55.5%), and influenza B was moderate 50.2% (95% CI: 13.3% to 71.4%). Adjusted VE for virus isolation for A(H1N1)pdm09 was 37.1% (95% CI: 1.7% to 59.7%), Yamagata lineage 51.3% (95% CI: 6.4% to 74.7%) and Victoria lineage 21.3% (95% CI: -50.0% to 58.9%). VE was highest and protective in 0-5 years old group against any influenza and influenza A and B/Yamagata, but the protective effect was not observed for other age groups and B/Victoria. RDT demonstrated concordant results with RT PCR and virus isolation. Sequencing of hemagglutinin gene showed that all A(H1N1)pdm09 belong to clade 6B including 31 strains (88.6%), which belong to clade 6B.1 possessing S162N mutations that may alter antigenicity and affect VE for A(H1N1)pdm09. CONCLUSIONS IIV4 influenza vaccine during 2015-2016 was effective against A(H1N1)pdm09 and the two lineages of type B. Younger children was more protected than older children and adults by vaccination.
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Affiliation(s)
- Irina Chon
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Reiko Saito
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akinobu Hibino
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ren Yagami
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Clyde Dapat
- Department of Virology, Tohoku University Graduate School of Medicine
| | - Takashi Odagiri
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroki Kondo
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Isamu Sato
- Yoiko-no-Syounika Sato Pediatric Clinic, Niigata, Japan
| | - Shinji Kimura
- Center for Medical Education, Sapporo Medical University, Sapporo, Japan
| | | | | | | | | | | | - Hassan Zaraket
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department Pathology, Immunology, and Microbiology, Faculty of Medicine American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Yugo Shobugawa
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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20
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Sullivan SG, Price OH, Regan AK. Burden, effectiveness and safety of influenza vaccines in elderly, paediatric and pregnant populations. Ther Adv Vaccines Immunother 2019; 7:2515135519826481. [PMID: 30793097 PMCID: PMC6376509 DOI: 10.1177/2515135519826481] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 12/20/2018] [Indexed: 11/17/2022] Open
Abstract
Vaccination is the most practical means available for preventing influenza. Influenza vaccines require frequent updates to keep pace with antigenic drift of the virus, and the effectiveness, and sometimes the safety, of the vaccine can therefore vary from season to season. Three key populations that the World Health Organization recommends should be prioritized for influenza vaccination are pregnant women, children younger than 5 years of age and the elderly. This review discusses the burden of influenza and the safety and effectiveness profile of influenza vaccines recommended for these groups.
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Affiliation(s)
- Sheena G. Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria 3000, Australia
- School of Population and Global Health, University of Melbourne, Australia Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Olivia H. Price
- WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Annette K. Regan
- School of Public Health, Texas A&M University, College Station, TX, United States; School of Public Health, Curtin University, Perth, Western Australia, Australia, and Wesfamers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Crawley, Western Australia, Australia
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21
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Shinjoh M, Sugaya N, Yamaguchi Y, Iibuchi N, Kamimaki I, Goto A, Kobayashi H, Kobayashi Y, Shibata M, Tamaoka S, Nakata Y, Narabayashi A, Nishida M, Hirano Y, Munenaga T, Morita K, Mitamura K, Takahashi T. Inactivated influenza vaccine effectiveness and an analysis of repeated vaccination for children during the 2016/17 season. Vaccine 2018; 36:5510-5518. [DOI: 10.1016/j.vaccine.2018.07.065] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/26/2018] [Accepted: 07/25/2018] [Indexed: 01/13/2023]
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22
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Influenza vaccine showed a good preventive effect against influenza-associated hospitalization among elderly patients, during the 2016/17 season in Japan. J Infect Chemother 2018; 24:873-880. [PMID: 30100400 DOI: 10.1016/j.jiac.2018.07.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/28/2018] [Accepted: 07/18/2018] [Indexed: 01/09/2023]
Abstract
The 2016/17 influenza season in Japan was characterized by a predominance of influenza A (H3N2) activity; with H3N2 accounting for 85% of all detected influenza virus infections. We assessed the vaccine effectiveness (VE) of an inactivated quadrivalent influenza vaccine (IIV4) in adult patients, using a test-negative case-control design study based on the results of a rapid influenza diagnostic test (RIDT). Between November 2016 and March 2017, a total of 1048 adult patients were enrolled: including 363 RIDT positive for influenza A, 9 RIDT-positive for influenza B, and 676 RIDT-negative. During the 2016/17 season, the overall adjusted VE was 28.8% (95% confidence interval [CI]: 6.3-46%). The adjusted VE against influenza A was 27.4% (95%CI: 4.4-45%). The VE against influenza B could not be estimated because of the very low number of influenza B patients. Twenty-nine patients were hospitalized due to influenza-associated illness-during the present study, all of whom were infected with influenza A virus. The adjusted VE, determined using a case-control study, for preventing hospitalization for influenza A infection was 72.6% (95%CI: 30.7-89.1%). In addition, the VE for preventing hospitalization of influenza patients with comorbidities was 78.2% (95%CI: 41.1-92%). Our study showed that, during the 2016/17season, IIV4 was effective for preventing both the onset of influenza and influenza-associated hospitalization.
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23
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Kimiya T, Shinjoh M, Anzo M, Takahashi H, Sekiguchi S, Sugaya N, Takahashi T. Effectiveness of inactivated quadrivalent influenza vaccine in the 2015/2016 season as assessed in both a test-negative case-control study design and a traditional case-control study design. Eur J Pediatr 2018; 177:1009-1017. [PMID: 29680993 DOI: 10.1007/s00431-018-3145-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/09/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
Abstract
UNLABELLED Both traditional case-control studies (TCCSs) and test-negative case-control studies (TNCCSs) are commonly used to assess influenza vaccine effectiveness (VE). To compensate for the fact that observational studies are susceptible to bias, we combined both methods to assess VE in one geographical area during the 2015/2016 season, when influenza A (H1N1)pdm was dominant. Our TNCCS covered 331 children aged 6 months to 15 years who visited our hospital with fever, including 182 with influenza, and our TCCS covered 812 pediatric outpatients aged 6 months to 15 years, including 214 with influenza. Influenza infection and vaccination history were reviewed, and VE was calculated as (1 - odds ratio) × 100. In the TNCCS, VE against influenza A was 68% (95% CI 47-81) overall, and 70% (48-83) for those given two doses; against influenza B, VE was 37% (- 12-64) overall and 49% (2-74) for two doses. In the TCCS, VE against influenza A was 44% (15-63) overall and 44% (13-64) for two doses, and VE against influenza B was 24% (- 19-52) overall and 41% (3-64) for two doses. CONCLUSION Both studies confirmed significant VE against influenza A, significant two-dose VE against influenza B, and better two-dose VE than one-dose VE. What is Known: • Influenza vaccine effectiveness (VE) varies from year to year. • Observational studies are conventionally used for VE assessment. However, they are inherently susceptible to bias and confounding. What is New: • This is the first report of influenza VE assessment using more than one observational study and performed in a specific area during the same season. • VE estimates obtained in our traditional case-control study were lower than those in our test-negative case-control study, but both studies found significant VE against influenza.
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Affiliation(s)
- Takahisa Kimiya
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan.
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Makoto Anzo
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan
| | - Hiroki Takahashi
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan
| | - Shinichiro Sekiguchi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
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24
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Ando S. Effectiveness of quadrivalent influenza vaccine based on the test-negative control study in children during the 2016-2017 season. J Infect Chemother 2018; 24:782-788. [PMID: 29945763 DOI: 10.1016/j.jiac.2018.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/18/2018] [Accepted: 05/29/2018] [Indexed: 11/17/2022]
Abstract
To estimate the vaccine effectiveness (VE) of quadrivalent influenza vaccine, I conducted a test-negative case control study in children, based on the rapid influenza diagnostic test (RIDT), during the 2016-2017 season. Overall, the adjusted VE was significant for any influenza (influenza A + B); VE: 30.2% (95% confidence interval [CI]: 5.4-48.4) and influenza B: 48.2% (95% CI: 11.3-69.7). The participants were divided into three age groups (group A: 0-4 years old, group B: 5-9 years old, and group C: 10-15 years old); in group A, the adjusted VE of quadrivalent influenza vaccine was significant for any influenza (A + B): 58.6% (95% CI: 28.8-76.0), influenza A: 53.9% (95% CI: 16.4-74.6), and influenza B: 78.6% (95% CI: 23.6-94.0). In both groups B and C, VE was not observed for any of the types of influenza. In only group A, two doses of vaccines provided significantly better VE against any influenza, as well as both influenzas A and B, than single-dose vaccines and cases in which vaccination was not administered. In conclusion, quadrivalent influenza vaccine showed significant VE and dose-dependent VE against any influenza and both influenzas A and B, in children aged 0-4 years during the 2016-2017 season. Both the VE and dose-dependent VE were almost not observed in older group. However, this may due to low rate of vaccination, particularly in children aged 10-15 years.
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Affiliation(s)
- Soichiro Ando
- Ando Clinic, 4-6-4 Mimomi, Narasino City, Chiba, 275-0002, Japan.
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25
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Shibata N, Kimura S, Hoshino T, Takeuchi M, Urushihara H. Effectiveness of influenza vaccination for children in Japan: Four-year observational study using a large-scale claims database. Vaccine 2018; 36:2809-2815. [DOI: 10.1016/j.vaccine.2018.03.082] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 02/26/2018] [Accepted: 03/29/2018] [Indexed: 12/25/2022]
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26
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Vono M, Eberhardt CS, Mohr E, Auderset F, Christensen D, Schmolke M, Coler R, Meinke A, Andersen P, Lambert PH, Mastelic-Gavillet B, Siegrist CA. Overcoming the Neonatal Limitations of Inducing Germinal Centers through Liposome-Based Adjuvants Including C-Type Lectin Agonists Trehalose Dibehenate or Curdlan. Front Immunol 2018. [PMID: 29541075 PMCID: PMC5835515 DOI: 10.3389/fimmu.2018.00381] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Neonates and infants are more vulnerable to infections and show reduced responses to vaccination. Consequently, repeated immunizations are required to induce protection and early life vaccines against major pathogens such as influenza are yet unavailable. Formulating antigens with potent adjuvants, including immunostimulators and delivery systems, is a demonstrated approach to enhance vaccine efficacy. Yet, adjuvants effective in adults may not meet the specific requirements for activating the early life immune system. Here, we assessed the neonatal adjuvanticity of three novel adjuvants including TLR4 (glucopyranosyl lipid adjuvant-squalene emulsion), TLR9 (IC31®), and Mincle (CAF01) agonists, which all induce germinal centers (GCs) and potent antibody responses to influenza hemagglutinin (HA) in adult mice. In neonates, a single dose of HA formulated into each adjuvant induced T follicular helper (TFH) cells. However, only HA/CAF01 elicited significantly higher and sustained antibody responses, engaging neonatal B cells to differentiate into GCs already after a single dose. Although antibody titers remained lower than in adults, HA-specific responses induced by a single neonatal dose of HA/CAF01 were sufficient to confer protection against influenza viral challenge. Postulating that the neonatal adjuvanticity of CAF01 may result from the functionality of the C-type lectin receptor (CLR) Mincle in early life we asked whether other C-type lectin agonists would show a similar neonatal adjuvanticity. Replacing the Mincle agonist trehalose 6,6′-dibehenate by Curdlan, which binds to Dectin-1, enhanced antibody responses through the induction of similar levels of TFH, GCs and bone marrow high-affinity plasma cells. Thus, specific requirements of early life B cells may already be met after a single vaccine dose using CLR-activating agonists, identified here as promising B cell immunostimulators for early life vaccines when included into cationic liposomes.
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Affiliation(s)
- Maria Vono
- WHO Collaborative Center for Vaccine Immunology, Department of Pathology-Immunology, University of Geneva, Geneva, Switzerland
| | - Christiane Sigrid Eberhardt
- WHO Collaborative Center for Vaccine Immunology, Department of Pathology-Immunology, University of Geneva, Geneva, Switzerland.,WHO Collaborative Center for Vaccine Immunology, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Elodie Mohr
- WHO Collaborative Center for Vaccine Immunology, Department of Pathology-Immunology, University of Geneva, Geneva, Switzerland
| | - Floriane Auderset
- WHO Collaborative Center for Vaccine Immunology, Department of Pathology-Immunology, University of Geneva, Geneva, Switzerland
| | - Dennis Christensen
- Vaccine Adjuvant Research, Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Mirco Schmolke
- Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland
| | - Rhea Coler
- Infectious Disease Research Institute, Seattle, WA, United States
| | | | - Peter Andersen
- Vaccine Adjuvant Research, Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Paul-Henri Lambert
- WHO Collaborative Center for Vaccine Immunology, Department of Pathology-Immunology, University of Geneva, Geneva, Switzerland
| | - Beatris Mastelic-Gavillet
- WHO Collaborative Center for Vaccine Immunology, Department of Pathology-Immunology, University of Geneva, Geneva, Switzerland
| | - Claire-Anne Siegrist
- WHO Collaborative Center for Vaccine Immunology, Department of Pathology-Immunology, University of Geneva, Geneva, Switzerland.,WHO Collaborative Center for Vaccine Immunology, Department of Pediatrics, University of Geneva, Geneva, Switzerland
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Uda K, Shoji K, Koyama-Wakai C, Furuichi M, Iwase N, Fujisaki S, Watanabe S, Miyairi I. Clinical characteristics of influenza virus-induced lower respiratory infection during the 2015 to 2016 season. J Infect Chemother 2018; 24:407-413. [PMID: 29433792 PMCID: PMC7129183 DOI: 10.1016/j.jiac.2018.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/05/2017] [Accepted: 01/07/2018] [Indexed: 12/23/2022]
Abstract
Background Influenza A(H1N1)pdm09 virus infections often manifest severe respiratory symptoms, particularly in patients with a past history of allergic disease. Most of these findings were reported during the 2009 pandemic. The purpose of this study was to detail the clinical characteristics of influenza virus-induced lower respiratory infection (LRI) during the A(H1N1)pdm09-predominant 2015–2016 season. Methods We retrospectively reviewed the clinical characteristics of influenza-induced LRI cases in children admitted to a tertiary children's hospital. Molecular diagnostic evaluation was performed on samples obtained from the most severe cases. Results We identified 66 patients with influenza-associated hospitalization and included 21 patients with influenza virus-induced LRI for analyses. Twelve patients (57%) were admitted to the pediatric intensive care unit, seven (33%) required mechanical ventilation, and three (14%) required extracorporeal membrane oxygenation. Plastic bronchitis (PB) was identified in six patients (29%), among whom a past medical history of asthma or food allergy were noted in all six patients. A past history of allergic disease was more common among patients with, than among those without, PB (p = 0.009). A(H1N1)pdm09 was detected from all the PB cases, and phylogenetic analyses of the hemagglutinin and neuraminidase genes demonstrated that this virus belonged to subclades 6B.1 and 6B.2. In the six PB cases, we found one patient with H275Y mutation in neuraminidase. Conclusion Allergic disease was a risk factor for developing PB due to influenza A(H1N1)pdm09 infection during the 2015–16 season.
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Affiliation(s)
- Kazuhiro Uda
- Office for Infection Control, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan.
| | - Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan.
| | - Chitose Koyama-Wakai
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan.
| | - Munehiro Furuichi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan.
| | - Noriyasu Iwase
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan.
| | - Seiichiro Fujisaki
- Influenza Virus Research Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan.
| | - Shinji Watanabe
- Influenza Virus Research Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan.
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan.
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28
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Sugaya N, Shinjoh M, Nakata Y, Tsunematsu K, Yamaguchi Y, Komiyama O, Takahashi H, Mitamura K, Narabayashi A, Takahashi T. Three-season effectiveness of inactivated influenza vaccine in preventing influenza illness and hospitalization in children in Japan, 2013–2016. Vaccine 2018; 36:1063-1071. [DOI: 10.1016/j.vaccine.2018.01.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 12/27/2017] [Accepted: 01/10/2018] [Indexed: 11/28/2022]
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29
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Vaccine epidemiology: Its role in promoting sound immunization programs in Japan. Vaccine 2017; 35:4787-4790. [PMID: 28818469 DOI: 10.1016/j.vaccine.2017.07.001] [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: 05/18/2016] [Revised: 10/05/2016] [Accepted: 11/24/2016] [Indexed: 10/19/2022]
Abstract
In Japan, the Vaccine Epidemiology Research Group created by the Ministry of Health, Labour and Welfare has played an important role in demonstrating the solid scientific basis for vaccine efficacy and safety since 2002. Members of the group, including epidemiologists, clinicians and microbiologists, have been conducting collaborative studies on vaccines for influenza, pertussis, rotavirus gastroenteritis, polio and pneumonia. So far, the group has achieved several works and contributed to the national vaccination program, including research on the immunogenicity of low doses of influenza vaccine among young children, the immunogenicity and effectiveness of the 2009 influenza pandemic vaccine among various risk groups, the interchangeability of live/inactivated polio vaccines, the health impact of influenza on pregnant women, and the monitoring of influenza vaccine effectiveness using case-control studies with a test-negative design. As part of the 18th Annual Meeting of the Japanese Society of Vaccinology, these accomplishments were featured in the Vaccine Epidemiology Symposium. This report summarizes the recent epidemiological studies on vaccine in Japan as a prologue to the next six papers collected from the symposium.
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30
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Seki Y, Onose A, Sugaya N. Influenza vaccine effectiveness in adults based on the rapid influenza diagnostic test results, during the 2015/16 season. J Infect Chemother 2017; 23:615-620. [PMID: 28668446 DOI: 10.1016/j.jiac.2017.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/11/2017] [Accepted: 06/01/2017] [Indexed: 10/19/2022]
Abstract
We assessed the influenza vaccine effectiveness (VE) of an inactivated quadrivalent influenza vaccine in adult patients, in our test-negative case-control design study based on the results of a rapid influenza diagnostic test. During the 2015/16 season in Japan, influenza A(H1N1)pdm09 virus and influenza B virus were epidemic. The overall adjusted VE was 44% (95% confidence interval [CI]: 13.6%-63.7%). The adjusted VE was 52.9% (95%CI: 20%-72.3%) against any influenza virus among those < 65 years of age and -5% (95%CI: 136%-53.5%) among the elderly ≧ 65 years of age. The adjusted VE against influenza A was 49.1% (95%CI: 13.9%-69.9%). Although the VE was 55.5% (95%CI: 14.8%-76.8%) among those <65 years of age, it was only 15.3% (95%CI: 120%-67.4%) among the elderly ≧ 65 years of age. The adjusted VE against influenza B was 33.8% (95%CI: 25%-64.8%) among adult patients (≧16 years of age) and 46.8% (95%CI: 13%-75%) among those < 65 years of age, the VE against influenza B could not be estimated in those ≧65 years of age because of the low number of elderly patients with that virus.
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Affiliation(s)
- Yuki Seki
- Department of Internal Medicine, Keiyu Hospital, Japan.
| | - Akira Onose
- Department of Internal Medicine, Nanashima Clinic, Japan
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31
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Influenza Vaccine Effectiveness in Preventing Influenza Illness Among Children During School-based Outbreaks in the 2014-2015 Season in Beijing, China. Pediatr Infect Dis J 2017; 36:e69-e75. [PMID: 27902651 DOI: 10.1097/inf.0000000000001434] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little is known about vaccine effectiveness (VE) against nonmedically attended A(H3N2) influenza illness during 2014-2015 when the vaccine component appeared to be a poor match with circulating strains. METHODS Forty-three eligible school influenza outbreaks in Beijing, China, from November 1, 2014, to December 31, 2014, were included in this study. The VE of 2014-2015 trivalent inactivated influenza vaccine (IIV3) was assessed in preventing laboratory-confirmed influenza among school-age children through a case-control design, using asymptomatic controls. Influenza vaccination was documented from a vaccination registry. VE was estimated adjusting for age group, sex, rural versus urban area, body mass index, chronic conditions, onset week and schools through a mixed effects logistic regression model. RESULTS The average coverage rate of 2014-2015 IIV3 among students across the 43 schools was 47.6%. The fully adjusted VE of 2014-2015 IIV3 against laboratory-confirmed influenza was 38% [95% confidence interval (CI): 12%-57%]. Receipt of previous season's (2013-2014) IIV3 significantly modified VE of the 2014-2015 IIV3; children who received both 2013-2014 and 2014-2015 vaccinations had VE of 29% (95% CI: -8% to 53%), whereas VE for children who received 2014-2015 IIV3 only was 54% (95% CI: 8%-77%). CONCLUSIONS VE for 2014-2015 IIV3 against A(H3N2) illness identified in schools was modest. Children who did not receive the prior season's vaccine with a homologous A(H3N2) component may have enjoyed greater protection than repeated vaccinees.
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32
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Uchida M, Kaneko M, Hidaka Y, Yamamoto H, Honda T, Takeuchi S, Saito M, Kawa S. Effectiveness of vaccination and wearing masks on seasonal influenza in Matsumoto City, Japan, in the 2014/2015 season: An observational study among all elementary schoolchildren. Prev Med Rep 2017; 5:86-91. [PMID: 27981021 PMCID: PMC5153448 DOI: 10.1016/j.pmedr.2016.12.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 11/28/2016] [Accepted: 12/04/2016] [Indexed: 11/25/2022] Open
Abstract
Measures of seasonal influenza control are generally divided into two categories: pharmaceutical and non-pharmaceutical interventions. The effectiveness of these measures remains unclear, because of insufficient study sample size and/or differences in study settings. This observational epidemiological study involved all elementary schoolchildren in Matsumoto City, Japan, with seasonal influenza during the 2014/2015 season. Questionnaires, including experiences with influenza diagnosis and socio-demographic factors, were distributed to all 29 public elementary schools, involving 13,217 children, at the end of February 2015. Data were obtained from 10,524 children and analyzed with multivariate logistic regression analysis. The result showed that vaccination (odds ratio 0.866, 95% confidence interval 0.786-0.954) and wearing masks (0.859, 0.778-0.949) had significant protective association. Hand washing (1.447, 1.274-1.644) and gargling (1.319, 1.183-1.471), however, were not associated with protection. In the natural setting, hand washing and gargling showed a negative association, which may have been due to inappropriate infection control measures or aggregating infected and non-infected children to conduct those measures. These results may indicate a pathway for influenza transmission and explain why seasonal influenza control remains difficult in school settings. The overall effectiveness of vaccination and mask wearing was 9.9% and 8.6%, respectively. After dividing children into higher (grades 4-6) and lower (grade 1-3) grade groups, the effectiveness of vaccination became greater in the lower grade group, and the effectiveness of wearing masks became greater in the higher grade group. These results may provide valuable information about designing infection control measures that allocate resources among children.
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Affiliation(s)
- Mitsuo Uchida
- Center for Health, Safety and Environment Management, Shinshu University, Matsumoto, Nagano, Japan
| | - Minoru Kaneko
- Center for Health, Safety and Environment Management, Shinshu University, Matsumoto, Nagano, Japan
| | - Yoshihiko Hidaka
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hiroshi Yamamoto
- The First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Takayuki Honda
- Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Shouhei Takeuchi
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
| | - Masaya Saito
- Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan
| | - Shigeyuki Kawa
- Center for Health, Safety and Environment Management, Shinshu University, Matsumoto, Nagano, Japan
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33
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Sugaya N, Shinjoh M, Kawakami C, Yamaguchi Y, Yoshida M, Baba H, Ishikawa M, Kono M, Sekiguchi S, Kimiya T, Mitamura K, Fujino M, Komiyama O, Yoshida N, Tsunematsu K, Narabayashi A, Nakata Y, Sato A, Taguchi N, Fujita H, Toki M, Myokai M, Ookawara I, Takahashi T. Trivalent inactivated influenza vaccine effective against influenza A(H3N2) variant viruses in children during the 2014/15 season, Japan. ACTA ACUST UNITED AC 2016; 21:30377. [PMID: 27784529 PMCID: PMC5291153 DOI: 10.2807/1560-7917.es.2016.21.42.30377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 06/25/2016] [Indexed: 11/29/2022]
Abstract
The 2014/15 influenza season in Japan was characterised by predominant influenza A(H3N2) activity; 99% of influenza A viruses detected were A(H3N2). Subclade 3C.2a viruses were the major epidemic A(H3N2) viruses, and were genetically distinct from A/New York/39/2012(H3N2) of 2014/15 vaccine strain in Japan, which was classified as clade 3C.1. We assessed vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children aged 6 months to 15 years by test-negative case–control design based on influenza rapid diagnostic test. Between November 2014 and March 2015, a total of 3,752 children were enrolled: 1,633 tested positive for influenza A and 42 for influenza B, and 2,077 tested negative. Adjusted VE was 38% (95% confidence intervals (CI): 28 to 46) against influenza virus infection overall, 37% (95% CI: 27 to 45) against influenza A, and 47% (95% CI: -2 to 73) against influenza B. However, IIV was not statistically significantly effective against influenza A in infants aged 6 to 11 months or adolescents aged 13 to 15 years. VE in preventing hospitalisation for influenza A infection was 55% (95% CI: 42 to 64). Trivalent IIV that included A/New York/39/2012(H3N2) was effective against drifted influenza A(H3N2) virus, although vaccine mismatch resulted in low VE.
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34
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Matsuoka T, Sato T, Akita T, Yanagida J, Ohge H, Kuwabara M, Tanaka J. High Vaccination Coverage among Children during Influenza A(H1N1)pdm09 as a Potential Factor of Herd Immunity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13101017. [PMID: 27763532 PMCID: PMC5086756 DOI: 10.3390/ijerph13101017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/24/2022]
Abstract
The objective of this study was to identify factors related to the expansion of infection and prevention of influenza A(H1N1)pdm09. A retrospective non-randomized cohort study (from June 2009 to May 2010) on influenza A(H1N1)pdm09 was conducted in a sample of residents from Hiroshima Prefecture, Japan. The cumulative incidence of the influenza A(H1N1)pdm09 and the pandemic vaccine effectiveness (VE) were estimated. The response rate was 53.5% (178,669/333,892). Overall, the odds ratio of non-vaccinated group to vaccinated group for cumulative incidence of influenza A(H1N1)pdm09 was 2.18 (95% confidence interval (CI): 2.13–2.23) and the VE was 43.9% (CI: 42.8–44.9). The expansion of infection, indicating the power of transmission from infected person to susceptible person, was high in the 7–15 years age groups in each area. In conclusion, results from this survey suggested that schoolchildren-based vaccination rate participates in determining the level of herd immunity to influenza and children might be the drivers of influenza transmission. For future pandemic preparedness, vaccination of schoolchildren may help to prevent disease transmission during influenza outbreak.
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Affiliation(s)
- Toshihiko Matsuoka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
| | - Tomoki Sato
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
| | - Jiturou Yanagida
- Hiroshima City Funairi Citizens Hospital, Hiroshima 730-0844, Japan.
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima 734-8551, Japan.
| | - Masao Kuwabara
- Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima 734-0007, Japan.
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
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35
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Zaraket H, Saito R. Japanese Surveillance Systems and Treatment for Influenza. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2016; 8:311-328. [PMID: 28035195 PMCID: PMC5155020 DOI: 10.1007/s40506-016-0085-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Influenza management and surveillance programs in Japan possess several unique features. The national influenza surveillance is affiliated with National Epidemiological Surveillance for Infectious Diseases (NESID) and features sentinel outpatient surveillance, virological surveillance, and reports on hospitalization, mortality, and influenza-associated encephalopathy. Of note, information on the number of student absences and class/grade/school closures due to influenza are also reported to the government and made publically available. A private online influenza surveillance portal by volunteer doctors provides a real-time information source for the Japanese clinicians and the general public. For influenza treatment, three classes of drugs are approved and covered by national medical insurance in Japan: M2 inhibitors, neuraminidase inhibitors (NAIs), and a polymerase inhibitor. Four NAIs, oseltamivir, zanamivir, laninamivir, and peramivir, are licensed in Japan and are prescribed to seven to eight million patients annually. NAIs are prescribed to any influenza outpatient rather than being limited to severe cases. The majority (80-95 %) of patients start the treatment within 48 h of onset. Laninamivir and peramivir were used almost solely in Japan, until the approval of the latter drug by the FDA. Observational studies showed that the two drugs have equal effectiveness as oseltamivir and zanamivir. The Japanese approach to influenza surveillance and management has facilitated bringing new influenza antivirals to the markets and has driven innovative research in this field. New classes of antivirals, including polymerase inhibitors and cap-dependent endonuclease inhibitor, provide novel tools for treatment of influenza in Japan and the rest of the world.
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Affiliation(s)
- Hassan Zaraket
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Reiko Saito
- Division of International Health, Graduate School of Medical and Dental Sciences, Niigata University, 1-757, Asahimachi-dori, Chuo-ku, Niigata City, Niigata Prefecture 951-8510 Japan
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36
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Porteous GH, Hanson NA, Sueda LAA, Hoaglan CD, Dahl AB, Ohlson BB, Schmidt BE, Wang CC, Fagley RE. Resurgence of Vaccine-Preventable Diseases in the United States: Anesthetic and Critical Care Implications. Anesth Analg 2016; 122:1450-73. [PMID: 27088999 DOI: 10.1213/ane.0000000000001196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Vaccine-preventable diseases (VPDs) such as measles and pertussis are becoming more common in the United States. This disturbing trend is driven by several factors, including the antivaccination movement, waning efficacy of certain vaccines, pathogen adaptation, and travel of individuals to and from areas where disease is endemic. The anesthesia-related manifestations of many VPDs involve airway complications, cardiovascular and respiratory compromise, and unusual neurologic and neuromuscular symptoms. In this article, we will review the presentation and management of 9 VPDs most relevant to anesthesiologists, intensivists, and other hospital-based clinicians: measles, mumps, rubella, pertussis, diphtheria, influenza, meningococcal disease, varicella, and poliomyelitis. Because many of the pathogens causing these diseases are spread by respiratory droplets and aerosols, appropriate transmission precautions, personal protective equipment, and immunizations necessary to protect clinicians and prevent nosocomial outbreaks are described.
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Affiliation(s)
- Grete H Porteous
- From the *Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington; and †Department of Infectious Diseases, Virginia Mason Medical Center, Seattle, Washington
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37
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Mizuno D, Kimoto T, Sakai S, Takahashi E, Kim H, Kido H. Induction of systemic and mucosal immunity and maintenance of its memory against influenza A virus by nasal vaccination using a new mucosal adjuvant SF-10 derived from pulmonary surfactant in young cynomolgus monkeys. Vaccine 2016; 34:1881-8. [PMID: 26954466 DOI: 10.1016/j.vaccine.2016.02.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/22/2016] [Accepted: 02/25/2016] [Indexed: 10/22/2022]
Abstract
Induction of systemic and mucosal immunity and maintenance of its memory was investigated in 12 young male cynomolgus monkeys after intranasal instillation of flu vaccine using a new mucosal adjuvant SF-10 derived from pulmonary surfactant constituents. Split-product of influenza virus A/California/7/2009(H1N1)pdm hemagglutinin vaccine (HAv) at 15 μg with or without SF-10 and the adjuvant alone were instilled intranasally three times every 2 weeks. SF-10-adjuvanted HAv (SF-10-HAv) elicited significantly higher HAv-specific IgG and hemagglutinin inhibition (HI) titers in serum and HAv-specific secretory IgA and its neutralizing activities in nasal washes compared with HAv antigen and SF-10 alone. Significant cross-neutralizing activities of nasal washes after the third vaccination to several other H1N1 and H3N2 strains were observed. HI titers in serum and neutralizing activities in nasal washes reached peak levels at 6 weeks after initial vaccination, then gradually decreased after 10 weeks and returned to the baseline levels at 36 weeks. A single intranasal revaccination of SF-10-HAv at 36 weeks rapidly and significantly increased both immunity in serum and nasal washes compared with naïve monkeys. Revaccination by one or two doses achieved almost maximal immunity at 2 or 4 weeks after instillation. Statistically significant adverse effects (e.g., body weight loss, elevated body temperature, nasal discharge, change in peripheral blood leukocyte and platelet counts) were not observed for 2 weeks after vaccination of SF-10-HAv, HAv or SF-10 and also during the experimental period. These results in young monkey model suggest the potential of clinical use SF-10 for intranasal flu vaccine.
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Affiliation(s)
- Dai Mizuno
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Kuramoto-cho 3-18-15, Tokushima 770-8503, Japan
| | - Takashi Kimoto
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Kuramoto-cho 3-18-15, Tokushima 770-8503, Japan
| | - Satoko Sakai
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Kuramoto-cho 3-18-15, Tokushima 770-8503, Japan
| | - Etsuhisa Takahashi
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Kuramoto-cho 3-18-15, Tokushima 770-8503, Japan
| | - Hyejin Kim
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Kuramoto-cho 3-18-15, Tokushima 770-8503, Japan
| | - Hiroshi Kido
- Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Kuramoto-cho 3-18-15, Tokushima 770-8503, Japan.
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