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Liu G, Pang Y, Lv M, Lu M, Huang Y, Ge F, Ma S, Qiu Y. Effectiveness of influenza vaccination on hospitalization outcomes among older patients with diabetes. Vaccine 2024; 42:126142. [PMID: 39019658 DOI: 10.1016/j.vaccine.2024.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 07/12/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE In older populations admitted for diabetes, limited evidence suggests that influenza vaccination protects against hospitalization outcomes. METHODS This study pooled 27,620 hospitalizations recorded for elderly diabetes patients from the Beijing Elderly Influenza Vaccination Information Registration Database (2013-2018) and the Beijing Urban Employee Basic Medical Insurance Database (2013-2018). Generalized linear regression and propensity score matching were conducted to estimate the effects of influenza vaccination on hospitalization outcomes (in-hospital all-cause mortality, readmission, length and costs of hospitalization), adjusting for measurable confounding factors. The low influenza period (May-July) was used as a reference period to adjust for unmeasured confounding factors during the peak influenza period (November-January). RESULTS In propensity score matching, influenza vaccination in peak influenza period could reduce the risk of in-hospital death (OR: 0.47[0.22,0.97]) and readmission (OR: 0.70[0.60,0.81]), length of hospitalization (β: -1.32[-1.47, -1.17]) and medical costs (GMR: 0.90[0.88,0.92]). After adjusting for unmeasured confounding factors, influenza vaccination was associated with 17% (ratio of ORs: 0.83 [0.69, 1.02]) lower risk of readmission and shorter length of hospitalization (difference in β: -0.23 [-0.62, 0.16]). The subgroup analyses showed that male patients with older age and poorer health conditions could benefit more after influenza vaccination. CONCLUSION Influenza vaccination could significantly improve hospitalization outcomes in elderly diabetic patients. This provides evidence supporting free influenza vaccination policies for vulnerable populations in low- and middle-income countries.
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Affiliation(s)
- Guangqi Liu
- Department of Global Health, School of Public Health, Peking University, Beijing. China; Energy Saving & Environmental Protection & Occupational Safety and Health Research Institute, China Academy of Railway Sciences Co., Ltd, Beijing 100081, China
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing. China
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing. China
| | - Ming Lu
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Yangmu Huang
- Department of Global Health, School of Public Health, Peking University, Beijing. China.
| | - Fei Ge
- Energy Saving & Environmental Protection & Occupational Safety and Health Research Institute, China Academy of Railway Sciences Co., Ltd, Beijing 100081, China
| | - Shiwei Ma
- Energy Saving & Environmental Protection & Occupational Safety and Health Research Institute, China Academy of Railway Sciences Co., Ltd, Beijing 100081, China.
| | - Yongxiang Qiu
- Energy Saving & Environmental Protection & Occupational Safety and Health Research Institute, China Academy of Railway Sciences Co., Ltd, Beijing 100081, China
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Stuurman AL, Carmona A, Biccler J, Descamps A, Levi M, Baum U, Mira-Iglesias A, Bellino S, Hoang U, de Lusignan S, Bonaiuti R, Lina B, Rizzo C, Nohynek H, Díez-Domingo J. Brand-specific estimates of influenza vaccine effectiveness for the 2021-2022 season in Europe: results from the DRIVE multi-stakeholder study platform. Front Public Health 2023; 11:1195409. [PMID: 37546295 PMCID: PMC10399959 DOI: 10.3389/fpubh.2023.1195409] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Development of Robust and Innovative Vaccine Effectiveness (DRIVE) was a European public-private partnership (PPP) that aimed to provide annual, brand-specific estimates of influenza vaccine effectiveness (IVE) for regulatory and public health purposes. DRIVE was launched in 2017 under the umbrella of the Innovative Medicines Initiative (IMI) and conducted IVE studies from its pilot season in 2017-2018 to its final season in 2021-2022. Methods In 2021-2022, DRIVE conducted four primary care-based test-negative design (TND) studies (Austria, Italy, Iceland, and England; involving >1,000 general practitioners), nine hospital-based TND studies (France, Iceland, Italy, Romania, and Spain, for a total of 21 hospitals), and one population-based cohort study in Finland. In the TND studies, patients with influenza-like illness (primary care) or severe acute respiratory infection (hospital) were enrolled, and laboratory tested for influenza using RT-PCR. Study contributor-specific IVE was calculated using logistic regression, adjusting for age, sex, and calendar time, and pooled by meta-analysis. Results In 2021-2022, pooled confounder-adjusted influenza vaccine effectiveness (IVE) estimates against laboratory-confirmed influenza (LCI) overall and per type and subtype/lineage was produced, albeit with wide confidence intervals (CI). The limited circulation of influenza in Europe did not allow the network to reach the optimal sample size to produce precise IVE estimates for all the brands included. The most significant IVE estimates were 76% (95% CI 23%-93%) for any vaccine and 81% (22%-95%) for Vaxigrip Tetra in adults ≥65 years old and 64% (25%-83%) for Fluenz Tetra in children (TND primary care setting), 85% (12%-97%) for any vaccine in adults 18-64 years (TND hospital setting), and 38% (1%-62%) in children 6 months-6 years (population-based cohort, mixed setting). Discussion Over five seasons, DRIVE collected data on >35,000 patients, more than 60 variables, and 13 influenza vaccines. DRIVE demonstrated that estimating brand-specific IVE across Europe is possible, but achieving sufficient sample size to obtain precise estimates for all relevant stratifications remains a challenge. Finally, DRIVE's network of study contributors and lessons learned have greatly contributed to the development of the COVID-19 vaccine effectiveness platform COVIDRIVE.
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Affiliation(s)
| | - Antonio Carmona
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (Fisabio), Valencia, Spain
- Biomedical Research Consortium in Epidemiology and Public Health (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jorne Biccler
- P95 Epidemiology and Pharmacovigilance, Leuven, Belgium
| | - Alexandre Descamps
- Inserm CIC 1417, Assistance Publique Hopitaux de Paris (APHP), CIC Cochin-Pasteur, Paris, France
| | - Miriam Levi
- UFC Epidemiologia, Dipartimento di Prevenzione, Azienda USL Toscana Centro, Firenze, Italy
| | - Ulrike Baum
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ainara Mira-Iglesias
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (Fisabio), Valencia, Spain
- Biomedical Research Consortium in Epidemiology and Public Health (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Stefania Bellino
- Department of Infectious Diseases, Istituto Superiore Di Sanità (ISS), Rome, Italy
| | - Uy Hoang
- Oxford-Royal College of General Practitioners Research and Surveillance Centre, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Simon de Lusignan
- Oxford-Royal College of General Practitioners Research and Surveillance Centre, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Roberto Bonaiuti
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Firenze, Italy
| | - Bruno Lina
- VirPath Research Laboratory, International Center for Infectiology Research, University Claude Bernard Lyon, Lyon, France
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Hanna Nohynek
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Javier Díez-Domingo
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (Fisabio), Valencia, Spain
- Biomedical Research Consortium in Epidemiology and Public Health (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain
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Immune Response and Effects of COVID-19 Vaccination in Patients with Lung Cancer-COVID Lung Vaccine Study. Cancers (Basel) 2022; 15:cancers15010137. [PMID: 36612134 PMCID: PMC9817972 DOI: 10.3390/cancers15010137] [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: 12/06/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Lung cancer patients represent a subgroup of special vulnerability in whom the SARS-CoV-2 infection could attain higher rates of morbidity and mortality. Therefore, those patients were recommended to receive SARS-CoV-2 vaccines once they were approved. However, little was known at that time regarding the degree of immunity developed after vaccination or vaccine-related adverse events, and more uncertainty involved the real need for a third dose. We sought to evaluate the immune response developed after vaccination, as well as the safety and efficacy of SARS-CoV-2 vaccines in a cohort of patients with lung cancer. Patients were identified through the Oncology/Hematology Outpatient Vaccination Program. Anti-Spike IgG was measured before any vaccine and at 3-6-, 6-9- and 12-15-month time points after the 2nd dose. Detailed clinical data were also collected. In total, 126 patients with lung cancer participated and received at least one dose of the SARS-CoV-2 vaccine. At 3-6 months after 2nd dose, 99.1% of baseline seronegative patients seroconverted and anti-Spike IgG titers went from a median value of 9.45 to 720 UI/mL. At the 6-9-month time point, titers raised to a median value of 924 UI/mL, and at 12-15 months, after the boost dose, they reached a median value of 3064 UI/mL. Adverse events to the vaccine were mild, and no SARS- CoV-2 infection-related deaths were recorded. In this lung cancer cohort, COVID-19 vaccines were safe and effective irrespective of the systemic anticancer therapy. Most of the patients developed anti-Spike IgG after the second dose, and these titers were maintained over time with low infection and reinfection rates with a mild clinical course.
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Cost Effectiveness of Quadrivalent Versus Trivalent Inactivated Influenza Vaccines for the Portuguese Elderly Population. Vaccines (Basel) 2022; 10:vaccines10081285. [PMID: 36016173 PMCID: PMC9416623 DOI: 10.3390/vaccines10081285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/02/2022] Open
Abstract
Background: quadrivalent inactivated vaccine (QIV) has replaced trivalent inactivated vaccine (TIV). In Portugal, TIV is free of charge for risk groups, including older adults (≥65 years old). In its turn, QIV—which provides broader protection as it includes an additional lineage B strain—was introduced in Portugal in October 2018; only since the 2019/20 influenza season has it been provided free of charge for risk groups. This study evaluates the cost effectiveness of switching from TIV to QIV, from the National Health Service perspective, in the Portuguese elderly mainland population. Methods: A decision tree model was developed to compare TIV and QIV, based on Portuguese hospitalization data for the 2015/16 influenza season. The primary health economic outcome under consideration was the incremental cost-effectiveness ratio (ICER). In addition, one-way sensitivity analysis and probabilistic sensitivity analysis were performed. Results: the high cost of QIV (approximately three times the cost of TIV) would lead to a total increment of EUR 5,283,047, and the resulting ICER would be EUR 26,403,007/QALY, above the usual willingness-to-pay threshold. Conclusions: from the National Health Service perspective, our findings reveal that QIV is not cost effective for the Portuguese elderly population due to the high cost. If the QIV costs were the same as the TIV, then QIV would be cost effective.
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5
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Halme J, Syrjänen RK, Baum U, Palmu AA. Effectiveness of trivalent influenza vaccines against hospitalizations due to laboratory-confirmed influenza a in the elderly: Comparison of test-negative design with register-based designs. Vaccine 2022; 40:4242-4252. [PMID: 35691869 DOI: 10.1016/j.vaccine.2022.05.080] [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: 02/21/2022] [Revised: 05/10/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Measuring influenza vaccine effectiveness (IVE) seasonally is important and has been conducted utilizing several observational study designs. The active test-negative design has been most widely used and the validity of passive register-based studies has been debated. We aimed to explore the potential differences, advantages, and weaknesses of different study designs in estimating influenza vaccine effectiveness. METHODS We compared three study designs in estimating IVE against hospitalization in the elderly aged 65 years or more over three influenza seasons 2015/16, 2016/17 and 2017/18. Designs compared were active test-negative design (TND), register-based cohort design and register-based case-control design with different selection criteria for cases and controls. RESULTS Adjusted IVE estimates for the three consecutive seasons 2015-18 in active test-negative design were 82% (95% confidence interval 26, 96), 21% (-179, 77), 15% (-113, 66). For case-control design, estimates from different analyses ranged in 2015/16 from 47% (-16, 76) to 52% (-48, 84), in 2016/17 from 10% (-42, 43) to 29% (-20, 58), and in 2017/18 from -27% (-91, 15) to 1% (-40, 30). In the cohort design, the adjusted IVE estimates were 48% (-9, 75), 29% (1, 49), 13% (-21, 37) for the three seasons. CONCLUSIONS The register-based cohort design produced results more concordant with the active test-negative design than the case-control design. Furthermore, the register-based cohort design yielded most precise estimates with narrower confidence intervals. In Finland with the availability of near real-time nationwide register data, the register-based cohort design is the method of choice to continue the annual surveillance of influenza vaccine effectiveness.
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Affiliation(s)
- Jussi Halme
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Biokatu 6, 33520 Tampere, Finland
| | - Ritva K Syrjänen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Biokatu 6, 33520 Tampere, Finland.
| | - Ulrike Baum
- Department of Health Security, Finnish Institute for Health and Welfare, Mannerheimintie 166, 00300 Helsinki, Finland
| | - Arto A Palmu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Biokatu 6, 33520 Tampere, Finland
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Zhang Y, Wang Y, Jia C, Li G, Zhang W, Li Q, Chen X, Leng W, Huang L, Xie Z, Zhang H, You W, An R, Jiang H, Zhao X, Cheng S, Tan J, Cui W, Gao F, Lu W, Wang Y, Yang Y, Xia S, Wang S. Immunogenicity and safety of an egg culture-based quadrivalent inactivated non-adjuvanted subunit influenza vaccine in subjects ≥3 years: A randomized, multicenter, double-blind, active-controlled phase III, non-inferiority trial. Vaccine 2022; 40:4933-4941. [PMID: 35810063 DOI: 10.1016/j.vaccine.2022.06.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022]
Abstract
Subunit influenza vaccine only formulated with surface antigen proteins has better safety profiles relative to split-virion influenza vaccine. Compared to the traditional quadrivalent split-virion influenza vaccine, a novel quadrivalent subunit influenza vaccine is urgently needed in China. We completed a phase 3, randomized, double-blind, active-controlled, non-inferiority clinical study at two sites in Henan Province, China. Eligible volunteers were split into four age cohorts (3-8 years, 9-17 years, 18-64 years, and ≥ 65 years, based on their dates of birth) and randomly assigned (1:1) to the subunit and the split-virion ecNAIIV4 groups. All volunteers were intramuscularly administered a single vaccine dose at baseline, and children aged 3-8 years received a boosting dose at day 28. And the immune response was evaluated by measuring hemagglutinin-inhibition antibody titers against the four vaccine strains in blood samples. Safety profiles had nonsignificant differences between the study groups in ≥ 3 years cohort. Most adverse reactions post-vaccination, both local and systemic, were mild to moderate and resolved within 3 days. And no serious adverse events occurred. The immunogenicity of the trial vaccine was non-inferior to the comparator. Further, a two-dose vaccine series can provide better seroprotection than that of a one-dose series in children aged 3-8 years, with clinically acceptable safety profiles. Clinical Trials Registration. ChiCTR2100049934.
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Affiliation(s)
| | - Yanxia Wang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | | | | | - Wei Zhang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Qin Li
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | | | - Lili Huang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Zhiqiang Xie
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | | | - Wangyang You
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Rui An
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | - Xue Zhao
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | - Jiebing Tan
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Weiyang Cui
- Puyang Centre for Disease Control and Prevention, Henan, China.
| | - Feilong Gao
- Kaifeng Municipal Centre for Disease Control and Prevention, Henan, China.
| | - Weifeng Lu
- Kaifeng Municipal Centre for Disease Control and Prevention, Henan, China.
| | - Yuping Wang
- Puyang Centre for Disease Control and Prevention, Henan, China.
| | - Yongli Yang
- Department of Epidemiology and Public Health, College of Public Health, Zhengzhou University, Zhenzhou, China.
| | - Shengli Xia
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Shuai Wang
- Ab&b Biotec Co., Ltd, Taizhou, China; Yither Biotech Co., Ltd, Shanghai, China.
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O Murchu E, Comber L, Jordan K, Hawkshaw S, Marshall L, O'Neill M, Ryan M, Teljeur C, Carnahan A, Pérez JJ, Robertson AH, Johansen K, Jonge JD, Krause T, Nicolay N, Nohynek H, Pavlopoulou I, Pebody R, Penttinen P, Soler-Soneira M, Wichmann O, Harrington P. Systematic review of the efficacy, effectiveness and safety of MF59 ® adjuvanted seasonal influenza vaccines for the prevention of laboratory-confirmed influenza in individuals ≥18 years of age. Rev Med Virol 2022; 33:e2329. [PMID: 35142401 DOI: 10.1002/rmv.2329] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 01/18/2023]
Abstract
The most effective means of preventing seasonal influenza is through vaccination. In this systematic review, we investigated the efficacy, effectiveness and safety of MF59® adjuvanted trivalent and quadrivalent influenza vaccines to prevent laboratory-confirmed influenza. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials and non-randomised studies of interventions (NRSIs) were eligible for inclusion. The search returned 28,846 records, of which 48 studies on MF59® adjuvanted vaccines met our inclusion criteria. No efficacy trials were identified. In terms of vaccine effectiveness (VE), MF59® adjuvanted trivalent influenza vaccines were effective in preventing laboratory-confirmed influenza in older adults (aged ≥65 years) compared with no vaccination (VE = 45%, 95% confidence interval (CI) 23%-61%, 5 NRSIs across 3 influenza seasons). By subtype, significant effect was found for influenza A(H1N1) (VE = 61%, 95% CI 44%-73%) and B (VE = 29%, 95% CI 5%-46%), but not for A(H3N2). In terms of relative VE, there was no significant difference comparing MF59® adjuvanted trivalent vaccines with either non-adjuvanted trivalent or quadrivalent vaccines. Compared with traditional trivalent influenza vaccines, MF59® adjuvanted trivalent influenza vaccines were associated with a greater number of local adverse events (RR = 1.90, 95% CI 1.50-2.39) and systemic reactions (RR = 1.18, 95% CI 1.02-1.38). In conclusion, MF59® adjuvanted trivalent influenza vaccines were found to be more effective than 'no vaccination'. Based on limited data, there was no significant difference comparing the effectiveness of MF59® adjuvanted vaccines with their non-adjuvanted counterparts.
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Affiliation(s)
- Eamon O Murchu
- Health Information and Quality Authority (HIQA), Dublin, Ireland.,Department of Health Policy & Management, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Laura Comber
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Karen Jordan
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Sarah Hawkshaw
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Liam Marshall
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Michelle O'Neill
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Máirín Ryan
- Health Information and Quality Authority (HIQA), Dublin, Ireland.,Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity Health Sciences, Dublin, Ireland
| | - Conor Teljeur
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | | | - Jaime Jesús Pérez
- General Directorate of Public Health and Addictions, IMIB-Arrixaca. Murcia University, Region of Murcia, Spain
| | - Anna Hayman Robertson
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kari Johansen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jorgen de Jonge
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ioanna Pavlopoulou
- Pediatric Research Laboratory, School of Health Sciences, Faculty of Nursing National and Kapodistrian University of Athens, Athens, Greece.,National Advisory Committee on Immunisation, Hellenic Ministry of Health, Athens, Greece
| | - Richard Pebody
- Institute of Epidemiology & Health, University College London, London, UK
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Marta Soler-Soneira
- Vigilancia de Enfermedades Prevenibles por Vacunación, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain
| | - Ole Wichmann
- Immunization Unit, Robert Koch-Institute, Berlin, Germany
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Gounant V, Ferré VM, Soussi G, Charpentier C, Flament H, Fidouh N, Collin G, Namour C, Assoun S, Bizot A, Brouk Z, Vicaut E, Teixeira L, Descamps D, Zalcman G. Efficacy of Severe Acute Respiratory Syndrome Coronavirus-2 Vaccine in Patients With Thoracic Cancer: A Prospective Study Supporting a Third Dose in Patients With Minimal Serologic Response After Two Vaccine Doses. J Thorac Oncol 2022; 17:239-251. [PMID: 34798306 PMCID: PMC8593625 DOI: 10.1016/j.jtho.2021.10.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/10/2021] [Accepted: 10/25/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 resulted in a 30% mortality rate in patients with thoracic cancer. Given that patients with cancer were excluded from serum antisevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine registration trials, it is still unknown whether they would develop a protective antispike antibody response after vaccination. This prospective vaccine monitoring study primarily aimed to assess humoral responses to the SARS-CoV-2 vaccine in patients with thoracic cancer. METHODS SARS-CoV-2-spike antibodies were measured using the Abbot Architect SARS-CoV-2 immunoglobulin G immunoassay before the first injection of BNT162b2 mRNA vaccine, at week 4, and 2 to 16 weeks after the second vaccine dose administration. The factors associated with antibody response were analyzed. RESULTS Overall, 306 patients, with a median age of 67.0 years (interquartile range: 58-74), were vaccinated. Of these, 283 patients received two vaccine doses at 28-day intervals. After a 6.7-month median follow-up, eight patients (2.6%) contracted proven symptomatic SARS-CoV-2 infection, with rapid favorable evolution. Of the 269 serologic results available beyond day 14 after the second vaccine dose administration, 17 patients (6.3%) were still negative (<50 arbitrary units/mL, whereas 34 (11%) were less than 300 arbitrary units/mL (12.5th percentile). In multivariate analysis, only age (p < 0.01) and long-term corticosteroid treatment (p = 0.01) were significantly associated with a lack of immunization. A total of 30 patients received a third vaccine dose, with only three patients showing persistently negative serology thereafter, whereas the others exhibited clear seroconversion. CONCLUSIONS SARS-CoV2 vaccines were found to be efficient in patients with thoracic cancer, most of them being immunized after two doses. A third shot given to 1% of patients with persistent low antibody titers resulted in an 88% immunization rate.
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Affiliation(s)
- Valérie Gounant
- Thoracic Oncology Department, Université de Paris, North-Paris Cancer University Institute, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1425, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Valentine Marie Ferré
- Virology Department, Université de Paris, INSERM Unité Mixte de Recherche (UMR) 1137 Infection, Antimicrobials, Modelling, Evolution, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Ghassen Soussi
- Thoracic Oncology Department, Université de Paris, North-Paris Cancer University Institute, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1425, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Charlotte Charpentier
- Virology Department, Université de Paris, INSERM Unité Mixte de Recherche (UMR) 1137 Infection, Antimicrobials, Modelling, Evolution, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Héloïse Flament
- Hematology, and Immunology Department, Université de Paris, INSERM-U1149, Research Center on Inflammation (CRI) Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Nadhira Fidouh
- Virology Department, Université de Paris, INSERM Unité Mixte de Recherche (UMR) 1137 Infection, Antimicrobials, Modelling, Evolution, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Gilles Collin
- Virology Department, Université de Paris, INSERM Unité Mixte de Recherche (UMR) 1137 Infection, Antimicrobials, Modelling, Evolution, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Céline Namour
- Thoracic Oncology Department, Université de Paris, North-Paris Cancer University Institute, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1425, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Sandra Assoun
- Thoracic Oncology Department, Université de Paris, North-Paris Cancer University Institute, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1425, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Alexandra Bizot
- Thoracic Oncology Department, Université de Paris, North-Paris Cancer University Institute, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1425, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Zohra Brouk
- Thoracic Oncology Department, Université de Paris, North-Paris Cancer University Institute, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1425, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Eric Vicaut
- Biostatistics and Clinical Research Department, Université de Paris, Lariboisière Hospital (AP-HP.Nord), Paris, France
| | - Luis Teixeira
- Breast Diseases Centre, North-Paris Cancer University Institute, Université de Paris, INSERM U976 Human Immunology, Pathophysiology, Immunotherapy (HIPI) (Pathophysiology of Breast Cancer Team), Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Diane Descamps
- Virology Department, Université de Paris, INSERM Unité Mixte de Recherche (UMR) 1137 Infection, Antimicrobials, Modelling, Evolution, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France
| | - Gérard Zalcman
- Thoracic Oncology Department, Université de Paris, North-Paris Cancer University Institute, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1425, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP.Nord), Paris, France; INSERM U830 Cancer, Heterogeneity Plasticity, Curie Institute Research Centre, Paris, France.
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9
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Lohan L, Cool C, Viault L, Cestac P, Renard E, Galtier F, Villiet M, Avignon A, Sultan A, Breuker C. Impact of Hospitalization in an Endocrinology Department on Vaccination Coverage in People Living with Diabetes: A Real-Life Study. Medicina (B Aires) 2022; 58:medicina58020219. [PMID: 35208544 PMCID: PMC8879927 DOI: 10.3390/medicina58020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/17/2022] [Accepted: 01/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background and Objectives: Vaccination coverage is suboptimal in people living with diabetes. The objectives of this study were to determine the impact of hospitalization on vaccination coverage and the variables associated with vaccination during hospital stay. Materials and Methods: This observational study was conducted from May 2019 to December 2019 in the Endocrinology-Nutrition-Diabetes Department of the University Hospital of Montpellier, France. This department encompasses three medical units, two of which have a full-time clinical pharmacist involved in the multidisciplinary management of patients. All adult diabetic patients who completed a questionnaire about vaccines were prospectively included by a clinical pharmacist and followed until department discharge. Coverage at the time of admission for the tetanus, diphtheria, pertussis (Tdap), pneumococcal, influenza, and herpes zoster vaccines was assessed from patient interviews and/or contact with the general practitioner and/or with the community pharmacist. Multivariable logistic regression analysis was performed to identify the factors associated with a vaccination update during the hospital stay. Results: A total of 222 patients were included (mean age: 59.4 years, 68.5% type 2 diabetes). Vaccination coverage increased by 26.7% (47.3% to 59.9%), 188.0% (10.8% to 31.1%) and 8.9% (45.9% to 50.0%), respectively, for the Tdap, pneumococcal and influenza vaccines during hospital stay. Female sex, admission to a diabetes care unit with a full-time pharmacist, favorable feelings about vaccination, unknown immunization coverage for pneumococcal vaccines, and evaluation and recording of vaccine coverage at admission in the patient medical records were associated with at least one vaccination during hospital stay. Conclusions: Our real-life study highlights that hospitalization and multidisciplinary management (i.e., physician-pharmacist) may be key points in the diabetes care pathway to improve vaccination coverage, especially for patients with advanced diabetes and comorbidities.
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Affiliation(s)
- Laura Lohan
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
- Phymedexp, University of Montpellier, INSERM, CNRS, CHRU de Montpellier, 34295 Montpellier, France;
| | - Charlène Cool
- Department of Pharmacy, Toulouse University Hospital, 31059 Toulouse, France; (C.C.); (P.C.)
- Centre for Epidemiology and Population Health Research (CERPOP), UMR 1027, INSERM, University of Toulouse (UPS), 31059 Toulouse, France
| | - Loriane Viault
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
| | - Philippe Cestac
- Department of Pharmacy, Toulouse University Hospital, 31059 Toulouse, France; (C.C.); (P.C.)
- Centre for Epidemiology and Population Health Research (CERPOP), UMR 1027, INSERM, University of Toulouse (UPS), 31059 Toulouse, France
| | - Eric Renard
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Florence Galtier
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Maxime Villiet
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
| | - Antoine Avignon
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Ariane Sultan
- Phymedexp, University of Montpellier, INSERM, CNRS, CHRU de Montpellier, 34295 Montpellier, France;
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Cyril Breuker
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
- Phymedexp, University of Montpellier, INSERM, CNRS, CHRU de Montpellier, 34295 Montpellier, France;
- Correspondence: ; Tel.: +33-467-338-562; Fax: +33-467-338-112
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10
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Sugishita Y, Sugawara T. Effectiveness and cost-effectiveness of influenza vaccination for elderly people. Vaccine 2021; 39:7531-7540. [PMID: 34857422 DOI: 10.1016/j.vaccine.2021.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 10/19/2022]
Abstract
For elderly people who have low incidence of influenza, calculation of credible vaccine effectiveness (VE) sometimes becomes difficult. Currently, VE for elderly people is insufficient to ascertain the precise efficacy specifically. Cost-effectiveness of influenza vaccination of elderly people is discussed widely in terms of topics and areas. This report describes research results demonstrating influenza vaccination effectiveness among elderly people based on recent findings. Newly available influenza vaccination for elderly people appears to be cost-effective compared with that of trivalent inactiveted influenza vaccine. Overall, for all influenza virus types, it remains unclear whether influenza vaccination shows high VE. A decreasing effect of repeated vaccination was confirmed partially by test negative design and a serological study of cohorts. However, some studies have found no such decreasing effect. Measurement of VE and subsequent analysis of the cost-effectiveness of influenza vaccination for elderly people requires long-term monitoring using serological studies and test negative design.
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11
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Manini I, Camarri A, Marchi S, Trombetta CM, Vicenti I, Dragoni F, Lazzeri G, Bova G, Montomoli E, Capecchi PL. Surveillance for Severe Acute Respiratory Infections among Hospitalized Subjects from 2015/2016 to 2019/2020 Seasons in Tuscany, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3875. [PMID: 33917106 PMCID: PMC8067855 DOI: 10.3390/ijerph18083875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 11/20/2022]
Abstract
In Italy, the influenza season lasts from October until April of the following year. Influenza A and B viruses are the two viral types that cocirculate during seasonal epidemics and are the main causes of respiratory infections. We analyzed influenza A and B viruses in samples from hospitalized patients at Le Scotte University Hospital in Siena (Central Italy). From 2015 to 2020, 182 patients with Severe Acute Respiratory Infections were enrolled. Oropharyngeal swabs were collected from patients and tested by means of reverse transcriptase-polymerase chain reaction to identify influenza A(H3N2), A(H1N1)pdm09 and B. Epidemiological and virological surveillance remain an essential tool for monitoring circulating viruses and possible mismatches with seasonal vaccine strains, and provide information that can be used to improve the composition of influenza vaccines.
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Affiliation(s)
- Ilaria Manini
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
| | - Andrea Camarri
- Emergency and Transplants Department, University Hospital of Siena, Viale Bracci 16, 53100 Siena, Italy; (A.C.); (G.B.)
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
| | - Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, Viale Bracci 16, 53100 Siena, Italy; (I.V.); (F.D.)
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, Viale Bracci 16, 53100 Siena, Italy; (I.V.); (F.D.)
| | - Giacomo Lazzeri
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
| | - Giovanni Bova
- Emergency and Transplants Department, University Hospital of Siena, Viale Bracci 16, 53100 Siena, Italy; (A.C.); (G.B.)
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
- VisMederi S.r.l., Strada del Petriccio e Belriguardo 35, 53100 Siena, Italy
| | - Pier Leopoldo Capecchi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy;
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12
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Stuurman AL, Bollaerts K, Alexandridou M, Biccler J, Díez Domingo J, Nohynek H, Rizzo C, Turunen T, Riera-Montes M. Vaccine effectiveness against laboratory-confirmed influenza in Europe - Results from the DRIVE network during season 2018/19. Vaccine 2020; 38:6455-6463. [PMID: 32778474 DOI: 10.1016/j.vaccine.2020.07.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/20/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
The DRIVE project aims to establish a sustainable network to estimate brand-specific influenza vaccine effectiveness (IVE) annually. DRIVE is a public-private partnership launched in response to EMA guidance that requires effectiveness evaluation from manufacturers for all individual influenza vaccine brands every season. IVE studies are conducted by public partners in DRIVE. Private partners (vaccine manufacturers from the European Federation of Pharmaceutical Industries and Association (EFPIA)) provide written feedback moderated by an independent scientific committee. Test-negative design (TND) case-control studies (4 in primary care and five in hospital) were conducted in six countries in Europe during the 2018/19 season. Site-specific confounder-adjusted vaccine effectiveness (VE) estimates for any vaccine exposure were calculated by age group (<18 years (y), 18-64y and 65 + y) and pooled by setting (primary care, hospital) through random effects meta-analysis. In addition, one population-based cohort study was conducted in Finland. TND studies included 3339 cases and 6012 controls; seven vaccine brands were reported. For ages 65 + y, pooled VE against any influenza strain was estimated at 27% (95%CI 6-44) in hospital setting. Sample size was insufficient for meaningful IVE estimates in other age groups, in the primary care setting, or by vaccine brand. The population-based cohort study included 274,077 vaccinated and 494,337 unvaccinated person-years, two vaccine brands were reported. Brand-specific IVE was estimated for Fluenz Tetra (36% [95%CI 24-45]) for ages 2-6y, Vaxigrip Tetra (54% [43-62]) for ages 6 months to 6y, and Vaxigrip Tetra (30% [25-35]) for ages 65 + y. The results presented are from the second influenza season covered by the DRIVE network. While sample size from the pooled TND studies was still too low for precise (brand-specific) IVE estimates, the network has approximately doubled in size compared to the pilot season. Taking measures to increase sample size is an important focus of DRIVE for the coming years.
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Affiliation(s)
| | | | | | - Jorne Biccler
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | | | - Hanna Nohynek
- Finnish Institute for Health and Welfare, Helsinki, Finland
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13
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Pițigoi D, Streinu-Cercel A, Ivanciuc AE, Lazãr M, Cherciu CM, Mihai ME, Nițescu M, Aramă V, Crăciun MD, Streinu-Cercel A, Săndulescu O. Surveillance of medically-attended influenza in elderly patients from Romania-data from three consecutive influenza seasons (2015/16, 2016/17, and 2017/18). Influenza Other Respir Viruses 2020; 14:530-540. [PMID: 32410402 PMCID: PMC7431641 DOI: 10.1111/irv.12752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background Influenza is an acute infection affecting all age groups; however, elderly patients are at an increased risk. We aim to describe the clinical characteristics and the circulation of influenza virus types in elderly patients admitted for severe acute respiratory infection (SARI) to a tertiary care hospital in Bucharest, Romania, part of the I‐MOVE+ hospital network. Methods We conducted an active surveillance study at the National Institute for Infectious Diseases “Prof. Dr Matei Balș,” Bucharest, Romania, during three consecutive influenza seasons: 2015/16, 2016/17, and 2017/18. All patients aged 65 and older admitted to our hospital for SARI were tested for influenza by PCR. Results A total of 349 eligible patients were tested during the study period, and 149 (42.7%) were confirmed with influenza. Most patients, 321 (92.5%) presented at least one underlying condition at the time of hospital admission, the most frequent being cardiovascular disease, 270 (78.3%). The main influenza viral subtype circulating in 2015/16 was A(H1N1)pdm09, followed by A(H3N2) in 2016/17 and B influenza in 2017/18. Case fatality was highest in the 2015/16 season (3.7%), 0% in 2016/17, and 1.0% in 2017/18. Vaccination coverage in elderly patients with SARI from our study population was 22 (6.3%) over the three seasons. Conclusions Our study has highlighted a high burden of comorbidities in elderly patients presenting with SARI during winter season in Romania. The influenza vaccine coverage rate needs to be substantially increased in the elderly population, through targeted interventions.
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Affiliation(s)
- Daniela Pițigoi
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Alina Elena Ivanciuc
- "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania
| | - Mihaela Lazãr
- "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania
| | - Carmen Maria Cherciu
- "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania
| | - Maria Elena Mihai
- "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania
| | - Maria Nițescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Victoria Aramă
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Maria Dorina Crăciun
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Grigore Alexandrescu Clinical Children's Emergency Hospital, Bucharest, Romania
| | - Adrian Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
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14
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Rose AMC, Kissling E, Gherasim A, Casado I, Bella A, Launay O, Lazăr M, Marbus S, Kuliese M, Syrjänen R, Machado A, Kurečić Filipović S, Larrauri A, Castilla J, Alfonsi V, Galtier F, Ivanciuc A, Meijer A, Mickiene A, Ikonen N, Gómez V, Lovrić Makarić Z, Moren A, Valenciano M. Vaccine effectiveness against influenza A(H3N2) and B among laboratory-confirmed, hospitalised older adults, Europe, 2017-18: A season of B lineage mismatched to the trivalent vaccine. Influenza Other Respir Viruses 2020; 14:302-310. [PMID: 32022450 PMCID: PMC7182608 DOI: 10.1111/irv.12714] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/09/2019] [Accepted: 12/15/2019] [Indexed: 01/22/2023] Open
Abstract
Background Influenza A(H3N2), A(H1N1)pdm09 and B viruses co‐circulated in Europe in 2017‐18, predominated by influenza B. WHO‐recommended, trivalent vaccine components were lineage‐mismatched for B. The I‐MOVE hospital network measured 2017‐18 seasonal influenza vaccine effectiveness (IVE) against influenza A(H3N2) and B among hospitalised patients (≥65 years) in Europe. Methods Following the same generic protocol for test‐negative design, hospital teams in nine countries swabbed patients ≥65 years with recent onset (≤7 days) severe acute respiratory infection (SARI), collecting information on demographics, vaccination status and underlying conditions. Cases were RT‐PCR positive for influenza A(H3N2) or B; controls: negative for any influenza. “Vaccinated” patients had SARI onset >14 days after vaccination. We measured pooled IVE against influenza, adjusted for study site, age, sex, onset date and chronic conditions. Results We included 3483 patients: 376 influenza A(H3N2) and 928 B cases, and 2028 controls. Most (>99%) vaccinated patients received the B lineage‐mismatched trivalent vaccine. IVE against influenza A(H3N2) was 24% (95% CI: 2 to 40); 35% (95% CI: 6 to 55) in 65‐ to 79‐year‐olds and 14% (95% CI: −22 to 39) in ≥80‐year‐olds. Against influenza B, IVE was 30% (95% CI: 16 to 41); 37% (95% CI: 19 to 51) in 65‐ to 79‐year‐olds and 19% (95% CI: −7 to 38) in ≥80‐year‐olds. Conclusions IVE against influenza B was similar to A(H3N2) in hospitalised older adults, despite trivalent vaccine and circulating B lineage mismatch, suggesting some cross‐protection. IVE was lower in those ≥80 than 65‐79 years. We reinforce the importance of influenza vaccination in older adults as, even with a poorly matched vaccine, it still protects one in three to four of this population from severe influenza.
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Affiliation(s)
| | | | - Alin Gherasim
- National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III, Madrid, Spain
| | - Itziar Casado
- Navarra Public Health Institute, IdiSNA-CIBERESP, Pamplona, Spain
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Odile Launay
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,CIC Cochin Pasteur, université Paris Descartes, Sorbonne Paris Cité, hôpital Cochin, AP-HP, Paris, France
| | - Mihaela Lazăr
- National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Sierk Marbus
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Monika Kuliese
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ritva Syrjänen
- Finnish Institute for Health and Welfare, Tampere, Finland
| | - Ausenda Machado
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Sanja Kurečić Filipović
- Division for epidemiology of communicable diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III, Madrid, Spain
| | - Jesús Castilla
- Navarra Public Health Institute, IdiSNA-CIBERESP, Pamplona, Spain
| | - Valeria Alfonsi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Florence Galtier
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,CHU de Montpellier, Inserm CIC 1411, Hôpital Saint-Eloi, Montpellier, France
| | - Alina Ivanciuc
- National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aukse Mickiene
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Niina Ikonen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Verónica Gómez
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Zvjezdana Lovrić Makarić
- Division for epidemiology of communicable diseases, Croatian Institute of Public Health, Zagreb, Croatia
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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: 90] [Impact Index Per Article: 22.5] [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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Bellino S, Piovesan C, Bella A, Rizzo C, Pezzotti P, Ramigni M. Determinants of vaccination uptake, and influenza vaccine effectiveness in preventing deaths and hospital admissions in the elderly population; Treviso, Italy, 2014/2015-2016/2017 seasons. Hum Vaccin Immunother 2019; 16:301-312. [PMID: 31486347 PMCID: PMC7062427 DOI: 10.1080/21645515.2019.1661754] [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] [Indexed: 12/15/2022] Open
Abstract
Seasonal influenza is an important cause of morbidity and mortality, particularly among the elderly population. Determinants of vaccination uptake and its impact on health outcomes in the seasons 2014/2015–2016/2017 in elderly living in Treviso area (Veneto Region, North-Eastern Italy) were evaluated. A retrospective cohort study was conducted combining information from several health administrative databases, and multiple Poisson regression models were applied to evaluate the influenza vaccine effectiveness, also adjusting for confounding factors. MF59-adjuvanted trivalent-inactivated vaccine was mainly administered. Data from more than 83,000 elderly people were analyzed by year. Vaccine coverage was about 50%; influenza vaccination uptake was independently associated with older age, male sex, increasing number of underlying chronic conditions, previous pneumococcal vaccination, annual expenses for specialist medical cares, and general practitioner to whom the elderly was in charge. After adjusting for previously described characteristics, vaccination was associated with lower mortality and influenza-related hospitalization rates. Specifically, during influenza season the adjusted incidence rate ratio of death and of influenza-related hospitalizations for vaccinated compared to unvaccinated persons was 0.63 [95% confidence interval (CI) 0.58–0.69, p < .001] and 0.86 (95% CI 0.81–0.91, p < .001), respectively. A similar effectiveness was estimated for death in all age groups (≤74, 75–84, ≥85 years old), whereas a higher effect was found for hospitalizations in subjects aged ≥75 years old. Vaccination was also effective both in males and females. Findings suggest a health benefit of the influenza vaccination in the elderly population. Efforts should be focused on strategies to increase the vaccination uptake as important instrument of prevention.
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Affiliation(s)
- Stefania Bellino
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Cinzia Piovesan
- Department of Epidemiology, Local Health Unit 2 Marca Trevigiana, Treviso, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Caterina Rizzo
- Direction of Clinical Departments, Bambino Gesù Children's Hospital, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), Rome, Italy
| | - Mauro Ramigni
- Department of Epidemiology, Local Health Unit 2 Marca Trevigiana, Treviso, Italy
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Ferdinands JM, Gaglani M, Martin ET, Middleton D, Monto AS, Murthy K, Silveira FP, Talbot HK, Zimmerman R, Alyanak E, Strickland C, Spencer S, Fry AM. Prevention of Influenza Hospitalization Among Adults in the United States, 2015-2016: Results From the US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN). J Infect Dis 2019; 220:1265-1275. [PMID: 30561689 PMCID: PMC6743848 DOI: 10.1093/infdis/jiy723] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/13/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Evidence establishing effectiveness of influenza vaccination for prevention of severe illness is limited. The US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) is a multiyear test-negative case-control study initiated in 2015-2016 to estimate effectiveness of vaccine in preventing influenza hospitalization among adults. METHODS Adults aged ≥18 years admitted to 8 US hospitals with acute respiratory illness and testing positive for influenza by polymerase chain reaction were cases; those testing negative were controls. Vaccine effectiveness was estimated with logistic regression adjusting for age, comorbidities, and other confounding factors and stratified by frailty, 2-year vaccination history, and clinical presentation. RESULTS We analyzed data from 236 cases and 1231 controls; mean age was 58 years. More than 90% of patients had ≥1 comorbidity elevating risk of influenza complications. Fifty percent of cases and 70% of controls were vaccinated. Vaccination was 51% (95% confidence interval [CI], 29%-65%) and 53% (95% CI, 11%-76%) effective in preventing hospitalization due to influenza A(H1N1)pdm09 and influenza B virus infection, respectively. Vaccine was protective for all age groups. CONCLUSIONS During the 2015-2016 US influenza A(H1N1)pdm09-predominant season, we found that vaccination halved the risk of influenza-association hospitalization among adults, most of whom were at increased risk of serious influenza complications due to comorbidity or age.
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Affiliation(s)
- Jill M Ferdinands
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manjusha Gaglani
- Baylor Scott & White Health, Texas A&M University Health Science Center College of Medicine, Temple, Texas
| | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor
| | - Don Middleton
- University of Pittsburgh Medical Center, Pennsylvania
| | - Arnold S Monto
- University of Michigan School of Public Health, Ann Arbor
| | | | | | - H Keipp Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Elif Alyanak
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Courtney Strickland
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Spencer
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia M Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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18
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Ortiz JR. The Challenge of Vaccine Policy-making With Imperfect Data. Clin Infect Dis 2019; 66:673-675. [PMID: 29028972 DOI: 10.1093/cid/cix876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Justin R Ortiz
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
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19
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Pițigoi D, Nițescu M, Streinu-Cercel A, Bacruban R, Ivanciuc AE, Lazăr M, Cherciu CM, Crăciun MD, Aramă V, Streinu-Cercel A, Săndulescu O. Characteristics of influenza in elderly patients with and without diabetes, hospitalized for severe acute respiratory infection in a tertiary care hospital from Bucharest Romania - a three-year prospective epidemiological surveillance study. Germs 2019; 9:142-147. [PMID: 31646144 DOI: 10.18683/germs.2019.1169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/29/2019] [Accepted: 08/06/2019] [Indexed: 11/08/2022]
Abstract
Introduction Patients with diabetes may be at a higher risk of developing complicated influenza. We report the characteristics of influenza in hospitalized elderly patients with and without diabetes, in three consecutive influenza seasons. Methods The study included patients admitted for severe acute respiratory infection (SARI) in the National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, during a three-year active epidemiological surveillance study (2015/16, 2016/17, 2017/18), in the I-MOVE+ hospital network. Results A total of 349 patients were tested by PCR over the duration of the study. The percentage of patients with diabetes was comparable throughout the seasons: 34.7%, 28.3% and 30.4% (p=0.587). Influenza A was the main viral type circulating in 2015/16 and 2016/17 (100% and 97.6%) in our study population, while in 2017/18, B viruses predominated (90.0%). Diabetics presented a higher median number of comorbidities (3 vs. 2) p<0.001, and two-fold higher odds of also associating obesity (OR=2.1, 95%CI:1.3-3.4, p=0.003), compared to those without diabetes. Diabetics also tested positive for influenza more often (p=0.296). Only 6 patients with diabetes (5.4%) from our study had been vaccinated against influenza, and most (n=4) of those who had been vaccinated tested negative for influenza. Conclusions Our study is the first to describe the circulation of influenza viral types in elderly diabetic patients hospitalized for SARI. The results reinforce the national and international recommendation to vaccinate against influenza all patients with diabetes.
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Affiliation(s)
- Daniela Pițigoi
- MD, PhD, Associate Professor, Department of Epidemiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Maria Nițescu
- MD, PhD, Associate Professor, Department of Hygiene and Medical Ecology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Anca Streinu-Cercel
- MD, PhD, Associate Professor, Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Rodica Bacruban
- MD, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Alina Elena Ivanciuc
- Biologist, PhD student, National Institute for Medico-Military Research Cantacuzino, National Influenza Centre, No. 103 Splaiul Independenței, Bucharest 050096, Romania
| | - Mihaela Lazăr
- Biologist, PhD, National Institute for Medico-Military Research Cantacuzino, National Influenza Centre, No. 103 Splaiul Independenței, Bucharest 050096, Romania
| | - Carmen Maria Cherciu
- Biochemist, National Institute for Medico-Military Research Cantacuzino, National Influenza Centre, No. 103 Splaiul Independenței, Bucharest 050096, Romania
| | - Maria Dorina Crăciun
- MD, PhD, Assistant Lecturer, Department of Epidemiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Grigore Alexandrescu Clinical Children's Emergency Hospital, No. 30-32 Iancu de Hunedoara boulevard, Bucharest 011743, Romania
| | - Victoria Aramă
- MD, PhD, Professor, Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Adrian Streinu-Cercel
- MD, PhD, Professor, Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Oana Săndulescu
- MD, PhD, Associate Professor, Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
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20
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Bella A, Gesualdo F, Orsi A, Arcuri C, Chironna M, Loconsole D, Napoli C, Orsi GB, Manini I, Montomoli E, Alfonsi V, Castrucci MR, Rizzo C. Effectiveness of the trivalent MF59 adjuvated influenza vaccine in preventing hospitalization due to influenza B and A(H1N1)pdm09 viruses in the elderly in Italy, 2017 - 2018 season. Expert Rev Vaccines 2019; 18:671-679. [PMID: 31159616 DOI: 10.1080/14760584.2019.1627206] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidity in the elderly is weak. Our aim was to measure the VE against severe outcomes in the elderly. Methods: We conducted a multicentre hospital-based test-negative design (TND) case-control study, during the 2017/18 season, in four Italian hospitals. The study population included individuals aged ≥65 years hospitalized with Severe Acute Respiratory Infections (SARI). Patients were classified as cases and controls based on the results of the PCR influenza testing. We estimated VE by virus subtypes and specific VE for the trivalent adjuvanted vaccine (TIVadj). Results: 502 patients with SARI were enrolled: 118 (23.5%) tested positive (cases) and 384 (76.5%) tested negative (controls) for influenza. The adjusted VE of 48.5% for all vaccines was comparable to the adjusted VE for the TIVadj vaccine (48.3%). Adjusted VE for the TIVadj vaccine was 67.5% for A(H1N1)pdm09 and 44.5% for B viruses. Conclusion: We show a moderate adjusted VE of the TIVadj against all viruses, a good adjusted VE against A(H1N1)pdm09 strains and a moderate adjusted VE against B strains, despite a mismatch between the B circulating lineage and the lineage included in the vaccine. This is likely due to the cross-protection among B strains induced by the TIVadj in elderly patients.
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Affiliation(s)
- Antonino Bella
- a Department of Infectious Diseases , National Institute of Health , Rome , Italy
| | - Francesco Gesualdo
- b Direction of Cinical Department , Bambino Gesù Children's Hospital , Rome , Italy
| | - Andrea Orsi
- c Department of Health Sciences , University of Genoa, IRCCS Ospedale Policlinico San Martino , Genoa , Italy
| | - Claudia Arcuri
- c Department of Health Sciences , University of Genoa, IRCCS Ospedale Policlinico San Martino , Genoa , Italy
| | - Maria Chironna
- d Department of Biomedical Science and Medical Oncology of the University of Bari , Bari , Italy
| | - Daniela Loconsole
- d Department of Biomedical Science and Medical Oncology of the University of Bari , Bari , Italy
| | - Christian Napoli
- e Department of Medical-Surgical Sciences and Translational Medicine , University of Rome "Sapienza", Sant'Andrea Hospital , Rome , Italy
| | - Giovanni Battista Orsi
- f Department of Public Health and Infectious Diseases , University of Rome "Sapienza" , Rome , Italy
| | - Ilaria Manini
- g Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Emanuele Montomoli
- g Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Valeria Alfonsi
- a Department of Infectious Diseases , National Institute of Health , Rome , Italy.,e Department of Medical-Surgical Sciences and Translational Medicine , University of Rome "Sapienza", Sant'Andrea Hospital , Rome , Italy
| | - Maria Rita Castrucci
- a Department of Infectious Diseases , National Institute of Health , Rome , Italy
| | - Caterina Rizzo
- b Direction of Cinical Department , Bambino Gesù Children's Hospital , Rome , Italy
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21
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Puig-Barberà J, Mira-Iglesias A, Burtseva E, Cowling BJ, Serhat U, Ruiz-Palacios GM, Launay O, Kyncl J, Koul P, Siqueira MM, Sominina A. Influenza epidemiology and influenza vaccine effectiveness during the 2015-2016 season: results from the Global Influenza Hospital Surveillance Network. BMC Infect Dis 2019; 19:415. [PMID: 31088481 PMCID: PMC6518734 DOI: 10.1186/s12879-019-4017-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/24/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The Global Influenza Hospital Surveillance Network is an international platform whose primary objective is to study severe cases of influenza requiring hospitalization. METHODS During the 2015-2016 influenza season, 11 sites in the Global Influenza Hospital Surveillance Network in nine countries (Russian Federation, Czech Republic, Turkey, France, China, Spain, Mexico, India, and Brazil) participated in a prospective, active-surveillance, hospital-based epidemiological study. Influenza infection was confirmed by reverse transcription-polymerase chain reaction. Influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza was estimated using a test-negative approach. RESULTS 9882 patients with laboratory results were included of which 2415 (24.4%) were positive for influenza, including 1415 (14.3%) for A(H1N1)pdm09, 235 (2.4%) for A(H3N2), 180 (1.8%) for A not subtyped, 45 (0.5%) for B/Yamagata-lineage, 532 (5.4%) for B/Victoria-lineage, and 33 (0.3%) for B not subtyped. Of included admissions, 39% were < 5 years of age and 67% had no underlying conditions. The odds of being admitted with influenza were higher among pregnant than non-pregnant women (odds ratio, 2.82 [95% confidence interval (CI), 1.90 to 4.19]). Adjusted IVE against influenza-related hospitalization was 16.3% (95% CI, 0.4 to 29.7). Among patients targeted for influenza vaccination, adjusted IVE against hospital admission with influenza was 16.2% (95% CI, - 3.6 to 32.2) overall, 23.0% (95% CI, - 3.3 to 42.6) against A(H1N1)pdm09, and - 25.6% (95% CI, - 86.3 to 15.4) against B/Victoria lineage. CONCLUSIONS The 2015-2016 influenza season was dominated by A(H1N1)pdm09 and B/Victoria-lineage. Hospitalization with influenza often occurred in healthy and young individuals, and pregnant women were at increased risk of influenza-related hospitalization. Influenza vaccines provided low to moderate protection against hospitalization with influenza and no protection against the predominant circulating B lineage, highlighting the need for more effective and broader influenza vaccines.
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Affiliation(s)
- Joan Puig-Barberà
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana, FISABIO, Valencia, Spain
| | - Ainara Mira-Iglesias
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana, FISABIO, Valencia, Spain
| | - Elena Burtseva
- Ivanovsky Institute of Virology FSBI “N.F, Gamaleya NRCEM” Ministry of Health, Moscow, Russian Federation
| | - Benjamin J. Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong, Special Administrative Region of China
| | - Unal Serhat
- Turkish Society of Internal Medicine, Ankara, Turkey
| | - Guillermo Miguel Ruiz-Palacios
- Salvador Zubirán National Institute of Medical Sciences and Nutrition (INCMNSZ), Vasco de Quiroga 15, Belisario Domínguez Sección 16, 14080 Tlalpan, CDMX Mexico
| | - Odile Launay
- INSERM, F-CRIN, Réseau National d’Investigation Clinique en Vaccinologie (I-REIVAC), CIC Cochin Pasteur, Paris, France and Université Paris Descartes, Sorbonne Paris Cité and Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Jan Kyncl
- National Institute of Public Health, Prague, Czech Republic
| | - Parvaiz Koul
- Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Bemina, Srinagar, Jammu & Kashmir 190011 India
| | | | - Anna Sominina
- Research Institute of Influenza, WHO National Influenza Centre of Russia and Ministry of Healthcare of the Russian Federation, St. Petersburg, Russian Federation
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22
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Rondy M, Kissling E, Emborg HD, Gherasim A, Pebody R, Trebbien R, Pozo F, Larrauri A, McMenamin J, Valenciano M. Interim 2017/18 influenza seasonal vaccine effectiveness: combined results from five European studies. ACTA ACUST UNITED AC 2019; 23. [PMID: 29510782 PMCID: PMC5840921 DOI: 10.2807/1560-7917.es.2018.23.9.18-00086] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Between September 2017 and February 2018, influenza A(H1N1)pdm09, A(H3N2) and B viruses (mainly B/Yamagata, not included in 2017/18 trivalent vaccines) co-circulated in Europe. Interim results from five European studies indicate that, in all age groups, 2017/18 influenza vaccine effectiveness was 25 to 52% against any influenza, 55 to 68% against influenza A(H1N1)pdm09, −42 to 7% against influenza A(H3N2) and 36 to 54% against influenza B. 2017/18 influenza vaccine should be promoted where influenza still circulates.
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Affiliation(s)
- Marc Rondy
- MR and EK contributed equally to the study and manuscript writing.,EpiConcept, Paris, France
| | - Esther Kissling
- MR and EK contributed equally to the study and manuscript writing.,EpiConcept, Paris, France
| | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Alin Gherasim
- National Epidemiology Centre, Institute of Health Carlos III, Madrid Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid Spain
| | | | - Ramona Trebbien
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
| | - Francisco Pozo
- Inmaculada Casas National Centre for Microbiology, National Influenza Reference Laboratory, World Health Organization National Influenza Centre, Institute of Health Carlos III
| | - Amparo Larrauri
- National Epidemiology Centre, Institute of Health Carlos III, Madrid Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid Spain
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- The members of the I-MOVE/I-MOVE+ group are listed at the end of the article
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23
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Bollaerts K, Alexandridou M, Verstraeten T. Risk factors for modified vaccine effectiveness of the live attenuated zoster vaccine among the elderly in England. Vaccine X 2019; 1:100007. [PMID: 31384729 PMCID: PMC6668231 DOI: 10.1016/j.jvacx.2019.100007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 12/30/2022] Open
Abstract
Background The United Kingdom introduced routine vaccination with the live-attenuated zoster vaccine for 70 year-olds in 2013, with the vaccine also offered to 79 year-olds as part of a catch-up campaign. In the subsequent years, the catch-up campaign was extended to also include adults aged 78 years. We investigated 14 pre-identified potential risk factors for potential modified vaccine effectiveness. Methods This retrospective cohort study in England included subjects born in 1943-1946 (the routine cohort) and in 1934-1937 (the catch-up cohort). We used the Clinical Practice Research Datalink (CPRD) to identify herpes zoster (HZ) cases and the risk factors: age, gender, ethnicity, socio-economic status, asthma, type 2 diabetes, chronic obstructive pulmonary disease, smoking, body mass index, immunosuppression, history of HZ, co-administration with influenza or pneumococcal vaccine. We derived HZ incidence by risk groups, overall vaccine effectiveness (VE) and modified VE expressed as relative differences in VE from Poisson regression models. Results Overall VE was 66.8% [95% CI: 62.2; 71.0]. Two out of the 14 investigated risk factors modified the HZ VE. Notably, lower VE was observed in diabetics and in persons with a history of HZ with relative differences in VE of -22·2%, [95% CI: -39·6, -4·5] and -22·5%, [95% CI: -44·9, -0·1]. Conclusions Live-attenuated zoster vaccine protection against HZ was lower in type 2 diabetics and in subjects with a history of HZ. Contrary to clinical trial results, age did not affect the observed VE. Further study is required to gain insights into why certain risk groups are less protected. Identifying and understanding the effect modifiers of VE is important for future vaccine development as well as vaccine recommendations.
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Affiliation(s)
- Kaatje Bollaerts
- P95 Epidemiology and Pharmacovigilance, Koning Leopold III Laan 1, 3001 Leuven, Belgium
| | - Maria Alexandridou
- P95 Epidemiology and Pharmacovigilance, Koning Leopold III Laan 1, 3001 Leuven, Belgium
| | - Thomas Verstraeten
- P95 Epidemiology and Pharmacovigilance, Koning Leopold III Laan 1, 3001 Leuven, Belgium
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Mosnier A, Launay O, Martinez L, Gavazzi G, Josset L, Crepey P, Hannoun C, Weil-Olivier C, Gaillat J. [Quadrivalent influenza vaccine: What is changed and what are the benefits?]. Presse Med 2018; 47:842-853. [PMID: 30219205 DOI: 10.1016/j.lpm.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022] Open
Abstract
Currently, circulating viruses responsible for annual seasonal influenza epidemics belong to two influenza A subtypes, A(H1N1) and A(H3N2), and to two antigenically distinct type B lineages, B/Yamagata and B/Victoria lineages. Like diseases due to influenza A virus, influenza B virus diseases may have severe consequences and should be prevented. Until now, in France, the vaccines used to prevent seasonal influenza were trivalent, systematically targeting viruses belonging to both A subtypes and to one or other of the B lineages. The protective efficacy of trivalent vaccines is diminished during the seasons when viruses belonging to both B lineages cocirculated or when the circulating dominant type B virus belonged to a lineage different from that targeted by the vaccine strain. By targeting viruses belonging to both B lineages, quadrivalent vaccines improve the antigenic concordance between circulating and vaccine type B strains. Three inactivated quadrivalent vaccines are authorized for marketing in France and should be available for the 2018-2019 season. It is expected that, by providing enlarged protection, these quadrivalent influenza vaccines will improve vaccine efficacy, the confidence in immunization of the public, the satisfaction of health professionals, and ultimately will help to complete immunization coverage.
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Affiliation(s)
- Anne Mosnier
- Open Rome & Réseau des GROG, 67, rue du Poteau, 75018 Paris, France
| | - Odile Launay
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | | | - Gaëtan Gavazzi
- CHU Grenoble-Alpes, clinique universitaire de gériatrie, pavillon Elisée-Chatin, et GREPI EA 7408, université Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 9, France
| | - Laurence Josset
- Institut des agents infectieux, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | | | | | | | - Jacques Gaillat
- Centre hospitalier Annecy-Genevois, 1, avenue de l'Hôpital, 74370 Metz-Tessy, France.
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25
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The effectiveness of influenza vaccination against medically-attended illnesses in Hong Kong across three years with different degrees of vaccine match, 2014-17. Vaccine 2018; 36:6117-6123. [PMID: 30190121 DOI: 10.1016/j.vaccine.2018.08.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/24/2018] [Accepted: 08/29/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Influenza vaccination is the most effective intervention to prevent influenza virus infections. Vaccine effectiveness (VE) can vary due to factors such as matching between vaccine strains and prevailing strains, age and other characteristics of the vaccine recipients. OBJECTIVE To evaluate influenza VE against medically-attended illness in different age groups and against specific influenza types/subtypes in Hong Kong. METHODS A test-negative study was conducted from December 2014 through August 2017 in 20 outpatient clinics. Patients at least 6 months of age presenting with at least two symptoms of acute respiratory illness, ARI (fever ≥37.8 °C, cough, sore throat, runny nose, headache, myalgia and phlegm) within 72 h of onset were tested for influenza virus by reverse transcription polymerase chain reaction (PCR). Vaccination history was assessed by self-report or medical records at the clinics. VE against medically-attended illness was estimated using conditional logistic regression for influenza PCR result versus vaccination history, matching by calendar time and adjusting for age, age-squared, sex, and chronic medical illness. Additional analyses examined VE by age group and by influenza type/subtype. RESULTS We enrolled 2566 patients, of whom 1118 (43.6%) tested positive for influenza A or B virus by PCR. Test-positive subjects were generally older, more likely to present with one of the symptoms of ARI, and less likely to receive vaccination against influenza. VE estimates for influenza A(H1N1), A(H3N2), B/Yamagata and B/Victoria were 61.6% (95% confidence interval, CI: 21.8%, 81.1%), 26.4% (95% CI: -1.3%, 46.6%), 67.0% (95% CI: 25.9%, 85.3%), 60.4% (95% CI: 0.3%, 84.3%), respectively. Estimates of VE by age group were generally higher in adults aged 50-64 and lower among children and older adults. CONCLUSIONS VE against medically-attended influenza was moderate in Hong Kong, confirming the impact of influenza vaccination in reducing disease burden. The reduced VE for influenza A(H3N2) is a continuing concern.
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Summary of the NACI literature review on the comparative effectiveness of subunit and split virus inactivated influenza vaccines in older adults. ACTA ACUST UNITED AC 2018; 44:129-133. [PMID: 31015805 DOI: 10.14745/ccdr.v44i06a02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Subunit and split virus inactivated influenza vaccines (IIV) are two commonly used types of seasonal influenza vaccines in Canada. The comparative effectiveness of these two formulations is particularly relevant for older adults, as older adults have reduced influenza vaccine effectiveness and experience more severe influenza than younger adults. Objective To compare the vaccine effectiveness and immunogenicity of unadjuvanted, standard-dose subunit IIVs versus unadjuvanted, standard-dose split virus IIVs in adults 65 years of age and older. Methods An a priori written protocol based on rapid review methods was developed that included studies published in 2007 or later in the EMBASE, MEDLINE and ClinicalTrials.gov databases with terms used in the objective. Due to the small number of records returned, hand searches of reference lists were completed, the publication date limit was removed, three additional databases (the Cochrane Central Register of Controlled Trials, Scopus and Web of Science) were searched, and studies including adults 60 years of age and older were included. Data from included studies were extracted into evidence tables and quality assessments were completed. The results were synthesized narratively. Results Eight eligible studies were identified. In the three studies that assessed vaccine effectiveness of subunit and split virus IIVs, there were no statistically significant differences in vaccine effectiveness in adults 65 years of age and older against laboratory-confirmed infection with any influenza virus strain, or against laboratory-confirmed infection with influenza A(H1N1), A(H3N2) or B virus, specifically. In the five studies that assessed immunogenicity, the findings were not consistent and the overall quality of immunogenicity evidence was weak. Conclusion The National Advisory Committee on Immunization (NACI) concludes that there is insufficient evidence to determine significant differences in the vaccine effectiveness or immunogenicity of unadjuvanted, standard-dose subunit and split virus IIVs in adults 65 years of age and older (Grade I evidence).
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Rondy M, Gherasim A, Casado I, Launay O, Rizzo C, Pitigoi D, Mickiene A, Marbus SD, Machado A, Syrjänen RK, Pem-Novose I, Horváth JK, Larrauri A, Castilla J, Vanhems P, Alfonsi V, Ivanciuc AE, Kuliese M, van Gageldonk-Lafeber R, Gomez V, Ikonen N, Lovric Z, Ferenczi A, Moren A. Low 2016/17 season vaccine effectiveness against hospitalised influenza A(H3N2) among elderly: awareness warranted for 2017/18 season. ACTA ACUST UNITED AC 2018; 22. [PMID: 29043961 PMCID: PMC5710120 DOI: 10.2807/1560-7917.es.2017.22.41.17-00645] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In a multicentre European hospital study we measured influenza vaccine effectiveness (IVE) against A(H3N2) in 2016/17. Adjusted IVE was 17% (95% confidence interval (CI): 1 to 31) overall; 25% (95% CI: 2 to 43) among 65–79-year-olds and 13% (95% CI: −15 to 30) among those ≥ 80 years. As the A(H3N2) vaccine component has not changed for 2017/18, physicians and public health experts should be aware that IVE could be low where A(H3N2) viruses predominate.
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Affiliation(s)
| | - Alin Gherasim
- CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain.,National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | - Odile Launay
- Université Paris Descartes, Sorbonne Paris Cité, APHP, CIC Cochin-Pasteur, Paris, France.,Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), CIC 1417, Paris, France
| | | | - Daniela Pitigoi
- University of Medicine and Pharmacy Carol Davila, National Institute for Research Cantacuzino, Bucharest, Romania
| | - Aukse Mickiene
- Department of Infectious diseases of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Sierk D Marbus
- Centre for Epidemiology and surveillance of infectious diseases, Centre for Infectious disease control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ausenda Machado
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ritva K Syrjänen
- Impact Assessment Unit, National Institute for Health and Welfare, Tampere, Finland
| | - Iva Pem-Novose
- Epidemiology Service, Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain.,National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | - Philippe Vanhems
- Emerging Pathogens Laboratory - Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, Centre National de la Recherche Scientifique (CNRS), UMR5308, Ecole Nationale Supérieure (ENS) de Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Infection Control and Epidemiology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), CIC 1417, Paris, France
| | | | - Alina E Ivanciuc
- National Institute for Research Cantacuzino, Bucharest, Romania, Faculty of Biology, Bucharest University
| | - Monika Kuliese
- Department of Infectious diseases of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rianne van Gageldonk-Lafeber
- Centre for Epidemiology and surveillance of infectious diseases, Centre for Infectious disease control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Veronica Gomez
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Niina Ikonen
- Unit of Expert Microbiology, National Institute for Health and Welfare, Helsinki, Finland
| | - Zvjezdana Lovric
- Epidemiology Service, Croatian Institute of Public Health, Zagreb, Croatia
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- The members of the I-Move+ hospital working group are listed at the end of the article
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