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Influenza vaccine effectiveness in Italy: Age, subtype-specific and vaccine type estimates 2014/15 season. Vaccine 2016; 34:3102-3108. [DOI: 10.1016/j.vaccine.2016.04.072] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 04/11/2016] [Accepted: 04/25/2016] [Indexed: 11/21/2022]
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Gilca R, Skowronski DM, Douville-Fradet M, Amini R, Boulianne N, Rouleau I, Martineau C, Charest H, De Serres G. Mid-Season Estimates of Influenza Vaccine Effectiveness against Influenza A(H3N2) Hospitalization in the Elderly in Quebec, Canada, January 2015. PLoS One 2015; 10:e0132195. [PMID: 26200655 PMCID: PMC4511737 DOI: 10.1371/journal.pone.0132195] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/10/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The 2014/15 influenza season in Canada was characterized by an early epidemic due to vaccine-mismatched influenza A(H3N2) viruses, disproportionately affecting elderly individuals ≥65-years-old. We assessed vaccine effectiveness (VE) against A(H3N2) hospitalization among elderly individuals during the peak weeks of the 2014/15 epidemic in Quebec, Canada. METHODS Nasal specimens and clinical/epidemiological data were collected within 7 days of illness onset from elderly patients admitted with respiratory symptoms to one of four participating hospitals between November 30, 2014 and January 13, 2015. Cases tested RT-PCR positive for influenza A(H3N2) and controls tested negative for any influenza. VE was assessed by test-negative case-control design. RESULTS There were 314 participants including 186 cases (62% vaccinated) and 128 controls (59% vaccinated) included in primary VE analysis. Median age was 81.5 years, two-thirds were admitted from the community and 91% had underlying comorbidity. Crude VE against A(H3N2) hospitalization was -17% (95%CI: -86% to 26%), decreasing to -23% (95%CI: -99 to 23%) with adjustment for age and comorbidity, and to -39% (95%CI: -142 to 20%) with additional adjustment for specimen collection interval, calendar time, type of residence and hospital. In sensitivity analyses, VE estimates were improved toward the null with restriction to participants admitted from the community (-2%; 95%CI: -105 to 49%) or with specimen collection ≤4 days since illness onset (- 8%; 95%CI: -104 to 43%) but further from the null with restriction to participants with comorbidity (-51%; 95%CI: -169 to 15%). CONCLUSION The 2014/15 mismatched influenza vaccine provided elderly patients with no cross-protection against hospitalization with the A(H3N2) epidemic strain, reinforcing the need for adjunct protective measures among high-risk individuals and improved vaccine options.
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Affiliation(s)
- Rodica Gilca
- Biological, Environmental and Occupational Risks, Institut National de Santé Publique du Québec, Quebec, QC, Canada
- CHU de Quebec, Quebec, QC, Canada
- Laval University, Quebec, QC, Canada
| | - Danuta M. Skowronski
- Influenza & Emerging Respiratory Pathogens, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Monique Douville-Fradet
- Biological, Environmental and Occupational Risks, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Rachid Amini
- Biological, Environmental and Occupational Risks, Institut National de Santé Publique du Québec, Quebec, QC, Canada
| | - Nicole Boulianne
- Biological, Environmental and Occupational Risks, Institut National de Santé Publique du Québec, Quebec, QC, Canada
- CHU de Quebec, Quebec, QC, Canada
| | - Isabelle Rouleau
- Bureau de surveillance et de vigie, Ministère de la Santé et des Services sociaux du Québec, Quebec, QC, Canada
| | - Christine Martineau
- Laboratoire de santé publique du Québec, Institut National de Santé Publique du Québec, Montreal, Canada
| | - Hugues Charest
- Laboratoire de santé publique du Québec, Institut National de Santé Publique du Québec, Montreal, Canada
| | - Gaston De Serres
- Biological, Environmental and Occupational Risks, Institut National de Santé Publique du Québec, Quebec, QC, Canada
- CHU de Quebec, Quebec, QC, Canada
- Laval University, Quebec, QC, Canada
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Mølbak K, Espenhain L, Nielsen J, Tersago K, Bossuyt N, Denissov G, Baburin A, Virtanen M, Fouillet A, Sideroglou T, Gkolfinopoulou K, Paldy A, Bobvos J, van Asten L, de Lange M, Nunes B, da Silva S, Larrauri A, Gómez IL, Tsoumanis A, Junker C, Green H, Pebody R, McMenamin J, Reynolds A, Mazick A. Excess mortality among the elderly in European countries, December 2014 to February 2015. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.11.21065] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since December 2014 and up to February 2015, the weekly number of excess deaths from all-causes among individuals?≥?65 years of age in 14 European countries have been significantly higher than in the four previous winter seasons. The rise in unspecified excess mortality coincides with increased proportion of influenza detection in the European influenza surveillance schemes with a main predominance of influenza A(H3N2) viruses seen throughout Europe in the current season, though cold snaps and other respiratory infections may also have had an effect.
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Affiliation(s)
- K Mølbak
- Statens Serum Institut, Copenhagen, Denmark
| | | | - J Nielsen
- Statens Serum Institut, Copenhagen, Denmark
| | - K Tersago
- Scientific Institute of Public Health, Brussels, Belgium
| | - N Bossuyt
- Scientific Institute of Public Health, Brussels, Belgium
| | - G Denissov
- National Institute for Health Devlopment, Tallinn, Estonia
| | - A Baburin
- National Institute for Health Devlopment, Tallinn, Estonia
| | - M Virtanen
- National Institute for Health and Welfare, Helsinki, Finland
| | - A Fouillet
- French Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS), Saint-Maurice, France
| | - T Sideroglou
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - K Gkolfinopoulou
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - A Paldy
- National Institute of Environmental Health, Budapest, Hungary
| | - J Bobvos
- National Institute of Environmental Health, Budapest, Hungary
| | - L van Asten
- National Institute of Public Health and The Environment (RIVM), the Netherlands
| | - M de Lange
- National Institute of Public Health and The Environment (RIVM), the Netherlands
| | - B Nunes
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - S da Silva
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - A Larrauri
- National Centre of Epidemiology; CIBER Epidemiología y Salud Pública (CIBERESP) Institute of Health Carlos III, Madrid, Spain
| | - I L Gómez
- National Centre of Epidemiology; CIBER Epidemiología y Salud Pública (CIBERESP) Institute of Health Carlos III, Madrid, Spain
| | - A Tsoumanis
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - C Junker
- Federal Statistical Office, Neuchâtel, Switzerland
| | - H Green
- Public Health England, London, United Kingdom
| | - R Pebody
- Public Health England, London, United Kingdom
| | - J McMenamin
- Health Protection Scotland, Glasgow, United Kingdom
| | - A Reynolds
- Health Protection Scotland, Glasgow, United Kingdom
| | - A Mazick
- Statens Serum Institut, Copenhagen, Denmark
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