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Mosmann TR, McMichael AJ, LeVert A, McCauley JW, Almond JW. Opportunities and challenges for T cell-based influenza vaccines. Nat Rev Immunol 2024; 24:736-752. [PMID: 38698082 DOI: 10.1038/s41577-024-01030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/05/2024]
Abstract
Vaccination remains our main defence against influenza, which causes substantial annual mortality and poses a serious pandemic threat. Influenza virus evades immunity by rapidly changing its surface antigens but, even when the vaccine is well matched to the current circulating virus strains, influenza vaccines are not as effective as many other vaccines. Influenza vaccine development has traditionally focused on the induction of protective antibodies, but there is mounting evidence that T cell responses are also protective against influenza. Thus, future vaccines designed to promote both broad T cell effector functions and antibodies may provide enhanced protection. As we discuss, such vaccines present several challenges that require new strategic and economic considerations. Vaccine-induced T cells relevant to protection may reside in the lungs or lymphoid tissues, requiring more invasive assays to assess the immunogenicity of vaccine candidates. T cell functions may contain and resolve infection rather than completely prevent infection and early illness, requiring vaccine effectiveness to be assessed based on the prevention of severe disease and death rather than symptomatic infection. It can be complex and costly to measure T cell responses and infrequent clinical outcomes, and thus innovations in clinical trial design are needed for economic reasons. Nevertheless, the goal of more effective influenza vaccines justifies renewed and intensive efforts.
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Affiliation(s)
- Tim R Mosmann
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, NY, USA.
| | - Andrew J McMichael
- Centre for Immuno-Oncology, Old Road Campus Research Building, University of Oxford, Oxford, UK
| | | | | | - Jeffrey W Almond
- The Sir William Dunn School of Pathology, South Parks Road, University of Oxford, Oxford, UK
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Wang X, Walker G, Kim KW, Stelzer-Braid S, Scotch M, Rawlinson WD. The resurgence of influenza A/H3N2 virus in Australia after the relaxation of COVID-19 restrictions during the 2022 season. J Med Virol 2024; 96:e29922. [PMID: 39295292 DOI: 10.1002/jmv.29922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/12/2024] [Accepted: 09/06/2024] [Indexed: 09/21/2024]
Abstract
This study retrospectively analyzed the genetic characteristics of influenza A H3N2 (A/H3N2) viruses circulating in New South Wales (NSW), the Australian state with the highest number of influenza cases in 2022, and explored the phylodynamics of A/H3N2 transmission within Australia during this period. Sequencing was performed on 217 archived specimens, and A/H3N2 evolution and spread within Australia were analyzed using phylogenetic and phylodynamic methods. Hemagglutinin genes of all analyzed NSW viruses belonged to subclade 3C.2a1b.2a.2 and clustered together with the 2022 vaccine strain. Complete genome analysis of NSW viruses revealed highly frequent interclade reassortments between subclades 3C.2a1b.2a.2 and 3C.2a1b.1a. The estimated earliest introduction time of the dominant subgroup 3C.2a1b.2a.2a.1 in Australia was February 22, 2022 (95% highest posterior density: December 19, 2021-March 13, 2022), following the easing of Australian travel restrictions, suggesting a possible international source. Phylogeographic analysis revealed that Victoria drove the transmission of A/H3N2 viruses across the country during this season, while NSW did not have a dominant role in viral dissemination to other regions. This study highlights the importance of continuous surveillance and genomic characterization of influenza viruses in the postpandemic era, which can inform public health decision-making and enable early detection of novel strains with pandemic potential.
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Affiliation(s)
- Xinye Wang
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Gregory Walker
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Ki W Kim
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Sacha Stelzer-Braid
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Matthew Scotch
- Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, Phoenix, Arizona, USA
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - William D Rawlinson
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
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3
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Broberg EK, Svartström O, Riess M, Kraus A, Vukovikj M, Melidou A. Co-circulation of seasonal influenza A(H1N1)pdm09, A(H3N2) and B/Victoria lineage viruses with further genetic diversification, EU/EEA, 2022/23 influenza season. Euro Surveill 2024; 29. [PMID: 39328158 DOI: 10.2807/1560-7917.es.2024.29.39.2400020] [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] [Indexed: 09/28/2024] Open
Abstract
BackgroundInfluenza viruses can cause large seasonal epidemics with high healthcare impact and severity as they continually change their virological properties such as genetic makeup over time.AimWe aimed to monitor the characteristics of circulating influenza viruses over the 2022/23 influenza season in the EU/EEA countries. In addition, we wanted to compare how closely the circulating viruses resemble the viral components selected for seasonal influenza vaccines, and whether the circulating viruses had acquired resistance to commonly used antiviral drugs.MethodsWe performed a descriptive analysis of the influenza virus detections and characterisations reported by National Influenza Centres (NIC) from the 30 EU/EEA countries from week 40/2022 to week 39/2023 to The European Surveillance System (TESSy) as part of the Global Influenza Surveillance and Response System (GISRS).ResultsIn the EU/EEA countries, the 2022/23 influenza season was characterised by co-circulation of A(H1N1)pdm09, A(H3N2) and B/Victoria-lineage viruses. The genetic evolution of these viruses continued and clade 6B.1A.5a.2a of A(H1N1)pdm09, 3C.2a1b.2a.2b of A(H3N2) and V1A.3a.2 of B/Victoria viruses dominated. Influenza B/Yamagata-lineage viruses were not reported.DiscussionThe World Health Organization (WHO) vaccine composition recommendation for the northern hemisphere 2023/24 season reflects the European virus evolution, with a change of the A(H1N1)pdm09 component, while keeping the A(H3N2) and B/Victoria-lineage components unchanged.
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Affiliation(s)
- Eeva K Broberg
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Olov Svartström
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Maximilian Riess
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Annette Kraus
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Maja Vukovikj
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Angeliki Melidou
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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4
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Corchis-Scott R, Beach M, Geng Q, Podadera A, Corchis-Scott O, Norton J, Busch A, Faust RA, McFarlane S, Withington S, Irwin B, Aloosh M, Ng KKS, McKay RM. Wastewater Surveillance to Confirm Differences in Influenza A Infection between Michigan, USA, and Ontario, Canada, September 2022-March 2023. Emerg Infect Dis 2024; 30:1580-1588. [PMID: 39043398 PMCID: PMC11286066 DOI: 10.3201/eid3008.240225] [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] [Indexed: 07/25/2024] Open
Abstract
Wastewater surveillance is an effective way to track the prevalence of infectious agents within a community and, potentially, the spread of pathogens between jurisdictions. We conducted a retrospective wastewater surveillance study of the 2022-23 influenza season in 2 communities, Detroit, Michigan, USA, and Windsor-Essex, Ontario, Canada, that form North America's largest cross-border conurbation. We observed a positive relationship between influenza-related hospitalizations and the influenza A virus (IAV) wastewater signal in Windsor-Essex (ρ = 0.785; p<0.001) and an association between influenza-related hospitalizations in Michigan and the IAV wastewater signal for Detroit (ρ = 0.769; p<0.001). Time-lagged cross correlation and qualitative examination of wastewater signal in the monitored sewersheds showed the peak of the IAV season in Detroit was delayed behind Windsor-Essex by 3 weeks. Wastewater surveillance for IAV reflects regional differences in infection dynamics which may be influenced by many factors, including the timing of vaccine administration between jurisdictions.
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Tenforde MW, Weber ZA, Yang DH, DeSilva MB, Dascomb K, Irving SA, Naleway AL, Gaglani M, Fireman B, Lewis N, Zerbo O, Goddard K, Timbol J, Hansen JR, Grisel N, Arndorfer J, McEvoy CE, Essien IJ, Rao S, Grannis SJ, Kharbanda AB, Natarajan K, Ong TC, Embi PJ, Ball SW, Dunne MM, Kirshner L, Wiegand RE, Dickerson M, Patel P, Ray C, Flannery B, Garg S, Adams K, Klein NP. Influenza Vaccine Effectiveness Against Influenza A-Associated Emergency Department, Urgent Care, and Hospitalization Encounters Among US Adults, 2022-2023. J Infect Dis 2024; 230:141-151. [PMID: 39052725 PMCID: PMC11306194 DOI: 10.1093/infdis/jiad542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/08/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND The 2022-2023 United States influenza season had unusually early influenza activity with high hospitalization rates. Vaccine-matched A(H3N2) viruses predominated, with lower levels of A(H1N1)pdm09 activity also observed. METHODS Using the test-negative design, we evaluated influenza vaccine effectiveness (VE) during the 2022-2023 season against influenza A-associated emergency department/urgent care (ED/UC) visits and hospitalizations from October 2022 to March 2023 among adults (aged ≥18 years) with acute respiratory illness (ARI). VE was estimated by comparing odds of seasonal influenza vaccination among case-patients (influenza A test positive by molecular assay) and controls (influenza test negative), applying inverse-propensity-to-be-vaccinated weights. RESULTS The analysis included 85 389 ED/UC ARI encounters (17.0% influenza A positive; 37.8% vaccinated overall) and 19 751 hospitalizations (9.5% influenza A positive; 52.8% vaccinated overall). VE against influenza A-associated ED/UC encounters was 44% (95% confidence interval [CI], 40%-47%) overall and 45% and 41% among adults aged 18-64 and ≥65 years, respectively. VE against influenza A-associated hospitalizations was 35% (95% CI, 27%-43%) overall and 23% and 41% among adults aged 18-64 and ≥65 years, respectively. CONCLUSIONS VE was moderate during the 2022-2023 influenza season, a season characterized with increased burden of influenza and co-circulation with other respiratory viruses. Vaccination is likely to substantially reduce morbidity, mortality, and strain on healthcare resources.
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Affiliation(s)
- Mark W. Tenforde
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Duck-Hye Yang
- Department of Clinical Resarch, Westat, Rockville, Maryland
| | - Malini B. DeSilva
- Department of Research, HealthPartners Institute, Minneapolis, Minnesota
| | - Kristin Dascomb
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah
| | - Stephanie A. Irving
- Department of Science Programs, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Allison L. Naleway
- Department of Science Programs, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Manjusha Gaglani
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Baylor Scott & White Health and Baylor College of Medicine, Temple, Texas
- Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas
| | - Bruce Fireman
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California
| | - Ned Lewis
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California
| | - Ousseny Zerbo
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California
| | - Kristin Goddard
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California
| | - Julius Timbol
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California
| | - John R. Hansen
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California
| | - Nancy Grisel
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah
| | - Julie Arndorfer
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah
| | - Charlene E. McEvoy
- Department of Research, HealthPartners Institute, Minneapolis, Minnesota
| | - Inih J. Essien
- Department of Research, HealthPartners Institute, Minneapolis, Minnesota
| | - Suchitra Rao
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Shaun J. Grannis
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana
- School of Medicine, Indiana University, Indianapolis, Indiana
| | - Anupam B. Kharbanda
- Department of Pediatric Emergency Medicine, Children’s Minnesota, Minneapolis, Minnesota
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York
- Medical Informatics Services, NewYork-Presbyterian Hospital, New York, New York
| | - Toan C. Ong
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Peter J. Embi
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sarah W. Ball
- Department of Clinical Resarch, Westat, Rockville, Maryland
| | | | | | - Ryan E. Wiegand
- Coronavirus and other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Monica Dickerson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Palak Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Caitlin Ray
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brendan Flannery
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shikha Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katherine Adams
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicola P. Klein
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California
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6
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Maurel M, Mazagatos C, Goerlitz L, Oroszi B, Hooiveld M, Machado A, Domegan L, Ilić M, Popescu R, Sève N, Martínez-Baz I, Larrauri A, Buda S, Túri G, Meijer A, Gomez V, O'Donnell J, Mlinarić I, Timnea O, Diez AO, Dürrwald R, Horváth JK, Dijkstra F, Rodrigues AP, McKenna A, Filipović SK, Lazar M, Kaczmarek M, Bacci S, Kissling E. Exploring the effect of clinical case definitions on influenza vaccine effectiveness estimation at primary care level: Results from the end-of-season 2022-23 VEBIS multicentre study in Europe. Vaccine 2024; 42:3547-3554. [PMID: 38704257 PMCID: PMC11152456 DOI: 10.1016/j.vaccine.2024.04.060] [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: 12/05/2023] [Revised: 04/03/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Within influenza vaccine effectiveness (VE) studies at primary care level with a laboratory-confirmed outcome, clinical case definitions for recruitment of patients can vary. We used the 2022-23 VEBIS primary care European multicentre study end-of-season data to evaluate whether the clinical case definition affected IVE estimates. METHODS We estimated VE using a multicentre test-negative case-control design. We measured VE against any influenza and influenza (sub)types, by age group (0-14, 15-64, ≥65 years) and by influenza vaccine target group, using logistic regression. We estimated IVE among patients meeting the European Union (EU) acute respiratory infection (ARI) case definition and among those meeting the EU influenza-like illness (ILI) case definition, including only sites providing information on specific symptoms and recruiting patients using an ARI case definition (as the EU ILI case definition is a subset of the EU ARI one). RESULTS We included 24 319 patients meeting the EU ARI case definition, of whom 21 804 patients (90 %) meet the EU ILI case definition, for the overall pooled VE analysis against any influenza. The overall and influenza (sub)type-specific VE varied by ≤2 % between EU ILI and EU ARI populations. DISCUSSION Among all analyses, we found similar VE estimates between the EU ILI and EU ARI populations, with few (10%) additional non-ILI ARI patients recruited. These results indicate that VE in the 2022-23 influenza season was not affected by use of a different clinical case definition for recruitment, although we recommend investigating whether this holds true for next seasons.
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Affiliation(s)
| | - Clara Mazagatos
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Luise Goerlitz
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Lisa Domegan
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - Maja Ilić
- Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Noémie Sève
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Silke Buda
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Joan O'Donnell
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Olivia Timnea
- "Cantacuzino" National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Ana Ordax Diez
- Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL). Consejería de Sanidad. Junta de Castilla y León, Valladolid, Spain
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Adele McKenna
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Marlena Kaczmarek
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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7
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Whitaker H, Willam N, Cottrell S, Goudie R, Andrews N, Evans J, Moore C, Agrawal U, Hassell K, Gunson R, Zitha J, Anand S, Sebastian‐Pillai P, Kalapotharakou P, Okusi C, Hoschler K, Jamie G, Kele B, Hamilton M, Couzens A, Quinot C, Pheasant K, Byford R, Marsh K, Robertson C, de Lusignan S, Williams C, Zambon M, McMenamin J, Watson C. End of 2022/23 Season Influenza Vaccine Effectiveness in Primary Care in Great Britain. Influenza Other Respir Viruses 2024; 18:e13295. [PMID: 38744684 PMCID: PMC11093773 DOI: 10.1111/irv.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The 2022/23 influenza season in the United Kingdom saw the return of influenza to prepandemic levels following two seasons with low influenza activity. The early season was dominated by A(H3N2), with cocirculation of A(H1N1), reaching a peak late December 2022, while influenza B circulated at low levels during the latter part of the season. From September to March 2022/23, influenza vaccines were offered, free of charge, to all aged 2-13 (and 14-15 in Scotland and Wales), adults up to 49 years of age with clinical risk conditions and adults aged 50 and above across the mainland United Kingdom. METHODS End-of-season adjusted vaccine effectiveness (VE) estimates against sentinel primary-care attendance for influenza-like illness, where influenza infection was laboratory confirmed, were calculated using the test negative design, adjusting for potential confounders. METHODS Results In the mainland United Kingdom, end-of-season VE against all laboratory-confirmed influenza for all those > 65 years of age, most of whom received adjuvanted quadrivalent vaccines, was 30% (95% CI: -6% to 54%). VE for those aged 18-64, who largely received cell-based vaccines, was 47% (95% CI: 37%-56%). Overall VE for 2-17 year olds, predominantly receiving live attenuated vaccines, was 66% (95% CI: 53%-76%). CONCLUSION The paper provides evidence of moderate influenza VE in 2022/23.
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Affiliation(s)
- Heather J. Whitaker
- Statistics, Modelling and Economics DepartmentUK Health Security AgencyLondonUK
| | - Naoma Willam
- Clinical and Protecting HealthPublic Health ScotlandGlasgowUK
| | - Simon Cottrell
- Public Health Wales Communicable Disease Surveillance CentrePublic Health WalesCardiffUK
| | - Rosalind Goudie
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Nick Andrews
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security AgencyLondonUK
| | - Josie Evans
- Clinical and Protecting HealthPublic Health ScotlandGlasgowUK
| | - Catherine Moore
- Wales Specialist Virology CentrePublic Health Wales MicrobiologyCardiffUK
| | - Utkarsh Agrawal
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Katie Hassell
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security AgencyLondonUK
| | - Rory Gunson
- West of Scotland Specialist Virology CentreNHS Greater Glasgow and ClydeGlasgowUK
| | - Jana Zitha
- Public Health Wales Communicable Disease Surveillance CentrePublic Health WalesCardiffUK
| | - Sneha Anand
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | | | | | - Cecilia Okusi
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | | | - Gavin Jamie
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Beatrix Kele
- Respiratory Virus UnitUK Health Security AgencyLondonUK
| | - Mark Hamilton
- Clinical and Protecting HealthPublic Health ScotlandGlasgowUK
| | - Anastasia Couzens
- Wales Specialist Virology CentrePublic Health Wales MicrobiologyCardiffUK
| | - Catherine Quinot
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security AgencyLondonUK
| | - Kathleen Pheasant
- Wales Specialist Virology CentrePublic Health Wales MicrobiologyCardiffUK
| | - Rachel Byford
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Kimberly Marsh
- Clinical and Protecting HealthPublic Health ScotlandGlasgowUK
| | - Chris Robertson
- Department of Mathematics and StatisticsUniversity of StrathclydeGlasgowUK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
- Research and Surveillance CentreRoyal College of General PractitionersLondonUK
| | - Christopher Williams
- Public Health Wales Communicable Disease Surveillance CentrePublic Health WalesCardiffUK
| | - Maria Zambon
- Respiratory Virus UnitUK Health Security AgencyLondonUK
| | - Jim McMenamin
- Clinical and Protecting HealthPublic Health ScotlandGlasgowUK
| | - Conall H. Watson
- Immunisation and Vaccine Preventable Diseases DivisionUK Health Security AgencyLondonUK
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8
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Lewis NM, Zhu Y, Peltan ID, Gaglani M, McNeal T, Ghamande S, Steingrub JS, Shapiro NI, Duggal A, Bender WS, Taghizadeh L, Brown SM, Hager DN, Gong MN, Mohamed A, Exline MC, Khan A, Wilson JG, Qadir N, Chang SY, Ginde AA, Mohr NM, Mallow C, Lauring AS, Johnson NJ, Gibbs KW, Kwon JH, Columbus C, Gottlieb RL, Raver C, Vaughn IA, Ramesh M, Johnson C, Lamerato L, Safdar B, Casey JD, Rice TW, Halasa N, Chappell JD, Grijalva CG, Talbot HK, Baughman A, Womack KN, Swan SA, Harker E, Price A, DeCuir J, Surie D, Ellington S, Self WH. Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, and Death: United States, 2022-2023. Clin Infect Dis 2024; 78:1056-1064. [PMID: 38051664 DOI: 10.1093/cid/ciad677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain. METHODS To understand effectiveness of the 2022-2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative control-patients. RESULTS A total of 3707 patients, including 714 influenza cases (33% vaccinated) and 2993 influenza- and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative controls (49% vaccinated) were analyzed. VE against influenza-associated hospitalization was 37% (95% confidence interval [CI]: 27%-46%) and varied by age (18-64 years: 47% [30%-60%]; ≥65 years: 28% [10%-43%]), and virus (A[H3N2]: 29% [6%-46%], A[H1N1]: 47% [23%-64%]). VE against more severe influenza-associated outcomes included: 41% (29%-50%) against influenza with hypoxemia treated with supplemental oxygen; 65% (56%-72%) against influenza with respiratory, cardiovascular, or renal failure treated with organ support; and 66% (40%-81%) against influenza with respiratory failure treated with invasive mechanical ventilation. CONCLUSIONS During an early 2022-2023 influenza season with a well-matched influenza vaccine, vaccination was associated with reduced risk of influenza-associated hospitalization and organ failure.
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Affiliation(s)
- Nathaniel M Lewis
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Yuwei Zhu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ithan D Peltan
- Department of Medicine, Intermountain Medical Center, Murray, Utah, and University of Utah, Salt Lake City, Utah, USA
| | - Manjusha Gaglani
- Baylor Scott and White Health, Temple and Dallas, Texas, and Texas A&M University College of Medicine, Temple, Texas, USA
| | - Tresa McNeal
- Baylor Scott and White Health, and Baylor College of Medicine, Temple, Texas, USA
| | - Shekhar Ghamande
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Jay S Steingrub
- Department of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA
| | - Nathan I Shapiro
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Abhijit Duggal
- Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Leyla Taghizadeh
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Samuel M Brown
- Department of Medicine, Intermountain Medical Center, Murray, Utah, and University of Utah, Salt Lake City, Utah, USA
| | - David N Hager
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michelle N Gong
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Amira Mohamed
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Matthew C Exline
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Akram Khan
- Department of Medicine, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Jennifer G Wilson
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Nida Qadir
- Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Steven Y Chang
- Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas M Mohr
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | - Adam S Lauring
- Departments of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicholas J Johnson
- Department of Emergency Medicine and Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | - Kevin W Gibbs
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennie H Kwon
- Department of Medicine, Washington University, St.Louis, Missouri, USA
| | | | - Robert L Gottlieb
- Baylor University Medical Center Dallas, Baylor, Scott & White Heart and Vascular Hospital, Baylor, Scott and White Research Institute, Dallas, Texas, USA
| | | | - Ivana A Vaughn
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA
| | - Mayur Ramesh
- Division of Infectious Diseases, Henry Ford Health, Detroit, Michigan, USA
| | - Cassandra Johnson
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lois Lamerato
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA
| | - Basmah Safdar
- Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jonathan D Casey
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Todd W Rice
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James D Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - H Keipp Talbot
- Departments of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kelsey N Womack
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sydney A Swan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth Harker
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Ashley Price
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jennifer DeCuir
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Diya Surie
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Sascha Ellington
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt Institute for Clinical and Translational Research, and Vanderbilt University Medical Center, Nashville, Tennessee, USA
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9
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Platas-Abenza G, Guerrero-Soler M, Silva-Afonso RDF, Gallardo-Rodriguez P, Gil-Sánchez F, Escribano-Cañadas I, Benito-Miralles CM, Solis-Aniorte N, Carnicer-Bueno R, Esclapez-Martínez A, Chico-Sánchez P, Sánchez-Payá J, Gras-Valentí P. Effectiveness of influenza vaccine in preventing severe cases of influenza: Season 2022/2023. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024; 42:140-145. [PMID: 38342648 DOI: 10.1016/j.eimce.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/04/2023] [Indexed: 02/13/2024]
Abstract
INTRODUCTION Influenza poses a significant burden in terms of morbidity and mortality, with vaccination being one of the most effective measures for its prevention. Therefore, the aim of this study is to determine the effectiveness of the influenza vaccine in preventing cases of severe influenza in patients admitted to a tertiary hospital during the 2022/23 season. METHODS Case-control study. All hospitalised patients with a positive result in an RT-PCR for influenza were included. Those who met the criteria for a severe case (pneumonia, sepsis, multi-organ failure, admission to ICU or exitus) were considered cases. Those who did not meet these criteria were considered controls. Vaccine effectiveness (VE) to prevent severe cases and its 95% confidence interval were calculated. RESULTS A total of 403 patients were admitted with confirmed influenza. Of these, 98 (24.3%) developed severe influenza. Of the total, 50.6% were men and 47.1% were over 65 years of age. VE adjusted for influenza type, age and certain comorbidities was 40.6% (-21.9 to 71.1). In a segmented analysis, influenza vaccine was effective in preventing severe cases in all categories. It was particularly relevant in the 65+ age group (VEa = 60.9%; -2.0 to 85.0) and in patients with influenza A (VEa = 56.7%; 1.5-80.9). CONCLUSION Influenza vaccination markedly reduced the occurrence of severe cases of influenza in hospitalised patients, therefore, it remains the main strategy to reduce morbidity and mortality and associated costs.
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Affiliation(s)
- Guillermo Platas-Abenza
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - María Guerrero-Soler
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Raissa de Fatima Silva-Afonso
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Pilar Gallardo-Rodriguez
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Francisco Gil-Sánchez
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Isabel Escribano-Cañadas
- Servicio de Microbiología, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Carmen M Benito-Miralles
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Noemi Solis-Aniorte
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Rocio Carnicer-Bueno
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Ana Esclapez-Martínez
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Pablo Chico-Sánchez
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.
| | - José Sánchez-Payá
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Paula Gras-Valentí
- Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
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10
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Skowronski DM, Zhan Y, Kaweski SE, Sabaiduc S, Khalid A, Olsha R, Carazo S, Dickinson JA, Mather RG, Charest H, Jassem AN, Levade I, Hasso M, Zelyas N, Gao R, Bastien N. 2023/24 mid-season influenza and Omicron XBB.1.5 vaccine effectiveness estimates from the Canadian Sentinel Practitioner Surveillance Network (SPSN). Euro Surveill 2024; 29:2400076. [PMID: 38362622 PMCID: PMC10986657 DOI: 10.2807/1560-7917.es.2024.29.7.2400076] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/14/2024] [Indexed: 02/17/2024] Open
Abstract
The Canadian Sentinel Practitioner Surveillance Network reports mid-season 2023/24 influenza vaccine effectiveness (VE) of 63% (95% CI: 51-72) against influenza A(H1N1)pdm09, lower for clade 5a.2a.1 (56%; 95% CI: 33-71) than clade 5a.2a (67%; 95% CI: 48-80), and lowest against influenza A(H3N2) (40%; 95% CI: 5-61). The Omicron XBB.1.5 vaccine protected comparably well, with VE of 47% (95% CI: 21-65) against medically attended COVID-19, higher among people reporting a prior confirmed SARS-CoV-2 infection at 67% (95% CI: 28-85).
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Affiliation(s)
- Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Yuping Zhan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Suzana Sabaiduc
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Ayisha Khalid
- British Columbia Centre for Disease Control, Vancouver, Canada
| | | | - Sara Carazo
- Institut National de Santé Publique du Québec, Québec, Canada
| | | | - Richard G Mather
- Public Health Ontario, Toronto, Canada
- Queen's University, Kingston, Canada
| | - Hugues Charest
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Inès Levade
- Institut National de Santé Publique du Québec, Québec, Canada
| | | | - Nathan Zelyas
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Ruimin Gao
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Nathalie Bastien
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
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11
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Smolarchuk C, Ickert C, Zelyas N, Kwong JC, Buchan SA. Early influenza vaccine effectiveness estimates using routinely collected data, Alberta, Canada, 2023/24 season. Euro Surveill 2024; 29:2300709. [PMID: 38214082 PMCID: PMC10785209 DOI: 10.2807/1560-7917.es.2024.29.2.2300709] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/10/2024] [Indexed: 01/13/2024] Open
Abstract
Timely and precise influenza vaccine effectiveness (VE) estimates are needed to guide public health messaging and impact vaccine uptake immediately. Using routinely collected laboratory, vaccination and health administrative data from Alberta, Canada, we estimated influenza VE against infection for the 2023/24 season on a near real-time basis, to late December, at 61% (95% CI: 58-64) against influenza A(H1N1), 49% (95% CI: 28-63) against influenza A(H3N2) and 75% (95% CI: 58-85) against influenza B.
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Affiliation(s)
- Christa Smolarchuk
- Public Health Analytics, Alberta Health, Edmonton, Alberta
- These authors contributed equally to this work and share first authorship
| | - Carla Ickert
- Public Health Analytics, Alberta Health, Edmonton, Alberta
- These authors contributed equally to this work and share first authorship
| | - Nathan Zelyas
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Jeffrey C Kwong
- ICES, Toronto, Canada
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- University Health Network, Toronto, Canada
| | - Sarah A Buchan
- ICES, Toronto, Canada
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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12
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Kislaya I, Torres AR, Gomes L, Melo A, Machado A, Henriques C, Verdasca N, Guiomar R, Rodrigues AP, Surveillance Network NI. End of season 2022/2023 quadrivalent influenza vaccine effectiveness in preventing influenza in primary care in Portugal. Hum Vaccin Immunother 2023; 19:2263219. [PMID: 37964588 PMCID: PMC10653732 DOI: 10.1080/21645515.2023.2263219] [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: 04/05/2023] [Accepted: 09/21/2023] [Indexed: 11/16/2023] Open
Abstract
Using a test-negative case-control design, we aim to estimate influenza vaccine effectiveness (VE) against medically attended laboratory-confirmed influenza in Portugal in 2022/2023 season. Between week 41/2022 and week 14/2023, data on 592 patients with influenza-like illness aged 18 or more years old were collected by the national sentinel influenza surveillance system in primary care settings. Of those, 218 were positive for influenza and 374 were negative controls. We estimated seasonal influenza VE as (1-odds ratio)*100% of being vaccinated in laboratory-confirmed influenza cases vs. negative controls using logistic regression model adjusted for age group, sex, presence of chronic conditions, and month of symptoms onset. The seasonal VE was 59.3% (95% confidence interval (CI): 27.3 to 77.3) against any laboratory-confirmed influenza and not statistically significant 44.5% (95% CI: -5.6 to 70.8) against influenza A (H3N2). In the 2022/2023 season, characterized by early and low influenza activity and predominant A (H3N2) circulation, vaccination provided a moderate protection against medically attended laboratory-confirmed influenza in primary care.
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Affiliation(s)
- Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Ana Rita Torres
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Licínia Gomes
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Aryse Melo
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Ausenda Machado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Camila Henriques
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Nuno Verdasca
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Raquel Guiomar
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge IP (INSA, IP), Lisboa, Portugal
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13
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Fall A, Han L, Yunker M, Gong YN, Li TJ, Norton JM, Abdullah O, Rothman RE, Fenstermacher KZJ, Morris CP, Pekosz A, Klein E, Mostafa HH. Evolution of Influenza A(H3N2) Viruses in 2 Consecutive Seasons of Genomic Surveillance, 2021-2023. Open Forum Infect Dis 2023; 10:ofad577. [PMID: 38088981 PMCID: PMC10715682 DOI: 10.1093/ofid/ofad577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/15/2023] [Indexed: 12/30/2023] Open
Abstract
Background The circulation and the genomic evolution of influenza A(H3N2) viruses during the 2021/2022 and 2022/2023 seasons were studied and associated with infection outcomes. Methods Remnant influenza A-positive samples following standard-of-care testing from patients across the Johns Hopkins Health System (JHHS) were used for the study. Samples were randomly selected for whole viral genome sequencing. The sequence-based pEpitope model was used to estimate the predicted vaccine efficacy (pVE) for circulating H3N2 viruses. Clinical data were collected and associated with viral genomic data. Results A total of 121 683 respiratory specimens were tested for influenza at JHHS between 1 September 2021 and 31 December 2022. Among them, 6071 (4.99%) tested positive for influenza A. Of these, 805 samples were randomly selected for sequencing, with hemagglutinin (HA) segments characterized for 610 samples. Among the characterized samples, 581 were H3N2 (95.2%). Phylogenetic analysis of HA segments revealed the exclusive circulation of H3N2 viruses with HA segments of the 3C.2a1b.2a.2 clade. Analysis of a total of 445 complete H3N2 genomes revealed reassortments; 200 of 227 of the 2022/2023 season genomes (88.1%) were found to have reassorted with clade 3C.2a1b.1a. The pVE was estimated to be -42.53% for the 2021/2022 season and 30.27% for the 2022/2023 season. No differences in clinical presentations or admissions were observed between the 2 seasons. Conclusions The increased numbers of cases and genomic diversity of influenza A(H3N2) during the 2022/2023 season were not associated with a change in disease severity compared to the previous influenza season.
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Affiliation(s)
- Amary Fall
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lijie Han
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Madeline Yunker
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Yu-Nong Gong
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- International Master Degree Program for Molecular Medicine in Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Tai-Jung Li
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- International Master Degree Program for Molecular Medicine in Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Julie M Norton
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Omar Abdullah
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - C Paul Morris
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, Maryland, USA
| | - Andrew Pekosz
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- W.Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eili Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Center for Disease Dynamics, Economics, and Policy, Washington, District of Columbia, USA
| | - Heba H Mostafa
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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14
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Cowling BJ, Kwan MYW, Murphy C, Chan ELY, Wong JSC, Sullivan SG, Peiris M, Lee SL. Influenza Vaccine Effectiveness Against Influenza-Associated Hospitalization in Hong Kong Children Aged 9 Months to 17 Years, March-June 2023. J Pediatric Infect Dis Soc 2023; 12:586-589. [PMID: 37818976 PMCID: PMC10687596 DOI: 10.1093/jpids/piad083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/09/2023] [Indexed: 10/13/2023]
Abstract
In March-June 2023, we conducted a test-negative study in 1671 children who were hospitalized with acute respiratory illness in Hong Kong. Two hundred and eighty-six children (17.2%) were tested positive for influenza virus including 188 with A(H1N1). We estimated influenza vaccine effectiveness against influenza-associated hospitalization as 69.6% (95% confidence interval: 49.3%, 81.7%).
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Affiliation(s)
- Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - Mike Y W Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
| | - Caitriona Murphy
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eunice L Y Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joshua S C Wong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Epidemiology, University of California, Los Angeles, California, USA
| | - Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Centre for Immunology & Infection, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region, China
| | - So-Lun Lee
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China
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15
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Harrison R, Mubareka S, Papenburg J, Schober T, Allen UD, Hatchette TF, Evans GA. AMMI Canada 2023 update on influenza: Management and emerging issues. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2023; 8:176-185. [PMID: 38058499 PMCID: PMC10697102 DOI: 10.3138/jammi-2023-07-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Affiliation(s)
- Robyn Harrison
- University of Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Samira Mubareka
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jesse Papenburg
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- Division of Microbiology, Department of Clinical Laboratory Medicine, Montreal Children’s Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Upton D Allen
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Todd F Hatchette
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gerald A Evans
- Division of Infectious Diseases, Department of Medicine, Kingston Health Sciences Centre, Queen’s University, Kingston, Ontario, Canada
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16
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Martínez-Baz I, Fernández-Huerta M, Navascués A, Pozo F, Trobajo-Sanmartín C, Casado I, Echeverria A, Ezpeleta C, Castilla J. Influenza Vaccine Effectiveness in Preventing Laboratory-Confirmed Influenza Cases and Hospitalizations in Navarre, Spain, 2022-2023. Vaccines (Basel) 2023; 11:1478. [PMID: 37766154 PMCID: PMC10534462 DOI: 10.3390/vaccines11091478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
We estimated influenza vaccine effectiveness (IVE) in preventing outpatient and hospitalized cases in the 2022-2023 season. A test-negative design included a representative sample of outpatients and all hospitalized patients with influenza-like illness (ILI) from October 2022 to May 2023 in Navarre, Spain. ILI patients were tested by PCR for influenza virus. Influenza vaccination status was compared between confirmed influenza cases and test-negative controls. Among 3321 ILI patients tested, IVE to prevent influenza cases was 34% (95% confidence interval (CI): 16 to 48) overall, 85% (95%CI: 63 to 94) against influenza B, and 28% (95%CI: 3 to 46) against A(H3N2). Among 558 outpatients, 222 (40%) were confirmed for influenza: 55% A(H3N2), 11% A(H1N1), and 31% B. Overall, IVE to prevent outpatient cases was 48% (95%CI: 8 to 70), 88% (95%CI: 3 to 98) against influenza B, and 50% (95%CI: -4 to 76) against A(H3N2). Of 2763 hospitalized patients, 349 (13%) were positive for influenza: 64% A(H3N2), 17% A(H1N1), and 8% B. IVE to prevent hospitalization was 24% (95%CI: -1 to 42) overall, 82% (95%CI: 49 to 93) against influenza B, and 16% (95%CI: -17 to 40) against A(H3N2). No IVE was observed in preventing influenza A(H1N1). IVE was high to prevent influenza B, moderate against A(H3N2) and null against A(H1N1). A lower proportion of influenza B cases may explain the smaller IVE in hospitalized patients than in outpatients. The null IVE against A(H1N1) was consistent with the observed antigenic drift and supports the new composition of the 2023-2024 influenza vaccine.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Miguel Fernández-Huerta
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Ana Navascués
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Francisco Pozo
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Aitziber Echeverria
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Carmen Ezpeleta
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
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Su Y, Guo Z, Gu X, Sun S, Wang K, Xie S, Zhao S. Influenza vaccine effectiveness against influenza A during the delayed 2022/23 epidemic in Shihezi, China. Vaccine 2023; 41:5683-5686. [PMID: 37604724 DOI: 10.1016/j.vaccine.2023.08.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023]
Abstract
After the temporary end of COVID-19 in China in February 2023, the influenza epidemic peaked in March across many Chinese places. We recruited a total of 258 all-age subjects presenting influenza-like illness (ILI) in Shihezi city, China from January 1 to March 16, 2023, and tested for influenza virus infection. Using a test-negative design, we assessed influenza vaccine effectiveness (VE) of 56.3% (95% CrI: 13.6, 73.6) against medically attended, influenza illness during the delayed 2022/23 influenza epidemic. The findings contributed to the continuous monitoring of the influenza vaccine performance across the world, especially in the "post-COVID" pandemic era.
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Affiliation(s)
- Yinxia Su
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China.
| | - Zihao Guo
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China.
| | - Xiu Gu
- School of Medicine, Shihezi University, Shihezi 832000, China.
| | - Shengzhi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China.
| | - Kai Wang
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China.
| | - Songsong Xie
- NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, The First Affiliated Hospital of Shihezi University, Shihezi 832000, China.
| | - Shi Zhao
- Centre for Health Systems and Policy Research, Chinese University of Hong Kong, Hong Kong 999077, China.
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Domnich A, Orsi A, Ogliastro M, Trombetta CS, Scarpaleggia M, Stefanelli F, Panatto D, Bruzzone B, Icardi G. Influenza vaccine effectiveness in preventing hospital encounters for laboratory-confirmed infection among Italian adults, 2022/23 season. Vaccine 2023:S0264-410X(23)00775-2. [PMID: 37385889 DOI: 10.1016/j.vaccine.2023.06.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Abstract
The effectiveness of seasonal influenza vaccination (SIV) varies from year to year. Interim estimates of vaccine effectiveness (VE) in outpatient settings have suggested that the 2022/23 northern hemisphere SIV was 54 % effective. The main goal of this study was to measure the 2022/23 SIV VE among Italian adults in a hospital setting. The study adopted a retrospective test-negative case-control design and was conducted in a large tertiary hospital (Genoa, Italy) between October 2022 and April 2023. Adult (≥18 years) patients accessing the hospital's Emergency Department for symptoms ascribable to an acute respiratory infection, for which a reverse-transcription real-time polymerase chain reaction test for the detection of influenza virus was prescribed, were potentially eligible. Of 33,692 referrals assessed, 487 patients were included in the study. A total of 13 % of patients were positive for influenza, most of which (63 %) belonged to the A(H3N2) subtype. SIV VE was 57 % (95 % CI: 11-81 %), 53 % (95 % CI: 2-80 %) and 38 % (95 % CI: -34-74 %) against any influenza, influenza A and A(H3N2), respectively. Although no cases caused by A(H1N1)pdm09 and B strains were observed among vaccinated individuals, VE estimates against the latter were imprecise, owing to their low detection rates. In conclusion, the 2022/23 SIV was moderately effective against hospital encounters for laboratory-confirmed influenza.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | | | - Federica Stefanelli
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Kissling E, Maurel M, Emborg HD, Whitaker H, McMenamin J, Howard J, Trebbien R, Watson C, Findlay B, Pozo F, Bolt Botnen A, Harvey C, Rose A. Interim 2022/23 influenza vaccine effectiveness: six European studies, October 2022 to January 2023. Euro Surveill 2023; 28:2300116. [PMID: 37227299 PMCID: PMC10283457 DOI: 10.2807/1560-7917.es.2023.28.21.2300116] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/21/2023] [Indexed: 05/26/2023] Open
Abstract
BackgroundBetween October 2022 and January 2023, influenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses circulated in Europe with different influenza (sub)types dominating in different areas.AimTo provide interim 2022/23 influenza vaccine effectiveness (VE) estimates from six European studies, covering 16 countries in primary care, emergency care and hospital inpatient settings.MethodsAll studies used the test-negative design, but with differences in other study characteristics, such as data sources, patient selection, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders.ResultsThere were 20,477 influenza cases recruited across the six studies, of which 16,589 (81%) were influenza A. Among all ages and settings, VE against influenza A ranged from 27 to 44%. Against A(H1N1)pdm09 (all ages and settings), VE point estimates ranged from 28% to 46%, higher among children (< 18 years) at 49-77%. Against A(H3N2), overall VE ranged from 2% to 44%, also higher among children (62-70%). Against influenza B/Victoria, overall and age-specific VE were ≥ 50% (87-95% among children < 18 years).ConclusionsInterim results from six European studies during the 2022/23 influenza season indicate a ≥ 27% and ≥ 50% reduction in disease occurrence among all-age influenza vaccine recipients for influenza A and B, respectively, with higher reductions among children. Genetic virus characterisation results and end-of-season VE estimates will contribute to greater understanding of differences in influenza (sub)type-specific results across studies.
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Affiliation(s)
| | | | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | | | | | | | - Ramona Trebbien
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
| | | | | | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Amanda Bolt Botnen
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
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McLean HQ, Petrie JG, Hanson KE, Meece JK, Rolfes MA, Sylvester GC, Neumann G, Kawaoka Y, Belongia EA. Interim Estimates of 2022-23 Seasonal Influenza Vaccine Effectiveness - Wisconsin, October 2022-February 2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:201-205. [PMID: 36821715 PMCID: PMC9949852 DOI: 10.15585/mmwr.mm7208a1] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
In the United States, 2022-23 influenza activity began earlier than usual, increasing in October 2022, and has been associated with high rates of hospitalizations among children* (1). Influenza A(H3N2) represented most influenza viruses detected and subtyped during this period, but A(H1N1)pdm09 viruses cocirculated as well. Most viruses characterized were in the same genetic subclade as and antigenically similar to the viruses included in the 2022-23 Northern Hemisphere influenza vaccine (1,2). Effectiveness of influenza vaccine varies by season, influenza virus subtype, and antigenic match with circulating viruses. This interim report used data from two concurrent studies conducted at Marshfield Clinic Health System (MCHS) in Wisconsin during October 23, 2022-February 10, 2023, to estimate influenza vaccine effectiveness (VE). Overall, VE was 54% against medically attended outpatient acute respiratory illness (ARI) associated with laboratory-confirmed influenza A among patients aged 6 months-64 years. In a community cohort of children and adolescents aged <18 years, VE was 71% against symptomatic laboratory-confirmed influenza A virus infection. These interim analyses indicate that influenza vaccination substantially reduced the risk for medically attended influenza among persons aged <65 years and for symptomatic influenza in children and adolescents. Annual influenza vaccination is the best strategy for preventing influenza and its complications. CDC recommends that health care providers continue to administer annual influenza vaccine to persons aged ≥6 months as long as influenza viruses are circulating (2).
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