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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:S0264-410X(24)00497-3. [PMID: 38704257 DOI: 10.1016/j.vaccine.2024.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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 Institue 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
| | | | - 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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Mazagatos C, Mendioroz J, Rumayor M, Gallardo García V, Álvarez Río V, Cebollada Gracia A, Batalla Rebollo N, Barranco Boada M, Pérez‐Martínez O, Lameiras Azevedo A, López González‐Coviella N, Castrillejo D, Fernández Ibáñez A, Giménez Duran J, Ramírez Córcoles C, Ramos Marín V, Larrauri A, Monge S. Estimated Impact of Nirsevimab on the Incidence of Respiratory Syncytial Virus Infections Requiring Hospital Admission in Children < 1 Year, Weeks 40, 2023, to 8, 2024, Spain. Influenza Other Respir Viruses 2024; 18:e13294. [PMID: 38716791 PMCID: PMC11077568 DOI: 10.1111/irv.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/11/2024] [Accepted: 03/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Data from the sentinel surveillance system of severe acute respiratory infections in Spain were used to estimate the impact of administration of nirsevimab to children born from 1 April 2023 onwards. METHODS Estimated RSV hospitalisations in < 1-year-olds during weeks 40, 2023, to 8, 2024, were compared to the number that would be expected after accounting for the background change in RSV circulation in the 2023/24 season, compared to 2022/23. RESULTS We estimated 9364-9875 RSV hospitalisations less than expected, corresponding to a 74%-75% reduction.
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Affiliation(s)
- Clara Mazagatos
- National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
- CIBER Epidemiology and Public HealthMadridSpain
| | - Jacobo Mendioroz
- Sub‐direcció General de Vigilància i Resposta a Emergències de Salut Pública, Departament de SalutGeneralitat de CatalunyaBarcelonaSpain
| | - Mercedes Belén Rumayor
- Área de Enfermedades Transmisibles, Subdirección General de Vigilancia en Salud PúblicaMadridSpain
| | - Virtudes Gallardo García
- Servicio de Vigilancia y Salud LaboralDirección General de Salud Pública y Ordenación Farmacéutica, Consejería de Salud y ConsumoAndalucíaSpain
| | - Virginia Álvarez Río
- Servicio de Epidemiología, Consejería de Sanidad, Dirección General de Salud PúblicaJunta de Castilla y LeónValladolidSpain
| | | | - Noa Batalla Rebollo
- Subdirección de Epidemiología de la Dirección General de Salud PúblicaServicio Extremeño de SaludMéridaSpain
| | - María Isabel Barranco Boada
- Servicio de Epidemiología (Sección Vigilancia Epidemiológica)Consejería de Salud‐Región de MurciaMurciaSpain
| | - Olaia Pérez‐Martínez
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de SanidadeXunta de GaliciaSantiagoSpain
| | - Ana Sofía Lameiras Azevedo
- Subdirecció General d'Epidemiologia i Vigilància de la Salut, Direcció General de Salut PúblicaGeneralitat ValencianaValenciaSpain
| | | | - Daniel Castrillejo
- Vigilancia Epidemiológica, Consejería de Políticas Sociales y Salud Pública de MelillaDirección General de Salud PúblicaMelillaSpain
| | - Ana Fernández Ibáñez
- Dirección General de Salud Pública y Atención a la Salud MentalConsejería de Sanidad, Principado de AsturiasOviedoSpain
| | - Jaume Giménez Duran
- Servicio de Epidemiología, Consellería de SalutGobierno de las Islas BalearesPalmaSpain
- Instituto de Investigación Sanitaria Illes Balears (IdISBa)PalmaSpain
| | | | - Violeta Ramos Marín
- Servicio de EpidemiologíaConsejería de Sanidad y Servicios Sociales de CeutaCeutaSpain
| | - Amparo Larrauri
- National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
- CIBER Epidemiology and Public HealthMadridSpain
| | - Susana Monge
- National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
- CIBER Infectious DiseasesMadridSpain
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3
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Varea-Jiménez E, Aznar Cano E, Vega-Piris L, Martínez Sánchez EV, Mazagatos C, García San Miguel Rodríguez-Alarcón L, Casas I, Sierra Moros MJ, Iglesias-Caballero M, Vazquez-Morón S, Larrauri A, Monge S. Comparative severity of COVID-19 cases caused by Alpha, Delta or Omicron SARS-CoV-2 variants and its association with vaccination. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:187-194. [PMID: 36737369 PMCID: PMC9890374 DOI: 10.1016/j.eimce.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/10/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study compares the severity of SARS-CoV-2 infections caused by Alpha, Delta or Omicron variants in periods of co-circulation in Spain, and estimates the variant-specific association of vaccination with severe disease. METHODS SARS-CoV-2 infections notified to the national epidemiological surveillance network with information on genetic variant and vaccination status were considered cases if they required hospitalisation or controls otherwise. Alpha and Delta were compared during June-July 2021; and Delta and Omicron during December 2021-January 2022. Adjusted odds ratios (aOR) were estimated using logistic regression, comparing variant and vaccination status between cases and controls. RESULTS We included 5,345 Alpha and 11,974 Delta infections in June-July and 5,272 Delta and 10,578 Omicron in December-January. Unvaccinated cases of Alpha (aOR: 0.57; 95% CI: 0.46-0.69) or Omicron (0.28; 0.21-0.36) had lower probability of hospitalisation vs. Delta. Complete vaccination reduced hospitalisation, similarly for Alpha (0.16; 0.13-0.21) and Delta (June-July: 0.16; 0.14-0.19; December-January: 0.36; 0.30-0.44) but lower from Omicron (0.63; 0.53-0.75) and individuals aged 65+ years. CONCLUSION Results indicate higher intrinsic severity of the Delta variant, compared with Alpha or Omicron, with smaller differences among vaccinated individuals. Nevertheless, vaccination was associated to reduced hospitalisation in all groups.
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Affiliation(s)
- Elena Varea-Jiménez
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain
| | - Esteban Aznar Cano
- Centre for the Coordination of Alerts and Health Emergencies - Ministry of Health, Madrid, Spain
| | - Lorena Vega-Piris
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain
| | - Elena Vanessa Martínez Sánchez
- Centre for the Coordination of Alerts and Health Emergencies - Ministry of Health, Madrid, Spain; CIBER Epidemiology and Public Health, Spain
| | - Clara Mazagatos
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain; CIBER Epidemiology and Public Health, Spain
| | | | - Inmaculada Casas
- CIBER Epidemiology and Public Health, Spain; National Centre of Microbiology - Institute of Health Carlos III, Madrid, Spain
| | - María José Sierra Moros
- Centre for the Coordination of Alerts and Health Emergencies - Ministry of Health, Madrid, Spain; CIBER Infectious Diseases, Spain
| | | | - Sonia Vazquez-Morón
- National Centre of Microbiology - Institute of Health Carlos III, Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain; CIBER Epidemiology and Public Health, Spain
| | - Susana Monge
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain; CIBER Infectious Diseases, Spain.
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4
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Canelas-Fernández J, Mazagatos C, Delgado-Sanz C, Larrauri A. Influenza hospitalisations in Spain between the last influenza and COVID-19 pandemic (2009-2019). Epidemiol Infect 2023; 151:e177. [PMID: 37791484 PMCID: PMC10600905 DOI: 10.1017/s0950268823001620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023] Open
Abstract
Knowing the burden of severe disease caused by influenza is essential for disease risk communication, to understand the true impact of vaccination programmes and to guide public health and disease control measures. We estimated the number of influenza-attributable hospitalisations in Spain during the 2010-2011 to 2019-2020 seasons - based on the hospitalisations due to severe acute respiratory infection (SARI) in Spain using the hospital discharge database and virological influenza information from the Spanish Influenza Sentinel Surveillance System (SISSS). The weekly numbers of influenza-attributable hospitalisations were calculated by multiplying the weekly SARI hospitalisations by the weekly influenza virus positivity, obtained from the SISSS in each season, stratified by age group and sex. The influenza-related hospitalisation burden is age-specific and varies significantly by influenza season. People aged 65 and over yielded the highest average influenza-attributable hospitalisation rates per season (615.6 per 100,000), followed by children aged under 5 (251.2 per 100,000). These results provide an essential contribution to influenza control and to improving existing vaccination programmes, as well as to the optimisation and planning of health resources and policies.
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Affiliation(s)
| | - Clara Mazagatos
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
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5
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Portillo-Van Diest A, Vilagut G, Alayo I, Ferrer M, Amigo F, Amann BL, Aragón-Peña A, Aragonès E, Asúnsolo Del Barco Á, Campos M, Del Cura-González I, Espuga M, González-Pinto A, Haro JM, Larrauri A, López-Fresneña N, Martínez de Salázar A, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Zapata A, Pijoan JI, Plana N, Puig T, Rius C, Rodríguez-Blázquez C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Mortier P. Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study. Epidemiol Psychiatr Sci 2023; 32:e50. [PMID: 37555258 PMCID: PMC10465320 DOI: 10.1017/s2045796023000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/06/2023] [Accepted: 06/24/2023] [Indexed: 08/10/2023] Open
Abstract
AIM To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. METHODS This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). RESULTS Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. CONCLUSIONS TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Asociación instituto de investigación en sistemas de salud Biosistemak, Barakaldo, País Vasco, España
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Benedikt L. Amann
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Centre Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Department of Health Services Research Group, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department for Psychiatry and Psychotherapy, Hospital of the Ludwig-Maximilians-University Munich, Germany
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Enric Aragonès
- Department of Atenció Primària Camp de Tarragona, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Isabel Del Cura-González
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain
| | - Meritxell Espuga
- Occupational Health Service, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- BIOARABA, UPV-EHU, Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain
| | - Josep M. Haro
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Department Facultat de Medicina y Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Amparo Larrauri
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Nieves López-Fresneña
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Juan D. Molina
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M. Ortí-Lucas
- Department of Preventive MedicineDepartment, Hospital Clínic Universitari, Valencia, Spain
| | - Mara Parellada
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José M. Pelayo-Terán
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Psiquiatría y Salud Mental, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
- Area de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Aurora Pérez-Zapata
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - José I. Pijoan
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Clinical Epidemiology Unit, Hospital Universitario Cruces/OSI EEC, Bilbao, Spain
| | - Nieves Plana
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Teresa Puig
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Rius
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ferran Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Instituto Nacional de Bioinformatica – ELIXIR-ES (IMPaCT-Data-ISCIII), Barcelona, Spain
| | - Consol Serra
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
- CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- Clinical Epidemiology, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Víctor Pérez-Solá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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6
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Mazagatos C, Delgado-Sanz C, Milagro A, Liébana-Rodríguez M, Larrauri A. Impact of Influenza Vaccination on the Burden of Severe Influenza in the Elderly: Spain, 2017-2020. Vaccines (Basel) 2023; 11:1110. [PMID: 37376499 DOI: 10.3390/vaccines11061110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Annual influenza vaccination is the main strategy to reduce the burden of seasonal influenza epidemics and is recommended for the elderly in most countries with influenza vaccination strategies, with the main objective of preventing hospitalizations and mortality associated with seasonal influenza in this age group. Studies from different countries have estimated the benefits of seasonal influenza vaccination programs in the elderly, preventing a considerable number of cases, hospitalizations and deaths every year. A study measured the number of medically attended confirmed influenza cases in primary care that are prevented annually by vaccination in the population aged 65 and older in Spain, the Netherlands and Portugal, but estimates of the impact of the national influenza vaccination program in the prevention of severe disease in Spain are lacking. The two objectives of this study were to estimate the burden of severe influenza disease in the Spanish population and to measure the impact of influenza vaccination in the prevention of these outcomes in the population aged 65 years and older. Using influenza surveillance systems put in place before the COVID-19 pandemic, we conducted a retrospective observational study to estimate the burden of hospitalizations and ICU admissions in Spain between 2017-18 and 2019-20, by season and age group. Burden estimates for the 65+ group, combined with vaccine effectiveness (VE) and vaccination coverage (VC) data, were used as input data in an ecological, observational study to estimate the impact of the influenza vaccination program on the elderly. We found a higher burden of severe influenza disease in seasons 2017-18 and 2018-19, with A(H3N2) circulation, and in the youngest and oldest age groups. In those aged 65 and older, we estimated an average of 9900 influenza hospitalizations and 1541 ICU admissions averted by vaccination each year. Seasonal influenza vaccination was able to prevent between 11 and 26% influenza hospitalizations and around 40% ICU admissions in the elderly in the three pre-pandemic seasons. In conclusion, our study complements previous analyses in the primary care setting in Spain and demonstrates the benefits of the annual influenza vaccination program in the prevention of severe influenza disease in the elderly, even in seasons with moderate VE.
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Affiliation(s)
- Clara Mazagatos
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Ana Milagro
- Miguel Servet University Hospital, Microbiology, 50009 Zaragoza, Spain
- Health Research Institute Aragón, 50009 Zaragoza, Spain
| | - María Liébana-Rodríguez
- Servicio Medicina Preventiva, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III, 28029 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Monge S, Rojas-Benedicto A, Olmedo C, Martín-Merino E, Mazagatos C, Limia A, Sierra MJ, Larrauri A, Hernán MA. Effectiveness of a Second Dose of an mRNA Vaccine Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Infection in Individuals Previously Infected by Other Variants. Clin Infect Dis 2023; 76:e367-e374. [PMID: 35687580 PMCID: PMC9214148 DOI: 10.1093/cid/ciac429] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/05/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Single-dose vaccination was widely recommended in the pre-Omicron era for persons with previous SARS-CoV-2 infection. The effectiveness of a second vaccine dose in this group in the Omicron era is unknown. METHODS We linked nationwide population registries in Spain to identify community-dwelling individuals aged 18-64, with a positive SARS-CoV-2 test before single-dose mRNA vaccination (mRNA-1273 or BNT162b2). Every day between 3 January and 6 February 2022 we matched 1:1 individuals receiving a second mRNA vaccine dose and controls on sex, age, province, first dose type and time, month of primary infection, and number of previous tests. We then estimated Kaplan-Meier risks of confirmed SARS-CoV-2 reinfection. We performed a similar analysis in a Delta-dominant period, between 19 July and 30 November 2021. RESULTS In the Omicron period, estimated effectiveness (95% CI) of a second dose was 62.2% (58.2-66.4%) 7-34 days after administration, similar across groups defined by age, sex, type of first vaccine, and time since the first dose. Estimated effectiveness was 65.4% (61.1-69.9%) for mRNA-1273 and 52.0% (41.8-63.1%) for BNT162b2. Estimated effectiveness was 78.5% (67.4-89.9%), 66.1% (54.9-77.5%), and 60.2% (55.5-64.8%) when primary infection had occurred in the Delta, Alpha, and pre-Alpha periods, respectively. In the Delta period, the estimated effectiveness of a second dose was 8.8% (-55.3% to 81.1%). CONCLUSIONS Our results suggest that, over 1 month after administration, a second dose of mRNA vaccine increases protection against SARS-CoV-2 reinfection with the Omicron variant among individuals with single-dose vaccination and previously infected with another variant.
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Affiliation(s)
- Susana Monge
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER on Infectious Diseases, Madrid, Spain
| | - Ayelén Rojas-Benedicto
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER on Epidemiology and Public Health, Madrid, Spain
- National Distance Education University, Madrid, Spain
| | - Carmen Olmedo
- Vaccines Division, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | | | - Clara Mazagatos
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER on Epidemiology and Public Health, Madrid, Spain
| | - Aurora Limia
- Vaccines Division, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - María José Sierra
- CIBER on Infectious Diseases, Madrid, Spain
- Centre for the Coordination of Heath Alerts and Emergencies, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Amparo Larrauri
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER on Epidemiology and Public Health, Madrid, Spain
| | - Miguel A Hernán
- CAUSALab and Departments of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Adlhoch C, Delgado-Sanz C, Carnahan A, Larrauri A, Popovici O, Bossuyt N, Thomas I, Kynčl J, Slezak P, Brytting M, Guiomar R, Redlberger-Fritz M, Maistre Melillo J, Melillo T, van Gageldonk-Lafeber AB, Marbus SD, O’Donnell J, Domegan L, Gomes Dias J, Olsen SJ. Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. Euro Surveill 2023; 28:2200340. [PMID: 36700868 PMCID: PMC9881178 DOI: 10.2807/1560-7917.es.2023.28.4.2200340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BackgroundTimely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.AimWe assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.MethodsCase-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.ResultsOf 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)).ConclusionNAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.
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Affiliation(s)
- Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Odette Popovici
- National Institute of Public Health Romania-National Centre for Communicable Diseases Surveillance and Control, Bucharest, Romania
| | | | | | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Pavel Slezak
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Raquel Guiomar
- National Influenza Reference Laboratory, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | | | | | - Tanya Melillo
- Infectious Disease prevention and Control unit, Malta
| | | | - Sierk D. Marbus
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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9
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Varea-Jiménez E, Cano EA, Vega-Piris L, Sánchez EVM, Mazagatos C, Rodríguez-Alarcón LGSM, Casas I, Moros MJS, Iglesias-Caballero M, Vazquez-Morón S, Larrauri A, Monge S. [Comparative severity of COVID-19 cases caused by Alpha, Delta or Omicron SARS-CoV-2 variants and its association with vaccination]. Enferm Infecc Microbiol Clin 2022:S0213-005X(22)00281-6. [PMID: 36506460 PMCID: PMC9722675 DOI: 10.1016/j.eimc.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study compares the severity of SARS-CoV-2 infections caused by Alpha, Delta or Omicron variants in periods of co-circulation in Spain, and estimates the variant-specific association of vaccination with severe disease. METHODS SARS-CoV-2 infections notified to the national epidemiological surveillance network with information on genetic variant and vaccination status were considered cases if they required hospitalisation or controls otherwise. Alpha and Delta were compared during June-July 2021; and Delta and Omicron during December 2021-January 2022. Adjusted Odds Ratios (aOR) were estimated using logistic regression, comparing variant and vaccination status between cases and controls. RESULTS We included 5,345 Alpha and 11,974 Delta infections in June-July and, 5,272 Delta and 10,578 Omicron in December-January. Unvaccinated cases of Alpha (aOR: 0.57; 95% CI: 0.46-0.69) or Omicron (0.28; 0.21-0.36) had lower probability of hospitalisation vs. Delta. Complete vaccination reduced hospitalisation, similarly for Alpha (0.16; 0.13-0.21) and Delta (June-July: 0.16; 0.14-0.19; December-January: 0.36; 0.30-0.44) but lower from Omicron (0.63; 0.53-0.75) and individuals aged 65+ years. CONCLUSION Results indicate higher intrinsic severity of the Delta variant, compared with Alpha or Omicron, with smaller differences among vaccinated individuals. Nevertheless, vaccination was associated to reduced hospitalisation in all groups.
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Affiliation(s)
- Elena Varea-Jiménez
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain
| | - Esteban Aznar Cano
- Centre for the Coordination of Alerts and Health Emergencies - Ministry of Health, Madrid, Spain
| | - Lorena Vega-Piris
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain
| | - Elena Vanessa Martínez Sánchez
- Centre for the Coordination of Alerts and Health Emergencies - Ministry of Health, Madrid, Spain
- CIBER Epidemiology and Public Health, Spain
| | - Clara Mazagatos
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain
- CIBER Epidemiology and Public Health, Spain
| | | | - Inmaculada Casas
- National Centre of Microbiology - Institute of Health Carlos III, Madrid, Spain
- CIBER Epidemiology and Public Health, Spain
| | - María José Sierra Moros
- Centre for the Coordination of Alerts and Health Emergencies - Ministry of Health, Madrid, Spain
- CIBER Infectious Diseases, Spain
| | | | - Sonia Vazquez-Morón
- National Centre of Microbiology - Institute of Health Carlos III, Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain
- CIBER Epidemiology and Public Health, Spain
| | - Susana Monge
- National Centre of Epidemiology - Institute of Health Carlos III, Madrid, Spain
- CIBER Infectious Diseases, Spain
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10
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Monge S, Rojas-Benedicto A, Olmedo C, Mazagatos C, José Sierra M, Limia A, Martín-Merino E, Larrauri A, Hernán MA. Effectiveness of mRNA vaccine boosters against infection with the SARS-CoV-2 omicron (B.1.1.529) variant in Spain: a nationwide cohort study. Lancet Infect Dis 2022; 22:1313-1320. [PMID: 35658998 PMCID: PMC9162477 DOI: 10.1016/s1473-3099(22)00292-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The omicron (B.1.1.529) variant of SARS-CoV-2 has increased capacity to elude immunity and cause breakthrough infections. The aim of this study was to estimate the effectiveness of mRNA-based vaccine boosters (third dose) against infection with the omicron variant by age, sex, time since complete vaccination, type of primary vaccine, and type of booster. METHODS In this nationwide cohort study, we linked data from three nationwide population registries in Spain (Vaccination Registry, Laboratory Results Registry, and National Health System registry) to select community-dwelling individuals aged 40 years or older, who completed their primary vaccine schedule at least 3 months before the start of follow-up, and had not tested positive for SARS-CoV-2 since the start of the pandemic. On each day between Jan 3, and Feb 6, 2022, we matched individuals who received a booster mRNA vaccine and controls of the same sex, age group, postal code, type of vaccine, time since primary vaccination, and number of previous tests. We estimated risk of laboratory-confirmed SARS-CoV-2 infection using the Kaplan-Meier method and compared groups using risk ratios (RR) and risk differences. Vaccine effectiveness was calculated as one minus RR. FINDINGS Between Jan 3, and Feb 6, 2022, 3 111 159 matched pairs were included in our study. Overall, the estimated effectiveness from day 7 to 34 after a booster was 51·3% (95% CI 50·2-52·4). Estimated effectiveness was 52·5% (51·3-53·7) for an mRNA-1273 booster and 46·2% (43·5-48·7) for a BNT162b2 booster. Effectiveness was 58·6% (55·5-61·6) if primary vaccination had been with ChAdOx1 nCoV-19 (Oxford-AstraZeneca), 55·3% (52·3-58·2) with mRNA-1273 (Moderna), 49·7% (48·3-51·1) with BNT162b2 (Pfizer-BioNTech), and 48·0% (42·5-53·7) with Ad26.COV2.S (Janssen). Estimated effectiveness was 43·6% (40·0-47·1) when the booster was administered between 151 days and 180 days after complete vaccination and 52·2% (51·0-53·3) if administered more than 180 days after primary scheduled completion. INTERPRETATION Booster mRNA vaccine-doses were moderately effective in preventing infection with the omicron variant of SARS-CoV-2 for over a month after administration, which indicates their suitability as a strategy to limit the health effects of COVID-19 in periods of omicron variant domination. Estimated effectiveness was higher for mRNA-1273 compared with BNT162b2 and increased with time between completed primary vaccination and booster. FUNDING None.
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Affiliation(s)
- Susana Monge
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain; Centro de Investigación Biomédica en Red (CIBER) on Infectious Diseases, Madrid, Spain.
| | - Ayelén Rojas-Benedicto
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain; CIBER on Epidemiology and Public Health, Madrid, Spain; National Distance Education University, Madrid, Spain
| | - Carmen Olmedo
- Vaccines Division, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Clara Mazagatos
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain; CIBER on Epidemiology and Public Health, Madrid, Spain
| | - María José Sierra
- Centre for the Coordination of Heath Alerts and Emergencies, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Aurora Limia
- Vaccines Division, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | | | - Amparo Larrauri
- Department of Communicable Diseases, National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain; CIBER on Epidemiology and Public Health, Madrid, Spain
| | - Miguel A Hernán
- CAUSALab and Departments of Epidemiology and Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
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11
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Armero G, Penela-Sánchez D, Belmonte J, Gómez-Barroso D, Larrauri A, Henares D, Vallejo V, Jordan I, Muñoz-Almagro C, Brotons P, Launes C. Concentrations of nitrogen compounds are related to severe rhinovirus infection in infants. A time-series analysis from the reference area of a pediatric university hospital in Barcelona. Pediatr Pulmonol 2022; 57:2180-2188. [PMID: 35652447 PMCID: PMC9543680 DOI: 10.1002/ppul.26021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/17/2022] [Accepted: 05/29/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND There is scarce information focused on the effect of weather conditions and air pollution on specific acute viral respiratory infections, such as rhinovirus (RV), with a wide clinical spectrum of severity. OBJECTIVE The aim of this study was to analyze the association between episodes of severe respiratory tract infection by RV and air pollutant concentrations (NOx and SO2 ) in the reference area of a pediatric university hospital. METHODS An analysis of temporal series of daily values of NOx and SO2 , weather variables, circulating pollen and mold spores, and daily number of admissions in the pediatric intensive care unit (PICU) with severe respiratory RV infection (RVi) in children between 6 months and 18 years was performed. Lagged variables for 0-5 days were considered. The study spanned from 2010 to 2018. Patients with comorbidities were excluded. RESULTS One hundred and fifty patients were admitted to the PICU. Median age was 19 months old (interquartile range [IQR]: 11-47). No relationship between RV-PICU admissions and temperature, relative humidity, cumulative rainfall, or wind speed was found. Several logistic regression models with one pollutant and two pollutants were constructed but the best model was that which included average daily NOx concentrations. Average daily NOx concentrations were related with the presence of PICU admissions 3 days later (odds ratio per IQR-unit increase: 1.64, 95% confidence interval: 1.20-2.25)). CONCLUSIONS This study has shown a positive correlation between NOx concentrations at Lag 3 and children's PICU admissions with severe RV respiratory infection. Air pollutant data should be taken into consideration when we try to understand the severity of RVis.
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Affiliation(s)
- Georgina Armero
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain.,Pediatrics Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Jordina Belmonte
- Botanic Unit of Animal Biology, Vegetal Biology and Ecology Department, Science and Ambiental Technology Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Diana Gómez-Barroso
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Larrauri
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Desiree Henares
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Violeta Vallejo
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Iolanda Jordan
- Pediatrics Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Molecular Microbiology Department, Hospital Sant Joan de Déu, Barcelona, Spain.,Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Pedro Brotons
- Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Department of Medicine, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristian Launes
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Grupo de investigación en enfermedades infecciosas pediátricas, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
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12
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Mazagatos C, Delgado-Sanz C, Monge S, Pozo F, Oliva J, Sandonis V, Gandarillas A, Quiñones-Rubio C, Ruiz-Sopeña C, Gallardo-García V, Basile L, Barranco-Boada MI, Hidalgo-Pardo O, Vazquez-Cancela O, García-Vázquez M, Fernández-Sierra A, Milagro-Beamonte A, Ordobás M, Martínez-Ochoa E, Fernández-Arribas S, Lorusso N, Martínez A, García-Fulgueiras A, Sastre-Palou B, Losada-Castillo I, Martínez-Cuenca S, Rodríguez-Del Águila M, Latorre M, Larrauri A. COVID-19 vaccine effectiveness against hospitalization due to SARS-CoV-2: A test-negative design study based on Severe Acute Respiratory Infection (SARI) sentinel surveillance in Spain. Influenza Other Respir Viruses 2022; 16:1014-1025. [PMID: 35880469 PMCID: PMC9350393 DOI: 10.1111/irv.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background With the emergence of SARS‐CoV‐2, influenza surveillance systems in Spain were transformed into a new syndromic sentinel surveillance system. The Acute Respiratory Infection Surveillance System (SiVIRA in Spanish) is based on a sentinel network for acute respiratory infection (ARI) surveillance in primary care and a network of sentinel hospitals for severe ARI (SARI) surveillance in hospitals. Methods Using a test‐negative design and data from SARI admissions notified to SiVIRA between January 1 and October 3, 2021, we estimated COVID‐19 vaccine effectiveness (VE) against hospitalization, by age group, vaccine type, time since vaccination, and SARS‐CoV‐2 variant. Results VE was 89% (95% CI: 83–93) against COVID‐19 hospitalization overall in persons aged 20 years and older. VE was higher for mRNA vaccines, and lower for those aged 80 years and older, with a decrease in protection beyond 3 months of completing vaccination, and a further decrease after 5 months. We found no differences between periods with circulation of Alpha or Delta SARS‐CoV‐2 variants, although variant‐specific VE was slightly higher against Alpha. Conclusions The SiVIRA sentinel hospital surveillance network in Spain was able to describe clinical and epidemiological characteristics of SARI hospitalizations and provide estimates of COVID‐19 VE in the population under surveillance. Our estimates add to evidence of high effectiveness of mRNA vaccines against severe COVID‐19 and waning of protection with time since vaccination in those aged 80 or older. No substantial differences were observed between SARS‐CoV‐2 variants (Alpha vs. Delta).
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Affiliation(s)
- Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Susana Monge
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Francisco Pozo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Jesús Oliva
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Virginia Sandonis
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Ana Gandarillas
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Madrid, Spain
| | - Carmen Quiñones-Rubio
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, Logroño, Spain
| | | | - Virtudes Gallardo-García
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Seville, Spain
| | - Luca Basile
- Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalonia, Spain
| | | | - Olga Hidalgo-Pardo
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Olalla Vazquez-Cancela
- Servicio de Medicina Preventiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Miriam García-Vázquez
- Vigilancia Epidemiológica, Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | | | - Ana Milagro-Beamonte
- Laboratorio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - María Ordobás
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Madrid, Spain
| | - Eva Martínez-Ochoa
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, Logroño, Spain
| | | | - Nicola Lorusso
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Seville, Spain
| | - Ana Martínez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalonia, Spain
| | - Ana García-Fulgueiras
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Servicio de Epidemiología, Dirección General de Salud Pública, Consejería de Salud, Murcia, Spain
| | - Bartolomé Sastre-Palou
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Isabel Losada-Castillo
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Silvia Martínez-Cuenca
- Vigilancia Epidemiológica, Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | | | - Miriam Latorre
- Laboratorio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Amparo Larrauri
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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13
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Kissling E, Hooiveld M, Martínez-Baz I, Mazagatos C, William N, Vilcu AM, Kooijman MN, Ilić M, Domegan L, Machado A, de Lusignan S, Lazar M, Meijer A, Brytting M, Casado I, Larrauri A, Murray JLK, Behillil S, de Gier B, Mlinarić I, O’Donnell J, Rodrigues AP, Tsang R, Timnea O, de Lange M, Riess M, Castilla J, Pozo F, Hamilton M, Falchi A, Knol MJ, Kurečić Filipović S, Dunford L, Guiomar R, Cogdale J, Cherciu C, Jansen T, Enkirch T, Basile L, Connell J, Gomez V, Sandonis Martín V, Bacci S, Rose AMC, Pastore Celentano L, Valenciano M. Effectiveness of complete primary vaccination against COVID-19 at primary care and community level during predominant Delta circulation in Europe: multicentre analysis, I-MOVE-COVID-19 and ECDC networks, July to August 2021. Euro Surveill 2022; 27:2101104. [PMID: 35620997 PMCID: PMC9137272 DOI: 10.2807/1560-7917.es.2022.27.21.2101104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IntroductionIn July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe.AimUsing a multicentre test-negative study, we measured COVID-19 vaccine effectiveness (VE) against symptomatic infection.MethodsIndividuals with COVID-19 or acute respiratory symptoms at primary care/community level in 10 European countries were tested for SARS-CoV-2. We measured complete primary course overall VE by vaccine brand and by time since vaccination.ResultsOverall VE was 74% (95% CI: 69-79), 76% (95% CI: 71-80), 63% (95% CI: 48-75) and 63% (95% CI: 16-83) among those aged 30-44, 45-59, 60-74 and ≥ 75 years, respectively. VE among those aged 30-59 years was 78% (95% CI: 75-81), 66% (95% CI: 58-73), 91% (95% CI: 87-94) and 52% (95% CI: 40-61), for Comirnaty, Vaxzevria, Spikevax and COVID-19 Vaccine Janssen, respectively. VE among people 60 years and older was 67% (95% CI: 52-77), 65% (95% CI: 48-76) and 83% (95% CI: 64-92) for Comirnaty, Vaxzevria and Spikevax, respectively. Comirnaty VE among those aged 30-59 years was 87% (95% CI: 83-89) at 14-29 days and 65% (95% CI: 56-71%) at ≥ 90 days between vaccination and onset of symptoms.ConclusionsVE against symptomatic infection with the SARS-CoV-2 Delta variant varied among brands, ranging from 52% to 91%. While some waning of the vaccine effect may be present (sample size limited this analysis to only Comirnaty), protection was 65% at 90 days or more between vaccination and onset.
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Affiliation(s)
| | | | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Ana-Maria Vilcu
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Marjolein N Kooijman
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Maja Ilić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Mihaela Lazar
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Amparo Larrauri
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Sylvie Behillil
- Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, France,CNR des virus des infections respiratoires, Institut Pasteur, Paris, France
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Olivia Timnea
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | | | | - Mirjam J Knol
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Carmen Cherciu
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | | | | | - Luca Basile
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalunya, Spain
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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14
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García-García D, Herranz-Hernández R, Rojas-Benedicto A, León-Gómez I, Larrauri A, Peñuelas M, Guerrero-Vadillo M, Ramis R, Gómez-Barroso D. Assessing the effect of non-pharmaceutical interventions on COVID-19 transmission in Spain, 30 August 2020 to 31 January 2021. Euro Surveill 2022; 27:2100869. [PMID: 35551707 PMCID: PMC9101969 DOI: 10.2807/1560-7917.es.2022.27.19.2100869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BackgroundAfter a national lockdown during the first wave of the COVID-19 pandemic in Spain, regional governments implemented different non-pharmaceutical interventions (NPIs) during the second wave.AimTo analyse which implemented NPIs significantly impacted effective reproduction number (Rt) in seven Spanish provinces during 30 August 2020-31 January 2021.MethodsWe coded each NPI and levels of stringency with a 'severity index' (SI) and computed a global SI (mean of SIs per six included interventions). We performed a Bayesian change point analysis on the Rt curve of each province to identify possible associations with global SI variations. We fitted and compared several generalised additive models using multimodel inference, to quantify the statistical effect on Rt of the global SI (stringency) and the individual SIs (separate effect of NPIs).ResultsThe global SI had a significant lowering effect on the Rt (mean: 0.16 ± 0.05 units for full stringency). Mandatory closing times for non-essential businesses, limited gatherings, and restricted outdoors seating capacities (negative) as well as curfews (positive) were the only NPIs with a significant effect. Regional mobility restrictions and limited indoors seating capacity showed no effect. Our results were consistent with a 1- to 3-week-delayed Rt as a response variable.ConclusionWhile response measures implemented during the second COVID-19 wave contributed substantially to a decreased reproduction number, the effectiveness of measures varied considerably. Our findings should be considered for future interventions, as social and economic consequences could be minimised by considering only measures proven effective.
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Affiliation(s)
- David García-García
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Centro Nacional de Epidemiología, Instituto de Salud Carlos IIII, Madrid, Spain
| | | | - Ayelén Rojas-Benedicto
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Centro Nacional de Epidemiología, Instituto de Salud Carlos IIII, Madrid, Spain
| | - Inmaculada León-Gómez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Centro Nacional de Epidemiología, Instituto de Salud Carlos IIII, Madrid, Spain
| | - Amparo Larrauri
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Centro Nacional de Epidemiología, Instituto de Salud Carlos IIII, Madrid, Spain
| | - Marina Peñuelas
- Centro Nacional de Epidemiología, Instituto de Salud Carlos IIII, Madrid, Spain
| | | | - Rebeca Ramis
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Centro Nacional de Epidemiología, Instituto de Salud Carlos IIII, Madrid, Spain
| | - Diana Gómez-Barroso
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
- Centro Nacional de Epidemiología, Instituto de Salud Carlos IIII, Madrid, Spain
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15
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Mortier P, Vilagut G, Alayo I, Ferrer M, Amigo F, Aragonès E, Aragón-Peña A, Asúnsolo del Barco A, Campos M, Espuga M, González-Pinto A, Haro J, López Fresneña N, Martínez de Salázar A, Molina J, Ortí-Lucas R, Parellada M, Pelayo-Terán J, Pérez-Gómez B, Pérez-Zapata A, Pijoan J, Plana N, Polentinos-Castro E, Portillo-Van Diest A, Puig M, Rius C, Sanz F, Serra C, Urreta-Barallobre I, Kessler R, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Alayo I, Alonso M, Álvarez M, Amann B, Amigo FF, Anmella G, Aragón A, Aragonés N, Aragonès E, Arizón AI, Asunsolo A, Ayora A, Ballester L, Barbas P, Basora J, Bereciartua E, Ignasi Bolibar IB, Bonfill X, Cotillas A, Cuartero A, de Paz C, Cura ID, Jesus del Yerro M, Diaz D, Domingo JL, Emparanza JI, Espallargues M, Espuga M, Estevan P, Fernandez MI, Fernandez T, Ferrer M, Ferreres Y, Fico G, Forjaz MJ, Barranco RG, Garcia TorrecillasC. Garcia-Ribera JM, Garrido A, Gil E, Gomez M, Gomez J, Pinto AG, Haro JM, Hernando M, Insigna MG, Iriberri M, Jimenez N, Jimenez X, Larrauri A, Leon F, Lopez-Fresneña N, Lopez C, Lopez-Atanes Juan Antonio Lopez-Rodriguez M, Lopez-Cortacans G, Marcos A, Martin J, Martin V, Martinez-Cortés M, Martinez-Martinez R, Martinez de Salazar AD, Martinez I, Marzola M, Mata N, Molina JM, de Dios Molina J, Molinero E, Mortier P, Muñoz C, Murru A, Olmedo J, Ortí RM, Padrós R, Pallejà M, Parra R, Pascual J, Pelayo JM, Pla R, Plana N, Aznar CP, Gomez BP, Zapata AP, Pijoan JI, Polentinos E, Puertolas B, Puig MT, Quílez A, Quintana MJ, Quiroga A, Rentero D, Rey C, Rius C, Rodriguez-Blazquez C, Rojas MJ, Romero Y, Rubio G, Rumayor M, Ruiz P, Saenz M, Sanchez J, Sanchez-Arcilla I, Sanz F, Serra C, Serra-Sutton V, Serrano M, Sola S, Solera S, Soto M, Tarrago A, Tolosa N, Vazquez M, Viciola M, Vieta E, Vilagut G, Yago S, Yañez J, Zapico Y, Zorita LM, Zorrilla I, Zurbano SL, Perez-Solá V. Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic. J Psychiatr Res 2022; 149:10-17. [PMID: 35217315 PMCID: PMC8852847 DOI: 10.1016/j.jpsychires.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 12/22/2022]
Abstract
Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May-September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October-December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0-4; odds ratio [OR] range = 1.23-1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0-4; OR range 1.30-1.32), and the perceived lack of healthcare center preparedness (scaled 0-4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3-57.6%. Other significant risk factors were financial stressors (OR range 1.26-1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.
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Affiliation(s)
- P. Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Corresponding author. IMIM, PRBB Building. Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
| | - G. Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - I. Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - M. Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - F. Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - E. Aragonès
- Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain,Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - A. Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain,Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - A. Asúnsolo del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain,Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain,Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - M. Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - M. Espuga
- Occupational Health Service. Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - A. González-Pinto
- Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain,CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - J.M. Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Parc Sanitari Sant Joan de Déu, Barcelona, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - J.D. Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Villaverde Mental Health Center. Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain,Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain,Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - M. Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J.M. Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Servicio de Psiquiatría y Salud Mental. Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain,Area de Medicina Preventiva y Salud Pública. Universidad de León, León, Spain
| | - B. Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A. Pérez-Zapata
- Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - J.I. Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain, Biocruces-Bizkaia Health Research Institute
| | - N. Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - E. Polentinos-Castro
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain,Research Unit. Primary Care Management. Madrid Health Service, Madrid, Spain,Department of Medical Specialities and Public Health. King Juan Carlos University, Madrid, Spain,Health Services Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
| | - A. Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - M.T. Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain,CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - C. Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - F. Sanz
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain,Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - C. Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Parc de Salut Mar PSMAR, Barcelona, Spain,CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - I. Urreta-Barallobre
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain,Biodonostia Health Research Institute, Clinical Epidemiology, San Sebastián, Spain
| | - R.C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - E. Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - V. Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Parc de Salut Mar PSMAR, Barcelona, Spain
| | - J. Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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16
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De Salazar PM, Lu F, Hay JA, Gómez-Barroso D, Fernández-Navarro P, Martínez EV, Astray-Mochales J, Amillategui R, García-Fulgueiras A, Chirlaque MD, Sánchez-Migallón A, Larrauri A, Sierra MJ, Lipsitch M, Simón F, Santillana M, Hernán MA. Near real-time surveillance of the SARS-CoV-2 epidemic with incomplete data. PLoS Comput Biol 2022; 18:e1009964. [PMID: 35358171 PMCID: PMC9004750 DOI: 10.1371/journal.pcbi.1009964] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/12/2022] [Accepted: 02/24/2022] [Indexed: 12/17/2022] Open
Abstract
When responding to infectious disease outbreaks, rapid and accurate estimation of the epidemic trajectory is critical. However, two common data collection problems affect the reliability of the epidemiological data in real time: missing information on the time of first symptoms, and retrospective revision of historical information, including right censoring. Here, we propose an approach to construct epidemic curves in near real time that addresses these two challenges by 1) imputation of dates of symptom onset for reported cases using a dynamically-estimated "backward" reporting delay conditional distribution, and 2) adjustment for right censoring using the NobBS software package to nowcast cases by date of symptom onset. This process allows us to obtain an approximation of the time-varying reproduction number (Rt) in real time. We apply this approach to characterize the early SARS-CoV-2 outbreak in two Spanish regions between March and April 2020. We evaluate how these real-time estimates compare with more complete epidemiological data that became available later. We explore the impact of the different assumptions on the estimates, and compare our estimates with those obtained from commonly used surveillance approaches. Our framework can help improve accuracy, quantify uncertainty, and evaluate frequently unstated assumptions when recovering the epidemic curves from limited data obtained from public health systems in other locations.
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Affiliation(s)
- Pablo M. De Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
| | - Fred Lu
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, Massachusetts, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts, United States of america
| | - James A Hay
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
| | - Diana Gómez-Barroso
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pablo Fernández-Navarro
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elena V Martínez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | | | - Rocío Amillategui
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - Ana García-Fulgueiras
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Maria D Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alonso Sánchez-Migallón
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Amparo Larrauri
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María J Sierra
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINF), Madrid, Spain
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
| | - Fernando Simón
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - Mauricio Santillana
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, Massachusetts, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts, United States of america
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts, United States of america
| | - Miguel A Hernán
- CAUSALab, Department of Epidemiology and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of america
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17
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Schmidt SSS, Iuliano AD, Vestergaard LS, Mazagatos-Ateca C, Larrauri A, Brauner JM, Olsen SJ, Nielsen J, Salomon JA, Krause TG. All-cause versus cause-specific excess deaths for estimating influenza-associated mortality in Denmark, Spain, and the United States. Influenza Other Respir Viruses 2022; 16:707-716. [PMID: 35194940 PMCID: PMC9178070 DOI: 10.1111/irv.12966] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Seasonal influenza-associated excess mortality estimates can be timely and provide useful information on the severity of an epidemic. This methodology can be leveraged during an emergency response or pandemic. METHOD For Denmark, Spain, and the United States, we estimated age-stratified excess mortality for (i) all-cause, (ii) respiratory and circulatory, (iii) circulatory, (iv) respiratory, and (v) pneumonia, and influenza causes of death for the 2015/2016 and 2016/2017 influenza seasons. We quantified differences between the countries and seasonal excess mortality estimates and the death categories. We used a time-series linear regression model accounting for time and seasonal trends using mortality data from 2010 through 2017. RESULTS The respective periods of weekly excess mortality for all-cause and cause-specific deaths were similar in their chronological patterns. Seasonal all-cause excess mortality rates for the 2015/2016 and 2016/2017 influenza seasons were 4.7 (3.3-6.1) and 14.3 (13.0-15.6) per 100,000 population, for the United States; 20.3 (15.8-25.0) and 24.0 (19.3-28.7) per 100,000 population for Denmark; and 22.9 (18.9-26.9) and 52.9 (49.1-56.8) per 100,000 population for Spain. Seasonal respiratory and circulatory excess mortality estimates were two to three times lower than the all-cause estimates. DISCUSSION We observed fewer influenza-associated deaths when we examined cause-specific death categories compared with all-cause deaths and observed the same trends in peaks in deaths with all death causes. Because all-cause deaths are more available, these models can be used to monitor virus activity in near real time. This approach may contribute to the development of timely mortality monitoring systems during public health emergencies.
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Affiliation(s)
- Sebastian S S Schmidt
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | | | - Lasse S Vestergaard
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - Clara Mazagatos-Ateca
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Jan M Brauner
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Sonja J Olsen
- Health Emergencies Program, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Jens Nielsen
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | | | - Tyra G Krause
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
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18
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Konstantinoudis G, Cameletti M, Gómez-Rubio V, Gómez IL, Pirani M, Baio G, Larrauri A, Riou J, Egger M, Vineis P, Blangiardo M. Regional excess mortality during the 2020 COVID-19 pandemic in five European countries. Nat Commun 2022; 13:482. [PMID: 35079022 PMCID: PMC8789777 DOI: 10.1038/s41467-022-28157-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/05/2022] [Indexed: 12/11/2022] Open
Abstract
The impact of the COVID-19 pandemic on excess mortality from all causes in 2020 varied across and within European countries. Using data for 2015-2019, we applied Bayesian spatio-temporal models to quantify the expected weekly deaths at the regional level had the pandemic not occurred in England, Greece, Italy, Spain, and Switzerland. With around 30%, Madrid, Castile-La Mancha, Castile-Leon (Spain) and Lombardia (Italy) were the regions with the highest excess mortality. In England, Greece and Switzerland, the regions most affected were Outer London and the West Midlands (England), Eastern, Western and Central Macedonia (Greece), and Ticino (Switzerland), with 15-20% excess mortality in 2020. Our study highlights the importance of the large transportation hubs for establishing community transmission in the first stages of the pandemic. Here, we show that acting promptly to limit transmission around these hubs is essential to prevent spread to other regions and countries.
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Affiliation(s)
- Garyfallos Konstantinoudis
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | | | - Virgilio Gómez-Rubio
- Departamento de Matemáticas, Escuela Técnica Superior de Ingenieros Industriales, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Inmaculada León Gómez
- National Centre of Epidemiology (CNE), Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Monica Pirani
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Gianluca Baio
- Department of Statistical Sciences, University College London, London, UK
| | - Amparo Larrauri
- National Centre of Epidemiology (CNE), Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Julien Riou
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paolo Vineis
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Marta Blangiardo
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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19
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Affiliation(s)
- Amparo Larrauri
- National Center of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Katarina Prosenc Trilar
- Laboratory for Public Health Virology, National Laboratory for Health, Environment and Food, Ljubljana, Slovenia
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20
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Kissling E, Hooiveld M, Sandonis Martín V, Martínez-Baz I, William N, Vilcu AM, Mazagatos C, Domegan L, de Lusignan S, Meijer A, Machado A, Brytting M, Casado I, Murray JLK, Belhillil S, Larrauri A, O'Donnell J, Tsang R, de Lange M, Rodrigues AP, Riess M, Castilla J, Hamilton M, Falchi A, Pozo F, Dunford L, Cogdale J, Jansen T, Guiomar R, Enkirch T, Burgui C, Sigerson D, Blanchon T, Martínez Ochoa EM, Connell J, Ellis J, van Gageldonk-Lafeber R, Kislaya I, Rose AM, Valenciano M. Vaccine effectiveness against symptomatic SARS-CoV-2 infection in adults aged 65 years and older in primary care: I-MOVE-COVID-19 project, Europe, December 2020 to May 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34296676 PMCID: PMC8299744 DOI: 10.2807/1560-7917.es.2021.26.29.2100670] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We measured COVID-19 vaccine effectiveness (VE) against symptomatic SARS-CoV-2 infection at primary care/outpatient level among adults ≥ 65 years old using a multicentre test-negative design in eight European countries. We included 592 SARS-CoV-2 cases and 4,372 test-negative controls in the main analysis. The VE was 62% (95% CI: 45–74) for one dose only and 89% (95% CI: 79–94) for complete vaccination. COVID-19 vaccines provide good protection against COVID-19 presentation at primary care/outpatient level, particularly among fully vaccinated individuals.
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Affiliation(s)
| | | | | | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Ana-Maria Vilcu
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Royal College of General Practitioners Research and Surveillance Centre, London, UK
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Itziar Casado
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Sylvie Belhillil
- Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, France.,CNR des virus des infections respiratoires, Institut Pasteur, Paris, France
| | - Amparo Larrauri
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Royal College of General Practitioners Research and Surveillance Centre, London, UK
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | | | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Cristina Burgui
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Thierry Blanchon
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Eva María Martínez Ochoa
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, La Rioja, Spain
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | | | - Irina Kislaya
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
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- The members of the I-MOVE-COVID-19 primary care study team are listed in the Investigators tab
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21
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Staadegaard L, Caini S, Wangchuk S, Thapa B, de Almeida WAF, de Carvalho FC, Fasce RA, Bustos P, Kyncl J, Novakova L, Caicedo AB, de Mora Coloma DJ, Meijer A, Hooiveld M, Huang QS, Wood T, Guiomar R, Rodrigues AP, Lee VJM, Ang LW, Cohen C, Moyes J, Larrauri A, Delgado-Sanz C, Demont C, Bangert M, Dückers M, van Summeren J, Paget J. Defining the seasonality of respiratory syncytial virus around the world: National and subnational surveillance data from 12 countries. Influenza Other Respir Viruses 2021; 15:732-741. [PMID: 34255934 PMCID: PMC8542954 DOI: 10.1111/irv.12885] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract infections and have a major burden on society. For prevention and control to be deployed effectively, an improved understanding of the seasonality of RSV is necessary. Objectives The main objective of this study was to contribute to a better understanding of RSV seasonality by examining the GERi multi‐country surveillance dataset. Methods RSV seasons were included in the analysis if they contained ≥100 cases. Seasonality was determined using the “average annual percentage” method. Analyses were performed at a subnational level for the United States and Brazil. Results We included 601 425 RSV cases from 12 countries. Most temperate countries experienced RSV epidemics in the winter, with a median duration of 10–21 weeks. Not all epidemics fit this pattern in a consistent manner, with some occurring later or in an irregular manner. More variation in timing was observed in (sub)tropical countries, and we found substantial differences in seasonality at a subnational level. No association was found between the timing of the epidemic and the dominant RSV subtype. Conclusions Our findings suggest that geographical location or climatic characteristics cannot be used as a definitive predictor for the timing of RSV epidemics and highlight the need for (sub)national data collection and analysis.
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Affiliation(s)
- Lisa Staadegaard
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Saverio Caini
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Binay Thapa
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | | | - Rodrigo A Fasce
- Subdepartamento Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Patricia Bustos
- Sección Virus Respiratorios, Subdepartamento Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic.,Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Novakova
- National Reference Laboratory for Influenza and Other Respiratory Viruses, National Institute of Public Health, Prague, Czech Republic
| | - Alfredo Bruno Caicedo
- Universidad Agraria del Ecuador, Guayaquil, Ecuador.,Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Domenica Joseth de Mora Coloma
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Q Sue Huang
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | | | - Li Wei Ang
- Ministry of Health, Singapore.,National Centre for Infectious Diseases, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | | | | | - Michel Dückers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | | | - John Paget
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
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22
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Machado A, Leite A, Larrauri A, Gomez V, Rodrigues AP, Kislaya I, Nunes B. No effect modification of influenza virus vaccine effectiveness by age or chronic condition was observed in the 2010/11 to 2017/18 seasons. Pharmacoepidemiol Drug Saf 2021; 30:1411-1419. [PMID: 34096151 DOI: 10.1002/pds.5302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE Most European influenza vaccine strategies target individuals at higher risk of complications, which include, among others, individuals aged ≥65 years and with chronic conditions. These individuals not only have a high-risk of post-infection complications but also could have lower capacity of acquiring adequate vaccine-induced protection. As such, chronic conditions and age could modify the effect of vaccines. This study aimed at assessing the potential effect modification of influenza vaccine effectiveness (IVE) by age and chronic conditions. METHODS We used eight-season data from the Portuguese vaccine effectiveness study. Every season, physicians at primary care units recruited patients with influenza-like illness. Clinical data and swabs were collected for Reverse Transverse Polymerase Chain Reaction (RT-PCR) detection of influenza. Trivalent inactivated IVE was estimated as 1 - odds ratio (OR) of being vaccinated in cases (RT-PCR positive for influenza) versus negative controls. ORs were obtained using a multivariable conditional logistic regression model, paired by week of onset within each season. Confounders were assessed by designing a specific causal diagram. Age (< 65 or ≥65 years) and chronic conditions (diabetes, cardiovascular disease, chronic renal disease, chronic hepatic disease, obesity, chronic respiratory disease, and congenital or acquired immunodeficiency) were studied as effect modifiers by including an interaction term in the regression models. Significance was established at 5%. RESULTS Point estimates indicate a higher IVE in the chronic condition strata compared to that in the no chronic condition strata. Regarding age, different results were obtained considering the virus type and (sub)type. When comparing the ≥65 years with the <65 years of age strata, we observed a higher IVE against A(H1N1)pdm09, an equal IVE against A(H3N2) and a lower IVE against B virus. However, all interaction terms were statistically insignificant, and this may be due to a small sample size. CONCLUSION The potential effect modification of age or chronic condition was not observed within our study.
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Affiliation(s)
- Ausenda Machado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Andreia Leite
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,Unidade de Saúde Pública, Agrupamento de Centros de Saúde Amadora, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Verónica Gomez
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
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23
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Mazagatos C, Monge S, Olmedo C, Vega L, Gallego P, Martín-Merino E, Sierra MJ, Limia A, Larrauri A. Effectiveness of mRNA COVID-19 vaccines in preventing SARS-CoV-2 infections and COVID-19 hospitalisations and deaths in elderly long-term care facility residents, Spain, weeks 53 2020 to 13 2021. Euro Surveill 2021; 26:2100452. [PMID: 34142647 PMCID: PMC8212595 DOI: 10.2807/1560-7917.es.2021.26.24.2100452] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/16/2021] [Indexed: 12/28/2022] Open
Abstract
Residents in long-term care facilities (LTCF) experienced a large morbidity and mortality during the COVID-19 pandemic in Spain and were prioritised for early COVID-19 vaccination. We used the screening method and population-based data sources to obtain estimates of mRNA COVID-19 vaccine effectiveness for elderly LTCF residents. The estimates were 71% (95% CI: 56-82%), 88% (95% CI: 75-95%), and 97% (95% CI: 92-99%), against SARS-CoV-2 infections (symptomatic and asymptomatic), and COVID-19 hospitalisations and deaths, respectively.
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Affiliation(s)
- Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Susana Monge
- Centre for the Coordination of Alerts and Health Emergencies, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Carmen Olmedo
- Vaccines Division, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Lorena Vega
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Pilar Gallego
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - María José Sierra
- Centre for the Coordination of Alerts and Health Emergencies, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Aurora Limia
- Vaccines Division, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Amparo Larrauri
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
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24
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Staadegaard L, Caini S, Wangchuk S, Thapa B, de Almeida WAF, de Carvalho FC, Njouom R, Fasce RA, Bustos P, Kyncl J, Novakova L, Caicedo AB, de Mora Coloma DJ, Meijer A, Hooiveld M, Huang S, Wood T, Guiomar R, Rodrigues AP, Danilenko D, Stolyarov K, Lee VJM, Ang LW, Cohen C, Moyes J, Larrauri A, Delgado-Sanz C, Le MQ, Hoang PVM, Demont C, Bangert M, van Summeren J, Dückers M, Paget J. The Global Epidemiology of RSV in Community and Hospitalized Care: Findings From 15 Countries. Open Forum Infect Dis 2021; 8:ofab159. [PMID: 34337092 PMCID: PMC8320297 DOI: 10.1093/ofid/ofab159] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/25/2021] [Indexed: 12/19/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is one of the leading causes of acute respiratory tract infections. To optimize control strategies, a better understanding of the global epidemiology of RSV is critical. To this end, we initiated the Global Epidemiology of RSV in Hospitalized and Community care study (GERi). Methods Focal points from 44 countries were approached to join GERi and share detailed RSV surveillance data. Countries completed a questionnaire on the characteristics of their surveillance system. Results Fifteen countries provided granular surveillance data and information on their surveillance system. A median (interquartile range) of 1641 (552–2415) RSV cases per season were reported from 2000 and 2020. The majority (55%) of RSV cases occurred in the <1-year-olds, with 8% of cases reported in those aged ≥65 years. Hospitalized cases were younger than those in community care. We found no age difference between RSV subtypes and no clear pattern of dominant subtypes. Conclusions The high number of cases in the <1-year-olds indicates a need to focus prevention efforts in this group. The minimal differences between RSV subtypes and their co-circulation implies that prevention needs to target both subtypes. Importantly, there appears to be a lack of RSV surveillance data in the elderly.
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Affiliation(s)
- Lisa Staadegaard
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Saverio Caini
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Sonam Wangchuk
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | - Binay Thapa
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | | | - Richard Njouom
- Service de Virologie, Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - Rodrigo A Fasce
- Subdepartamento Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Patricia Bustos
- Sección Virus Respiratorios, Subdepartamento Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile
| | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic.,Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Novakova
- National Reference Laboratory for Influenza and Other Respiratory Viruses, National Institute of Public Health, Prague, Czech Republic
| | - Alfredo Bruno Caicedo
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador.,Universidad Agraria del Ecuador, Guayaquil, Ecuador
| | - Domenica Joseth de Mora Coloma
- Instituto Nacional de Investigación en Salud Pública (INSPI), Centro de Referencia Nacional de Influenza y otros Virus Respiratorios, Guayaquil, Ecuador
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Sue Huang
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research Limited (ESR), National Centre for Biosecurity and Infectious Disease (NCBID), Upper Hutt, New Zealand
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | - Daria Danilenko
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russian Federation
| | - Kirill Stolyarov
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russian Federation
| | | | - Li Wei Ang
- Ministry of Health, Singapore.,National Centre for Infectious Diseases, Singapore
| | - Cheryl Cohen
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mai Quynh Le
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | | | | | | | - Michel Dückers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.,ARQ National Psychotrauma Centre, Diemen, the Netherlands.,Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - John Paget
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
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25
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De Salazar PM, Lu F, Hay JA, Gómez-Barroso D, Fernández-Navarro P, Martínez E, Astray-Mochales J, Amillategui R, García-Fulgueiras A, Chirlaque MD, Sánchez-Migallón A, Larrauri A, Sierra MJ, Lipsitch M, Simón F, Santillana M, Hernán MA. Near real-time surveillance of the SARS-CoV-2 epidemic with incomplete data. medRxiv 2021:2021.01.25.20230094. [PMID: 33532788 PMCID: PMC7852239 DOI: 10.1101/2021.01.25.20230094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Designing public health responses to outbreaks requires close monitoring of population-level health indicators in real-time. Thus, an accurate estimation of the epidemic curve is critical. We propose an approach to reconstruct epidemic curves in near real time. We apply this approach to characterize the early SARS-CoV-2 outbreak in two Spanish regions between March and April 2020. We address two data collection problems that affected the reliability of the available real-time epidemiological data, namely, the frequent missing information documenting when a patient first experienced symptoms, and the frequent retrospective revision of historical information (including right censoring). This is done by using a novel back-calculating procedure based on imputing patients' dates of symptom onset from reported cases, according to a dynamically-estimated "backward" reporting delay conditional distribution, and adjusting for right censoring using an existing package, NobBS , to estimate in real time (nowcast) cases by date of symptom onset. This process allows us to obtain an approximation of the time-varying reproduction number ( R t ) in real-time. At each step, we evaluate how different assumptions affect the recovered epidemiological events and compare the proposed approach to the alternative procedure of merely using curves of case counts, by report day, to characterize the time-evolution of the outbreak. Finally, we assess how these real-time estimates compare with subsequently documented epidemiological information that is considered more reliable and complete that became available later in time. Our approach may help improve accuracy, quantify uncertainty, and evaluate frequently unstated assumptions when recovering the epidemic curves from limited data obtained from public health surveillance systems in other locations.
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Affiliation(s)
- PM De Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - F Lu
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
| | - JA Hay
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - D Gómez-Barroso
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
| | - P Fernández-Navarro
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
| | - E Martínez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - J Astray-Mochales
- Directorate-General for Public Health, Madrid General Health Authority, Spain
| | - R Amillategui
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - A García-Fulgueiras
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - MD Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Sánchez-Migallón
- Directorate-General for Public Health, Madrid General Health Authority, Spain
| | - A Larrauri
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - MJ Sierra
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - M Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - F Simón
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - M Santillana
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, United States
| | - MA Hernán
- Department of Epidemiology and Department of Biostatistics, Harvard T.H. Chan School of Public Health; Harvard-MIT Division of Health Sciences and Technology, Boston, United States
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26
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Nørgaard SK, Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braye T, Athanasiadou M, Lytras T, Denissov G, Veideman T, Luomala O, Möttönen T, Fouillet A, Caserio-Schönemann C, An der Heiden M, Uphoff H, Gkolfinopoulou K, Bobvos J, Paldy A, Rotem N, Kornilenko I, Domegan L, O'Donnell J, Donato FD, Scortichini M, Hoffmann P, Velez T, England K, Calleja N, van Asten L, Stoeldraijer L, White RA, Paulsen TH, da Silva SP, Rodrigues AP, Klepac P, Zaletel M, Fafangel M, Larrauri A, León I, Farah A, Galanis I, Junker C, Perisa D, Sinnathamby M, Andrews N, O'Doherty MG, Irwin D, Kennedy S, McMenamin J, Adlhoch C, Bundle N, Penttinen P, Pukkila J, Pebody R, Krause TG, Mølbak K. Real-time monitoring shows substantial excess all-cause mortality during second wave of COVID-19 in Europe, October to December 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 33446304 PMCID: PMC7809719 DOI: 10.2807/1560-7917.es.2021.26.1.2002023] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The European monitoring of excess mortality for public health action (EuroMOMO) network monitors weekly excess all-cause mortality in 27 European countries or subnational areas. During the first wave of the coronavirus disease (COVID-19) pandemic in Europe in spring 2020, several countries experienced extraordinarily high levels of excess mortality. Europe is currently seeing another upsurge in COVID-19 cases, and EuroMOMO is again witnessing a substantial excess all-cause mortality attributable to COVID-19.
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Affiliation(s)
| | | | - Jens Nielsen
- EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
| | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | | | - Oskari Luomala
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Möttönen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | | | | | - Helmut Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | | | - Janos Bobvos
- National Public Health Center, Budapest, Hungary
| | - Anna Paldy
- National Public Health Center, Budapest, Hungary
| | - Naama Rotem
- Health & Vital Statistics Sector, Central Bureau of Statistics, Jerusalem, Israel
| | - Irene Kornilenko
- Health & Vital Statistics Sector, Central Bureau of Statistics, Jerusalem, Israel
| | - Lisa Domegan
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Patrick Hoffmann
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | - Telma Velez
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | | | - Neville Calleja
- Directorate for Health Information and Research, Pieta, Malta
| | - Liselotte van Asten
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | | | | | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Petra Klepac
- National Institute of Public Health, Ljubljana, Slovenia
| | - Metka Zaletel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mario Fafangel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Inmaculada León
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Damir Perisa
- Federal Office of Public Health, Bern, Switzerland
| | - Mary Sinnathamby
- Public Health England, Colindale, United Kingdom of Great Britain and Northern Ireland
| | - Nick Andrews
- Public Health England, Colindale, United Kingdom of Great Britain and Northern Ireland
| | - Mark G O'Doherty
- Public Health Agency, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - David Irwin
- Public Health Agency, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Sharon Kennedy
- Public Health Scotland, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Jim McMenamin
- Public Health Scotland, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jukka Pukkila
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Tyra G Krause
- EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
| | - Kåre Mølbak
- Department of Veterinary and Animal Science, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
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27
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Delgado-Sanz C, Mazagatos-Ateca C, Oliva J, Gherasim A, Larrauri A. Illness Severity in Hospitalized Influenza Patients by Virus Type and Subtype, Spain, 2010-2017. Emerg Infect Dis 2021; 26:220-228. [PMID: 31961295 PMCID: PMC6986827 DOI: 10.3201/eid2602.181732] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Influenza A(H1N1)pdm09 caused more hospitalizations, intensive care unit admissions, and deaths than influenza A(H3N2) or B. We conducted a retrospective cohort study to assess the effect of influenza virus type and subtype on disease severity among hospitalized influenza patients in Spain. We analyzed the cases of 8,985 laboratory-confirmed case-patients hospitalized for severe influenza by using data from a national surveillance system for the period 2010–2017. Hospitalized patients with influenza A(H1N1)pdm09 virus were significantly younger, more frequently had class III obesity, and had a higher risk for pneumonia or acute respiratory distress syndrome than patients infected with influenza A(H3N2) or B (p<0.05). Hospitalized patients with influenza A(H1N1)pdm09 also had a higher risk for intensive care unit admission, death, or both than patients with influenza A(H3N2) or B, independent of other factors. Determining the patterns of influenza-associated severity and how they might differ by virus type and subtype can help guide planning and implementation of adequate control and preventive measures during influenza epidemics.
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28
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Redondo-Bravo L, Delgado-Sanz C, Oliva J, Vega T, Lozano J, Larrauri A, The Spanish Influenza Sentinel Surveillance System. Transmissibility of influenza during the 21st-century epidemics, Spain, influenza seasons 2001/02 to 2017/18. ACTA ACUST UNITED AC 2020; 25. [PMID: 32489178 PMCID: PMC7268270 DOI: 10.2807/1560-7917.es.2020.25.21.1900364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundUnderstanding influenza seasonality is necessary for determining policies for influenza control.AimWe characterised transmissibility during seasonal influenza epidemics, including one influenza pandemic, in Spain during the 21th century by using the moving epidemic method (MEM) to calculate intensity levels and estimate differences across seasons and age groups.MethodsWe applied the MEM to Spanish Influenza Sentinel Surveillance System data from influenza seasons 2001/02 to 2017/18. A modified version of Goldstein's proxy was used as an epidemiological-virological parameter. We calculated the average starting week and peak, the length of the epidemic period and the length from the starting week to the peak of the epidemic, by age group and according to seasonal virus circulation.ResultsIndividuals under 15 years of age presented higher transmissibility, especially in the 2009 influenza A(H1N1) pandemic. Seasons with dominance/co-dominance of influenza A(H3N2) virus presented high intensities in older adults. The 2004/05 influenza season showed the highest influenza-intensity level for all age groups. In 12 seasons, the epidemic started between week 50 and week 3. Epidemics started earlier in individuals under 15 years of age (-1.8 weeks; 95% confidence interval (CI):-2.8 to -0.7) than in those over 64 years when influenza B virus circulated as dominant/co-dominant. The average time from start to peak was 4.3 weeks (95% CI: 3.6-5.0) and the average epidemic length was 8.7 weeks (95% CI: 7.9-9.6).ConclusionsThese findings provide evidence for intensity differences across seasons and age groups, and can be used guide public health actions to diminish influenza-related morbidity and mortality.
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Affiliation(s)
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús Oliva
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Tomás Vega
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - Jose Lozano
- Public Health Directorate, Castilla y León Regional Health Ministry, Valladolid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
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29
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Brugueras S, Fernández-Martínez B, Martínez-de la Puente J, Figuerola J, Porro TM, Rius C, Larrauri A, Gómez-Barroso D. Environmental drivers, climate change and emergent diseases transmitted by mosquitoes and their vectors in southern Europe: A systematic review. Environ Res 2020; 191:110038. [PMID: 32810503 DOI: 10.1016/j.envres.2020.110038] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/02/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
Mosquito borne diseases are a group of infections that affect humans. Emerging or reemerging diseases are those that (re)occur in regions, groups or hosts that were previously free from these diseases: dengue virus; chikungunya virus; Zika virus; West Nile fever and malaria. In Europe, these infections are mostly imported; however, due to the presence of competent mosquitoes and the number of trips both to and from endemic areas, these pathogens are potentially emergent or re-emergent. Present and future climatic conditions, as well as meteorological, environmental and demographic aspects are risk factors for the distribution of different vectors and/or diseases. This review aimed to identify and analyze the existing literature on the transmission of mosquito borne diseases and those factors potentially affecting their transmission risk of them in six southern European countries with similar environmental conditions: Croatia, France, Greece, Italy, Portugal and Spain. In addition, we would identify those factors potentially affecting the (re)introduction or spread of mosquito vectors. This task has been undertaken with a focus on the environmental and climatic factors, including the effects of climate change. We undertook a systematic review of the vectors, diseases and their associations with climactic and environmental factors in European countries of the Mediterranean region. We followed the PRISMA guidelines and used explicit and systematic methods to identify, select and critically evaluate the studies which were relevant to the topic. We identified 1302 articles in the first search of the databases. Of those, 160 were selected for full-text review. The final data set included 61 articles published between 2000 and 2017.39.3% of the papers were related with dengue, chikungunya and Zika virus or their vectors. Temperature, precipitation and population density were key factors among others. 32.8% studied West Nile virus and its vectors, being temperature, precipitation and NDVI the most frequently used variables. Malaria have been studied in 23% of the articles, with temperature, precipitation and presence of water indexes as the most used variables. The number of publications focused on mosquito borne diseases is increasing in recent years, reflecting the increased interest in that diseases in southern European countries. Climatic and environmental variables are key factors on mosquitoes' distribution and to show the risk of emergence and/or spread of emergent diseases and to study the spatial changes in that distributions.
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Affiliation(s)
- Silvia Brugueras
- Agencia de Salud Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain
| | - Beatriz Fernández-Martínez
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Calle Monforte de Lemos 5, 28029, Madrid, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain
| | - Josué Martínez-de la Puente
- Estación Biológica de Doñana (EBD-CSIC), Calle Américo Vespucio, 26, E-41092, Sevilla, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain
| | - Jordi Figuerola
- Estación Biológica de Doñana (EBD-CSIC), Calle Américo Vespucio, 26, E-41092, Sevilla, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain
| | - Tomas Montalvo Porro
- Agencia de Salud Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain
| | - Cristina Rius
- Agencia de Salud Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain
| | - Amparo Larrauri
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Calle Monforte de Lemos 5, 28029, Madrid, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain
| | - Diana Gómez-Barroso
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Calle Monforte de Lemos 5, 28029, Madrid, Spain; CIBER de Epidemiología y Salud Pública, Calle Monforte de Lemos 5, 28029, Madrid, Spain.
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30
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Pastor-Barriuso R, Pérez-Gómez B, Hernán MA, Pérez-Olmeda M, Yotti R, Oteo-Iglesias J, Sanmartín JL, León-Gómez I, Fernández-García A, Fernández-Navarro P, Cruz I, Martín M, Delgado-Sanz C, Fernández de Larrea N, León Paniagua J, Muñoz-Montalvo JF, Blanco F, Larrauri A, Pollán M. Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study. BMJ 2020; 371:m4509. [PMID: 33246972 PMCID: PMC7690290 DOI: 10.1136/bmj.m4509] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To estimate the infection fatality risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on deaths with confirmed coronavirus disease 2019 (covid-19) and excess deaths from all causes. DESIGN Nationwide seroepidemiological study. SETTING First wave of covid-19 pandemic in Spain. PARTICIPANTS Community dwelling individuals of all ages. MAIN OUTCOME MEASURES The main outcome measure was overall, and age and sex specific, infection fatality risk for SARS-CoV-2 (the number of covid-19 deaths and excess deaths divided by the estimated number of SARS-CoV-2 infections) in the community dwelling Spanish population. Deaths with laboratory confirmed covid-19 were obtained from the National Epidemiological Surveillance Network (RENAVE) and excess all cause deaths from the Monitoring Mortality System (MoMo), up to 15 July 2020. SARS-CoV-2 infections in Spain were derived from the estimated seroprevalence by a chemiluminescent microparticle immunoassay for IgG antibodies in 61 098 participants in the ENE-COVID nationwide seroepidemiological survey between 27 April and 22 June 2020. RESULTS The overall infection fatality risk was 0.8% (19 228 of 2.3 million infected individuals, 95% confidence interval 0.8% to 0.9%) for confirmed covid-19 deaths and 1.1% (24 778 of 2.3 million infected individuals, 1.0% to 1.2%) for excess deaths. The infection fatality risk was 1.1% (95% confidence interval 1.0% to 1.2%) to 1.4% (1.3% to 1.5%) in men and 0.6% (0.5% to 0.6%) to 0.8% (0.7% to 0.8%) in women. The infection fatality risk increased sharply after age 50, ranging from 11.6% (8.1% to 16.5%) to 16.4% (11.4% to 23.2%) in men aged 80 or more and from 4.6% (3.4% to 6.3%) to 6.5% (4.7% to 8.8%) in women aged 80 or more. CONCLUSION The increase in SARS-CoV-2 infection fatality risk after age 50 appeared to be more noticeable in men than in women. Based on the results of this study, fatality from covid-19 was greater than that reported for other common respiratory diseases, such as seasonal influenza.
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Affiliation(s)
- Roberto Pastor-Barriuso
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint first authors
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint first authors
| | - Miguel A Hernán
- Departments of Epidemiology and Biostatistics, Harvard TH Chan School of Public Health; Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
| | - Mayte Pérez-Olmeda
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Jesús Oteo-Iglesias
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
- Spanish Network for Research in Infectious Diseases (REIPI), Institute of Health Carlos III, Madrid, Spain
| | | | - Inmaculada León-Gómez
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Aurora Fernández-García
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Pablo Fernández-Navarro
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Israel Cruz
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | | | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Nerea Fernández de Larrea
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | | | - Amparo Larrauri
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint senior authors
| | - Marina Pollán
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint senior authors
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De Salazar P, Gómez-Barroso D, Pampaka D, Gil J, Peñalver B, Fernández-Escobar C, Lipsitch M, Larrauri A, Goldstein E, Hernán M. Lockdown measures and relative changes in the age-specific incidence of SARS-CoV-2 in Spain. Epidemiol Infect 2020; 148:e268. [PMID: 33081851 PMCID: PMC7674783 DOI: 10.1017/s0950268820002551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 01/05/2023] Open
Abstract
During the first months of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) epidemic in 2020, Spain implemented an initial lockdown period on 15 March followed by a strengthened lockdown period on 30 March when only essential workers continued to commute to work. However, little is known about the epidemic dynamics in different age groups during these periods.We used the daily number of coronavirus 2019 cases (by date of symptom onset) reported to the National Epidemiological Surveillance Network among individuals aged 15-19 years through 65-69 years. For each age group g, we computed the proportion PrE(g) of individuals in age group g among all reported cases aged 15-69 years during the pre-lockdown period (1-10 March 2020) and the corresponding proportion PrL(g) during two lockdown periods (initial: 25 March-3 April; strengthened: 8-17 April 2020). For each lockdown period, we computed the proportion ratios PR(g) = PrL(g)/PrE(g). For each pair of age groups g1, g2, PR(g1)>PR(g2) implies a relative increase in the incidence of detected SARS-CoV-2 infection in the age group g1 compared with g2 for the lockdown period vs. the pre-lockdown period.For the initial lockdown period, the highest PR values were in age groups 50-54 years (PR = 1.21; 95% CI: 1.12,1.30) and 55-59 years (PR = 1.19; 1.11,1.27). For the second lockdown period, the highest PR values were in age groups 15-19 years (PR = 1.26; 0.95,1.68) and 50-54 years (PR = 1.20; 1.09,1.31).Our results suggest that different outbreak control measures led to different changes in the relative incidence by age group. During the initial lockdown period, when non-essential work was allowed, individuals aged 40-64 years, particularly those aged 50-59 years, had a higher relative incidence compared with the pre-lockdown period. Younger adults/older adolescents had an increased relative incidence during the later, strengthened lockdown. The role of different age groups during the epidemic should be considered when implementing future mitigation efforts.
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Affiliation(s)
- P.M. De Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D. Gómez-Barroso
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - D. Pampaka
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - J.M. Gil
- Department of Anesthesiology, Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - B. Peñalver
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | - M. Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - A. Larrauri
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - E. Goldstein
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M.A. Hernán
- Department of Epidemiology and Department of Biostatistics, Harvard T.H. Chan School of Public Health; Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
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Machado A, Mazagatos C, Dijkstra F, Kislaya I, Gherasim A, McDonald SA, Kissling E, Valenciano M, Meijer A, Hooiveld M, Nunes B, Larrauri A. Impact of influenza vaccination programmes among the elderly population on primary care, Portugal, Spain and the Netherlands: 2015/16 to 2017/18 influenza seasons. ACTA ACUST UNITED AC 2020; 24. [PMID: 31718740 PMCID: PMC6852314 DOI: 10.2807/1560-7917.es.2019.24.45.1900268] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background To increase the acceptability of influenza vaccine, it is important to quantify the overall benefits of the vaccination programme. Aim To assess the impact of influenza vaccination in Portugal, Spain and the Netherlands, we estimated the number of medically attended influenza-confirmed cases (MAICC) in primary care averted in the seasons 2015/16 to 2017/18 among those ≥ 65 years. Methods We used an ecological approach to estimate vaccination impact. We compared the number of observed MAICC (n) to the estimated number that would have occurred without the vaccination programme (N). To estimate N, we used: (i) MAICC estimated from influenza surveillance systems, (ii) vaccine coverage, (iii) pooled (sub)type-specific influenza vaccine effectiveness estimates for seasons 2015/16 to 2017/18, weighted by the proportion of virus circulation in each season and country. We estimated the number of MAICC averted (NAE) and the prevented fraction (PF) by the vaccination programme. Results The annual average of NAE in the population ≥ 65 years was 33, 58 and 204 MAICC per 100,000 in Portugal, Spain and the Netherlands, respectively. On average, influenza vaccination prevented 10.7%, 10.9% and 14.2% of potential influenza MAICC each season in these countries. The lowest PF was in 2016/17 (4.9–6.1%) with an NAE ranging from 24 to 69 per 100,000. Conclusions Our results suggest that influenza vaccination programmes reduced a substantial number of MAICC. Together with studies on hospitalisations and deaths averted by influenza vaccination programmes, this will contribute to the evaluation of the impact of vaccination strategies and strengthen public health communication.
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Affiliation(s)
- Ausenda Machado
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,These authors contributed equally.,National Institute for Health Doutor Ricardo Jorge, Epidemiology department, Lisbon, Portugal
| | - Clara Mazagatos
- National Centre of Epidemiology, Carlos III Health Institute, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,These authors contributed equally
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,These authors contributed equally
| | - Irina Kislaya
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,National Institute for Health Doutor Ricardo Jorge, Epidemiology department, Lisbon, Portugal
| | - Alin Gherasim
- National Centre of Epidemiology, Carlos III Health Institute, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Scott A McDonald
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mariëtte Hooiveld
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Baltazar Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,National Institute for Health Doutor Ricardo Jorge, Epidemiology department, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, Carlos III Health Institute, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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33
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Kissling E, Pozo F, Buda S, Vilcu AM, Gherasim A, Brytting M, Domegan L, Gómez V, Meijer A, Lazar M, Vučina VV, Dürrwald R, van der Werf S, Larrauri A, Enkirch T, O'Donnell J, Guiomar R, Hooiveld M, Petrović G, Stoian E, Penttinen P, Valenciano M. Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15-64-year-olds in Europe: exploration by birth cohort. ACTA ACUST UNITED AC 2020; 24. [PMID: 31796152 PMCID: PMC6891946 DOI: 10.2807/1560-7917.es.2019.24.48.1900604] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE). Aim The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort. Methods We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0–14, 15–64, ≥ 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32–54-year-olds (1964–86) sharing potential childhood imprinting to serine at haemagglutinin position 159. Results Influenza A(H3N2) VE among all ages was −1% (95% confidence interval (CI): −24 to 18) and 46% (95% CI: 8–68), −26% (95% CI: −66 to 4) and 20% (95% CI: −20 to 46) among 0–14, 15–64 and ≥ 65-year-olds, respectively. Among 15–64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: −34 to 50) and −74% (95% CI: −259 to 16), respectively. VE was −18% (95% CI: −140 to 41), −53% (95% CI: −131 to −2) and −12% (95% CI: −74 to 28) among 15–31-year-olds (1987–2003), 32–54-year-olds (1964–86) and 55–64-year-olds (1954–63), respectively. Discussion The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964–86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15–64-year-olds and the public health impact of the I-REV hypothesis warrant further study.
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Affiliation(s)
| | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
| | - Silke Buda
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Alin Gherasim
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Health Service Executive- Health Protection Surveillance Centre, Dublin, Ireland
| | - Verónica Gómez
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Vesna Višekruna Vučina
- Croatian Institute of Public Health, Division for epidemiology of communicable diseases, Zagreb, Croatia
| | - Ralf Dürrwald
- Robert Koch Institute, National Reference Center for Influenza, Germany
| | - Sylvie van der Werf
- CNR des virus des infections respiratoires, WHO National Influenza Center, Institut Pasteur, Paris, France.,Unité de Génétique Moléculaire des Virus à ARN, Institut Pasteur, CNRS UMR3569, Université Paris Diderot SPC, France
| | - Amparo Larrauri
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain
| | | | - Joan O'Donnell
- Health Service Executive- Health Protection Surveillance Centre, Dublin, Ireland
| | - Raquel Guiomar
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Goranka Petrović
- Croatian Institute of Public Health, Division for epidemiology of communicable diseases, Zagreb, Croatia
| | - Elena Stoian
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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- The I-MOVE primary care study team members are listed at the end of the article
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34
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Mazagatos C, Godoy P, Muñoz Almagro C, Pozo F, Larrauri A. Effectiveness of influenza vaccination during pregnancy to prevent severe infection in children under 6 months of age, Spain, 2017-2019. Vaccine 2020; 38:8405-8410. [PMID: 32741669 DOI: 10.1016/j.vaccine.2020.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/14/2020] [Accepted: 07/09/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Influenza vaccination is recommended to pregnant women in Spain to reduce the risk of influenza-related complications. Influenza related hospitalizations pose a significant disease burden in children every year. Although children below 6 months are too young to be vaccinated, they can receive protection against influenza through vaccination of their mothers during pregnancy. We estimated the effectiveness of maternal influenza vaccination to prevent influenza hospitalizations in infants under 6 months of age. METHODS This is a retrospective pilot study, using data from the Severe Hospitalized Confirmed Influenza Cases (SHCIC) surveillance system in seasons 2017/18 and 2018/19 in Spain. Maternal vaccination status during pregnancy was collected for cases in children 6 months and younger hospitalized with confirmed influenza infection. Influenza vaccine effectiveness was estimated using the screening method, by comparing the proportion of children with vaccinated mothers during pregnancy (proportion of cases vaccinated, PCV), with the vaccination coverage among pregnant women in Spain (proportion of population vaccinated, PPV). RESULTS For all the study period, the PCV was 17% and the PPV was 35%. Influenza vaccination in mothers during pregnancy prevented influenza confirmed hospitalizations in infants aged 6 months and younger with a 61% (95%CI: 27-79%) effectiveness. CONCLUSIONS In line with evidence from other countries, influenza vaccination during pregnancy protects infants up to 6 months of age from influenza hospitalizations in Spain. These results support current recommendations of influenza vaccination in pregnant women, and more studies are needed in Spain to confirm the double protection of maternal vaccination in mothers and infants.
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Affiliation(s)
- Clara Mazagatos
- Dirección General de Salud Pública y Ordenación Farmacéutica, Consejería de Salud, Andalucía, Spain; Servicio de Epidemiología y Prevención, Dirección General de Salud Pública, Servicio Canario de la Salud, Canarias, Spain
| | - Pere Godoy
- Servicio de Vigilancia y Salud, Consejería de Salud, Andalucía, Spain; Servicio de Epidemiología y Prevención, Dirección General de Salud Pública, Servicio Canario de la Salud, Canarias, Spain
| | - Carmen Muñoz Almagro
- Dirección General de Salud Pública, Aragón, Spain; Servicio de Vigilancia Epidemiológica, Dirección General de Salud Pública, Consejería de Sanidad, Asturias, Spain; Servicio de Epidemiología y Prevención, Dirección General de Salud Pública, Servicio Canario de la Salud, Canarias, Spain
| | - Francisco Pozo
- Servicio de Epidemiología, Dirección General de Salud Pública y Participación, Baleares, Spain; Servicio de Epidemiología y Prevención, Dirección General de Salud Pública, Servicio Canario de la Salud, Canarias, Spain
| | - A Larrauri
- Dirección General de Salud Pública y Ordenación Farmacéutica, Consejería de Salud, Andalucía, Spain; Servicio de Epidemiología y Prevención, Dirección General de Salud Pública, Servicio Canario de la Salud, Canarias, Spain.
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Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braeye T, Denissov G, Veideman T, Luomala O, Möttönen T, Fouillet A, Caserio-Schönemann C, An der Heiden M, Uphoff H, Lytras T, Gkolfinopoulou K, Paldy A, Domegan L, O'Donnell J, De' Donato F, Noccioli F, Hoffmann P, Velez T, England K, van Asten L, White RA, Tønnessen R, da Silva SP, Rodrigues AP, Larrauri A, Delgado-Sanz C, Farah A, Galanis I, Junker C, Perisa D, Sinnathamby M, Andrews N, O'Doherty M, Marquess DF, Kennedy S, Olsen SJ, Pebody R, Krause TG, Mølbak K. Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32643601 PMCID: PMC7346364 DOI: 10.2807/1560-7917.es.2020.25.26.2001214] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A remarkable excess mortality has coincided with the COVID-19 pandemic in Europe. We present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March–April 2020. Excess mortality particularly affected ≥ 65 year olds (91% of all excess deaths), but also 45–64 (8%) and 15–44 year olds (1%). No excess mortality was observed in 0–14 year olds.
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Affiliation(s)
| | | | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | | | - Oskari Luomala
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Möttönen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | | | | | - Helmut Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | | | | | - Anna Paldy
- National Public Health Institute, Budapest, Hungary
| | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Patrick Hoffmann
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Telma Velez
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Kathleen England
- Directorate for Health Information and Research, Ministry for Health, Malta
| | - Liselotte van Asten
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | | | | | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Damir Perisa
- Federal Office of Public Health, Bern, Switzerland
| | | | - Nick Andrews
- Public Health England, Colindale, United Kingdom
| | | | | | | | - Sonja J Olsen
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | -
- The members of the ECDC Public Health Emergency Team for COVID-19 are listed below
| | | | - Kåre Mølbak
- Department of Veterinary and Animal Science, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Statens Serum Institut, Copenhagen, Denmark
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Singh DE, Marinescu MC, Carretero J, Delgado-Sanz C, Gomez-Barroso D, Larrauri A. Evaluating the impact of the weather conditions on the influenza propagation. BMC Infect Dis 2020; 20:265. [PMID: 32248792 PMCID: PMC7132999 DOI: 10.1186/s12879-020-04977-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 03/17/2020] [Indexed: 11/10/2022] Open
Abstract
Background Predicting the details of how an epidemic evolves is highly valuable as health institutions need to better plan towards limiting the infection propagation effects and optimizing their prediction and response capabilities. Simulation is a cost- and time-effective way of predicting the evolution of the infection as the joint influence of many different factors: interaction patterns, personal characteristics, travel patterns, meteorological conditions, previous vaccination, etc. The work presented in this paper extends EpiGraph, our influenza epidemic simulator, by introducing a meteorological model as a modular component that interacts with the rest of EpiGraph’s modules to refine our previous simulation results. Our goal is to estimate the effects of changes in temperature and relative humidity on the patterns of epidemic influenza based on data provided by the Spanish Influenza Sentinel Surveillance System (SISSS) and the Spanish Meteorological Agency (AEMET). Methods Our meteorological model is based on the regression model developed by AB and JS, and it is tuned with influenza surveillance data obtained from SISSS. After pre-processing this data to clean it and reconstruct missing samples, we obtain new values for the reproduction number of each urban region in Spain, every 10 minutes during 2011. We simulate the propagation of the influenza by setting the date of the epidemic onset and the initial influenza-illness rates for each urban region. Results We show that the simulation results have the same propagation shape as the weekly influenza rates as recorded by SISSS. We perform experiments for a realistic scenario based on actual meteorological data from 2010-2011, and for synthetic values assumed under simplified predicted climate change conditions. Results show that a diminishing relative humidity of 10% produces an increment of about 1.6% in the final infection rate. The effect of temperature changes on the infection spread is also noticeable, with a decrease of 1.1% per extra degree.Conclusions: Using a tool like ours could help predict the shape of developing epidemics and its peaks, and would permit to quickly run scenarios to determine the evolution of the epidemic under different conditions. We make EpiGraph source code and epidemic data publicly available.
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Affiliation(s)
| | | | | | - Concepcion Delgado-Sanz
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Diana Gomez-Barroso
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Amparo Larrauri
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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Rose A, Kissling E, Emborg HD, Larrauri A, McMenamin J, Pozo F, Trebbien R, Mazagatos C, Whitaker H, Valenciano M. Interim 2019/20 influenza vaccine effectiveness: six European studies, September 2019 to January 2020. Euro Surveill 2020; 25:2000153. [PMID: 32183932 PMCID: PMC7078828 DOI: 10.2807/1560-7917.es.2020.25.10.2000153] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BackgroundInfluenza A(H1N1)pdm09, A(H3N2) and B viruses were co-circulating in Europe between September 2019 and January 2020.AimTo provide interim 2019/20 influenza vaccine effectiveness (VE) estimates from six European studies, covering 10 countries and both primary care and hospital settings.MethodsAll studies used the test-negative design, although there were some differences in other study characteristics, e.g. patient selection, data sources, 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 31,537 patients recruited across the six studies, of which 5,300 (17%) were cases with 5,310 infections. Most of these (4,466; 84%) were influenza A. The VE point estimates for all ages were 29% to 61% against any influenza in the primary care setting and 35% to 60% in hospitalised older adults (aged 65 years and over). The VE point estimates against A(H1N1)pdm09 (all ages, both settings) was 48% to 75%, and against A(H3N2) ranged from -58% to 57% (primary care) and -16% to 60% (hospital). Against influenza B, VE for all ages was 62% to 83% (primary care only).ConclusionsInfluenza vaccination is of continued benefit during the ongoing 2019/20 influenza season. Robust end-of-season VE estimates and genetic virus characterisation results may help understand the variability in influenza (sub)type-specific results across studies.
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Affiliation(s)
- Angela Rose
- Epiconcept, Paris, France,Authors contributed equally to the study and manuscript writing
| | - Esther Kissling
- Epiconcept, Paris, France,Authors contributed equally to the study and manuscript writing
| | - Hanne-Dorthe Emborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - 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
| | | | - 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
| | - Ramona Trebbien
- Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Copenhagen, Denmark
| | - Clara Mazagatos
- National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | - European IVE group
- European Influenza Vaccine Effectiveness (IVE) group members are listed at the end of the article
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38
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Spiteri G, Fielding J, Diercke M, Campese C, Enouf V, Gaymard A, Bella A, Sognamiglio P, Sierra Moros MJ, Riutort AN, Demina YV, Mahieu R, Broas M, Bengnér M, Buda S, Schilling J, Filleul L, Lepoutre A, Saura C, Mailles A, Levy-Bruhl D, Coignard B, Bernard-Stoecklin S, Behillil S, van der Werf S, Valette M, Lina B, Riccardo F, Nicastri E, Casas I, Larrauri A, Salom Castell M, Pozo F, Maksyutov RA, Martin C, Van Ranst M, Bossuyt N, Siira L, Sane J, Tegmark-Wisell K, Palmérus M, Broberg EK, Beauté J, Jorgensen P, Bundle N, Pereyaslov D, Adlhoch C, Pukkila J, Pebody R, Olsen S, Ciancio BC. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill 2020; 25:2000178. [PMID: 32156327 PMCID: PMC7068164 DOI: 10.2807/1560-7917.es.2020.25.9.2000178] [Citation(s) in RCA: 354] [Impact Index Per Article: 88.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/05/2020] [Indexed: 12/14/2022] Open
Abstract
In the WHO European Region, COVID-19 surveillance was implemented 27 January 2020. We detail the first European cases. As at 21 February, nine European countries reported 47 cases. Among 38 cases studied, 21 were linked to two clusters in Germany and France, 14 were infected in China. Median case age was 42 years; 25 were male. Late detection of the clusters' index cases delayed isolation of further local cases. As at 5 March, there were 4,250 cases.
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Affiliation(s)
| | - James Fielding
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | | | - Christine Campese
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Vincent Enouf
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Alexandre Gaymard
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | | | - Paola Sognamiglio
- Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Maria José Sierra Moros
- Coordination Centre for Health Alerts and Emergencies. Spanish Ministry of Health, Madrid, Spain
| | | | - Yulia V Demina
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor), Moscow, Russia
| | - Romain Mahieu
- Department of Infectious Disease Prevention and Control, Common Community Commission, Brussels-Capital Region, Brussels, Belgium
| | - Markku Broas
- Chief Physician, Infection control unit, Lapland Hospital District, Rovaniemi, Finland
| | - Malin Bengnér
- County Medical Officer, Jönköping Region, Jönköping, Sweden
| | | | | | - Laurent Filleul
- Santé publique France - Direction des régions, Cellule régionale Nouvelle Aquitaine, Bordeaux, France
| | - Agnès Lepoutre
- Santé publique France - Direction des régions, Cellule régionale Ile-de-France, Paris, France
| | - Christine Saura
- Santé publique France - Direction des régions, Cellule régionale Auvergne-Rhône-Alpes, Lyon, France
| | - Alexandra Mailles
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Daniel Levy-Bruhl
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | - Bruno Coignard
- Santé Publique France - Direction des maladies infectieuses, Saint-Maurice, France
| | | | - Sylvie Behillil
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Sylvie van der Werf
- Centre national de référence Virus des infections respiratoires, dont la grippe, Institut Pasteur, Paris, France
| | - Martine Valette
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | - Bruno Lina
- Centre national de référence Virus des infections respiratoires, dont la grippe, Hospices civils de Lyon, Lyon, France
| | | | - Emanuele Nicastri
- Istituto Nazionale Malattie Infettive Lazzaro Spallanzani, Rome, Italy
| | - Inmaculada Casas
- National Centre for Microbiology, WHO-National Influenza Centre, Institute of Health Carlos III. Madrid, Spain
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III. Madrid, Spain
| | | | - Francisco Pozo
- National Centre for Microbiology, WHO-National Influenza Centre, Institute of Health Carlos III. Madrid, Spain
| | - Rinat A Maksyutov
- State Research Center of Virology and Biotechnology "Vector", Rospotrebnadzor, Moscow, Russia
| | | | - Marc Van Ranst
- Laboratory of Clinical Virology, Department of Microbiology and Immunology, Rega Institute, KU Leuven - University of Leuven, Leuven, Belgium
| | - Nathalie Bossuyt
- Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | - Lotta Siira
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Jussi Sane
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | - Eeva K Broberg
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Julien Beauté
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Pernille Jorgensen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Dmitriy Pereyaslov
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jukka Pukkila
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Sonja Olsen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
- These authors have contributed equally to the manuscript
| | - Bruno Christian Ciancio
- European Centre for Disease Prevention and Control, Stockholm, Sweden
- These authors have contributed equally to the manuscript
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39
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Machado A, Santos AJ, Kislaya I, Larrauri A, Nunes B. Understanding influenza vaccination among Portuguese elderly: the social ecological framework. Health Promot Int 2020; 35:1427-1440. [DOI: 10.1093/heapro/daaa011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
This study intended to identify and quantify the social ecological model (SEM) levels associated to seasonal IV uptake in the Portuguese elderly population. Data from the 2014 National Health Survey was restricted to individuals aged 65+ years (n = 5669). Twenty-three independent variables were allocated to the SEM levels: individual, interpersonal, organizational, community and policy. Sex stratified and age adjusted analysis using Poisson regression were performed for each level and for a fitted full model. Relative reduction in pseudo R magnitude measured marginal contribution of each level. For men and women, older groups (85+ vs. 65–69; men, PR = 1.59 and women, PR = 1.56); having 3+ chronic conditions (men, PR = 1.39 and women, PR = 1.35); previous 4 weeks GP and outpatient visits were associated to higher IV uptake. For men, only 2 SEM levels were associated (individual and organizational) while for women the community level was also relevant. Main marginal contribution came from individual (17.9% and 16.3%) and organizational (30.7% and 22.7%) levels. This study highlights the importance of individual characteristics, access and use of health care services for the IV uptake and the sex differential behaviour.
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Affiliation(s)
- Ausenda Machado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ana João Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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40
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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: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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41
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Machado A, Kislaya I, Larrauri A, Matias Dias C, Nunes B. Impact of national influenza vaccination strategy in severe influenza outcomes among the high-risk Portuguese population. BMC Public Health 2019; 19:1690. [PMID: 31842831 PMCID: PMC6916191 DOI: 10.1186/s12889-019-7958-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/18/2019] [Indexed: 01/07/2023] Open
Abstract
Background All aged individuals with a chronic condition and those with 65 and more years are at increased risk of severe influenza post-infection complications. There is limited research on cases averted by the yearly vaccination programs in high-risk individuals. The objective was to estimate the impact of trivalent seasonal influenza vaccination on averted hospitalizations and death among the high-risk population in Portugal. Methods The impact of trivalent seasonal influenza vaccination was estimated using vaccine coverage, vaccine effectiveness and the number of influenza-related hospitalizations and deaths. The number of averted events (NAE), prevented fraction (PF) and number needed to vaccinate (NVN) were estimated for seasons 2014/15 to 2016/17. Results The vaccination strategy averted on average approximately 1833 hospitalizations and 383 deaths per season. Highest NAE was observed in the ≥65 years population (85% of hospitalizations and 95% deaths) and in the 2016/17 season (1957 hospitalizations and 439 deaths). On average, seasonal vaccination prevented 21% of hospitalizations in the population aged 65 and more, and 18.5% in the population with chronic conditions. The vaccination also prevented 29% and 19.5% of deaths in each group of the high-risk population. It would be needed to vaccinate 3360 high-risk individuals, to prevent one hospitalization and 60,471 high-risk individuals to prevent one death. Conclusion The yearly influenza vaccination campaigns had a sustained positive benefit for the high-risk population, reducing hospitalizations and deaths. These results can support public health plans toward increased vaccine coverage in high-risk groups.
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Affiliation(s)
- Ausenda Machado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016, Lisbon, Portugal. .,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016, Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016, Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016, Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
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42
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Adlhoch C, Gomes Dias J, Bonmarin I, Hubert B, Larrauri A, Oliva Domínguez JA, Delgado-Sanz C, Brytting M, Carnahan A, Popovici O, Lupulescu E, O'Donnell J, Domegan L, Van Gageldonk-Lafeber AB, Meijer A, Kynčl J, Slezák P, Guiomar R, Orta Gomes CM, Popow-Kraupp T, Mikas J, Staroňová E, Melillo JM, Melillo T, Ikonen N, Lyytikäinen O, Snacken R, Penttinen P. Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017. Open Forum Infect Dis 2019; 6:ofz462. [PMID: 32258201 PMCID: PMC7105050 DOI: 10.1093/ofid/ofz462] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 10/23/2019] [Indexed: 01/13/2023] Open
Abstract
Background Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
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Affiliation(s)
- Cornelia Adlhoch
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Joana Gomes Dias
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | - Bruno Hubert
- Bruno Hubert, Santé Public France, Saint-Maurice Cedex, France
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús A Oliva Domínguez
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mia Brytting
- The Public Health Agency of Sweden, Solna, Sweden
| | | | - Odette Popovici
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Emilia Lupulescu
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Pavel Slezák
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge (National Institute of Health Dr. Ricardo Jorge), Lisboa, Portugal
| | - Carlos M Orta Gomes
- Department of Public Health of Regional Health Administration of Lisbon and Tagus Valley, Lisboa, Portugal
| | | | - Ján Mikas
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Edita Staroňová
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Jackie M Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Niina Ikonen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Outi Lyytikäinen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - René Snacken
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Pasi Penttinen
- Office of the Chief Scientist, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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Kissling E, Pozo F, Buda S, Vilcu AM, Rizzo C, Gherasim A, Horváth JK, Brytting M, Domegan L, Meijer A, Paradowska-Stankiewicz I, Machado A, Vučina VV, Lazar M, Johansen K, Dürrwald R, van der Werf S, Bella A, Larrauri A, Ferenczi A, Zakikhany K, O'Donnell J, Dijkstra F, Bogusz J, Guiomar R, Filipović SK, Pitigoi D, Penttinen P, Valenciano M. Effectiveness of influenza vaccine against influenza A in Europe in seasons of different A(H1N1)pdm09 and the same A(H3N2) vaccine components (2016-17 and 2017-18). Vaccine X 2019; 3:100042. [PMID: 31660536 PMCID: PMC6807025 DOI: 10.1016/j.jvacx.2019.100042] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 11/09/2022] Open
Abstract
Influenza A(H3N2) circulated in Europe in 2016–17 and 2017–18 and A(H1N1)pdm09 in 2017–18. Changed A(H1N1)pdm09 vaccine component VE was 58% against A(H1N1)pdm09 in 2017–18. A(H3N2) VE was 13% and 28% among all ages in 2016–17 and 2017–18, respectively.
Introduction Influenza A(H3N2) viruses predominated in Europe in 2016–17. In 2017–18 A(H3N2) and A(H1N1)pdm09 viruses co-circulated. The A(H3N2) vaccine component was the same in both seasons; while the A(H1N1)pdm09 component changed in 2017–18. In both seasons, vaccine seed A(H3N2) viruses developed adaptations/alterations during propagation in eggs, impacting antigenicity. Methods We used the test-negative design in a multicentre primary care case-control study in 12 European countries to measure 2016–17 and 2017–18 influenza vaccine effectiveness (VE) against laboratory-confirmed influenza A(H1N1)pdm09 and A(H3N2) overall and by age group. Results During the 2017–18 season, the overall VE against influenza A(H1N1)pdm09 was 59% (95% CI: 47–69). Among those aged 0–14, 15–64 and ≥65 years, VE against A(H1N1)pdm09 was 64% (95% CI: 37–79), 50% (95% CI: 28–66) and 66% (95% CI: 42–80), respectively. Overall VE against influenza A(H3N2) was 28% (95% CI: 17–38) in 2016–17 and 13% (95% CI: −15 to 34) in 2017–18. Among 0–14-year-olds VE against A(H3N2) was 28% (95%CI: −10 to 53) and 29% (95% CI: −87 to 73), among 15–64-year-olds 34% (95% CI: 18–46) and 33% (95% CI: −3 to 56) and among those aged ≥65 years 15% (95% CI: −10 to 34) and −9% (95% CI: −74 to 32) in 2016–17 and 2017–18, respectively. Conclusions Our study suggests the new A(H1N1)pdm09 vaccine component conferred good protection against circulating strains, while VE against A(H3N2) was <35% in 2016–17 and 2017–18. The egg propagation derived antigenic mismatch of the vaccine seed virus with circulating strains may have contributed to this low effectiveness. A(H3N2) seed viruses for vaccines in subsequent seasons may be subject to the same adaptations; in years with lower than expected VE, recommendations of preventive measures other than vaccination should be given in a timely manner.
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Affiliation(s)
- Esther Kissling
- Epidemiology Department, Epiconcept, 47 rue de Charenton, 75012 Paris, France
| | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
| | - Silke Buda
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Respiratory Infections Unit, Seestrasse 10, 13353 Berlin, Germany
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F-75012, Paris, France
| | - Caterina Rizzo
- Department of Infectious Diseases, National Institute of Health, Rome, Italy.,Bambino Gesù Children's Hospital, Rome, Italy
| | - 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
| | | | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 D01 A4A3, Ireland
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Ausenda Machado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Mihaela Lazar
- "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania
| | - Kari Johansen
- European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73 Solna, Sweden
| | - Ralf Dürrwald
- Robert Koch Institute, National Reference Center for Influenza, Seestrasse 10, 13353 Berlin, Germany
| | - Sylvie van der Werf
- Unité de Génétique Moléculaire des Virus à ARN, Institut Pasteur, CNRS UMR3569, Université Paris Diderot SPC, France.,CNR des Virus des Infections Respiratoires, WHO National Influenza Center, Institut Pasteur, France
| | - Antonino Bella
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - 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
| | | | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 D01 A4A3, Ireland
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joanna Bogusz
- National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Raquel Guiomar
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Portugal
| | | | - Daniela Pitigoi
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73 Solna, Sweden
| | - Marta Valenciano
- Epidemiology Department, Epiconcept, 47 rue de Charenton, 75012 Paris, France
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44
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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45
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Arístegui Fernández J, González Pérez-Yarza E, Mellado Peña MJ, Rodrigo Gonzalo de Liria C, Hernández Sampelayo T, García García JJ, Ruiz Contreras J, Moreno Pérez D, Garrote Llanos E, Ramos Amador JT, Cilla Eguiluz CG, Méndez Hernández M, Aristegui J, Garrote E, Larrauri A, Pérez-Yarza E, Cilla G, Unsain M, Contreras JR, García-Ochoa E, Gordillo J, Sampelayo TH, Rodríguez R, González F, Mellado M, Calvo C, Méndez A, Bustamante J, Salas D, Lacasta C, Ramos J, Illán M, Mendez M, Barjuan M, García J, Urraca S, Caballero M, Launes C, Rodrigo C, Fàbregas A, Esmel R, Antón A, Moreno D, Valdivielso A, Piñero P, Carazo B. Hospitalizaciones infantiles asociadas a infección por virus de la gripe en 6 ciudades de España (2014-2016). An Pediatr (Barc) 2019; 90:86-93. [DOI: 10.1016/j.anpedi.2018.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/21/2018] [Accepted: 06/22/2018] [Indexed: 12/20/2022] Open
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46
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Valenciano M, Kissling E, Larrauri A, Nunes B, Pitigoi D, O'Donnell J, Reuss A, Horváth JK, Paradowska‐Stankiewicz I, Rizzo C, Falchi A, Daviaud I, Brytting M, Meijer A, Kaic B, Gherasim A, Machado A, Ivanciuc A, Domegan L, Schweiger B, Ferenczi A, Korczyńska M, Bella A, Vilcu A, Mosnier A, Zakikhany K, de Lange M, Kurečić Filipovićović S, Johansen K, Moren A. Exploring the effect of previous inactivated influenza vaccination on seasonal influenza vaccine effectiveness against medically attended influenza: Results of the European I-MOVE multicentre test-negative case-control study, 2011/2012-2016/2017. Influenza Other Respir Viruses 2018; 12:567-581. [PMID: 29659149 PMCID: PMC6086844 DOI: 10.1111/irv.12562] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Results of previous influenza vaccination effects on current season influenza vaccine effectiveness (VE) are inconsistent. OBJECTIVES To explore previous influenza vaccination effects on current season VE among population targeted for vaccination. METHODS We used 2011/2012 to 2016/2017 I-MOVE primary care multicentre test-negative data. For each season, we compared current season adjusted VE (aVE) between individuals vaccinated and unvaccinated in previous season. Using unvaccinated in both seasons as a reference, we then compared aVE between vaccinated in both seasons, current only, and previous only. RESULTS We included 941, 2645 and 959 influenza-like illness patients positive for influenza A(H1N1)pdm09, A(H3N2) and B, respectively, and 5532 controls. In 2011/2012, 2014/2015 and 2016/2017, A(H3N2) aVE point estimates among those vaccinated in previous season were -68%, -21% and -19%, respectively; among unvaccinated in previous season, these were 33%, 48% and 46%, respectively (aVE not computable for influenza A(H1N1)pdm09 and B). Compared to current season vaccination only, VE for both seasons' vaccination was (i) similar in two of four seasons for A(H3N2) (absolute difference [ad] 6% and 8%); (ii) lower in three of four seasons for influenza A(H1N1)pdm09 (ad 18%, 26% and 29%), in two seasons for influenza A(H3N2) (ad 27% and 39%) and in two of three seasons for influenza B (ad 26% and 37%); (iii) higher in one season for influenza A(H1N1)pdm09 (ad 20%) and influenza B (ad 24%). CONCLUSIONS We did not identify any pattern of previous influenza vaccination effect. Prospective cohort studies documenting influenza infections, vaccinations and vaccine types are needed to understand previous influenza vaccinations' effects.
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Affiliation(s)
| | | | - Amparo Larrauri
- National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
| | - Baltazar Nunes
- Department of EpidemiologyInstituto Nacional de Saúde, Doctor Ricardo JorgeLisboaPortugal
| | - Daniela Pitigoi
- University of Medicine and Pharmacy Carol DavilaBucharestRomania
- Cantacuzino InstituteNational Institute of Research – Development for Microbiology and ImmunologyBucharestRomania
| | - Joan O'Donnell
- Health Service Executive – Health Protection Surveillance CentreDublinIreland
| | - Annicka Reuss
- Department for Infectious Disease EpidemiologyRobert Koch InstituteBerlinGermany
| | - Judit Krisztina Horváth
- Department of Disease Prevention and SurveillanceNational Centre for EpidemiologyBudapestHungary
| | | | - Caterina Rizzo
- National Center for Epidemiology, Surveillance and Health PromotionIstituto Superiore di SanitàRomeItaly
| | | | | | - Mia Brytting
- The Public Health Agency of SwedenStockholmSweden
| | - Adam Meijer
- Centre for Infectious Disease ControlNational Institute of Public Health and Environment (RIVM)BilthovenThe Netherlands
| | | | - Alin Gherasim
- National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
| | - Ausenda Machado
- Department of EpidemiologyInstituto Nacional de Saúde, Doctor Ricardo JorgeLisboaPortugal
| | - Alina Ivanciuc
- Cantacuzino InstituteNational Institute of Research – Development for Microbiology and ImmunologyBucharestRomania
| | - Lisa Domegan
- Health Service Executive – Health Protection Surveillance CentreDublinIreland
| | - Brunhilde Schweiger
- Department for Infectious Disease EpidemiologyRobert Koch InstituteBerlinGermany
| | - Annamária Ferenczi
- Department of Disease Prevention and SurveillanceNational Centre for EpidemiologyBudapestHungary
| | - Monika Korczyńska
- National Institute of Public Health – National Institute of HygieneWarsawPoland
| | - Antonino Bella
- National Center for Epidemiology, Surveillance and Health PromotionIstituto Superiore di SanitàRomeItaly
| | - Ana‐Maria Vilcu
- Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136)UPMC Univ Paris 06, INSERMSorbonne UniversitésParisFrance
| | | | | | - Marit de Lange
- Centre for Infectious Disease ControlNational Institute of Public Health and Environment (RIVM)BilthovenThe Netherlands
| | | | - Kari Johansen
- European Centre for Disease Prevention and Control (ECDC)StockholmSweden
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47
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Mazagatos C, Delgado-Sanz C, Oliva J, Gherasim A, Larrauri A. Exploring the risk of severe outcomes and the role of seasonal influenza vaccination in pregnant women hospitalized with confirmed influenza, Spain, 2010/11-2015/16. PLoS One 2018; 13:e0200934. [PMID: 30089148 PMCID: PMC6082521 DOI: 10.1371/journal.pone.0200934] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 07/05/2018] [Indexed: 11/19/2022] Open
Abstract
Based on previous observations during pandemics and seasonal epidemics, pregnant women are considered at risk of developing severe influenza outcomes after influenza infection. With the aim of preventing severe influenza illness, the World Health Organization (WHO) includes pregnant women as a target group for seasonal influenza vaccination. However, influenza vaccine uptake during pregnancy remains low in many countries, including Spain. The objectives of this study were to increase the evidence of pregnancy as a risk factor for severe influenza illness and to study the potential role of seasonal influenza vaccination in the prevention of severe outcomes in infected pregnant women. Using information from the surveillance of Severe Hospitalized Confirmed Influenza Cases (SHCIC) in Spain, from seasons 2010/11 to 2015/16, we estimated that pregnant women in our study had a relative risk of hospitalization with severe influenza nearly 7.8 times higher than non-pregnant women of reproductive age. Only 5 out of 167 pregnant women with known vaccination status in our study had been vaccinated (3.6%). Such extremely low vaccination coverage only allowed obtaining crude estimates suggesting a protective effect of the vaccine against influenza complications (ICU admission or death). Our overall results support that pregnant women could benefit from seasonal influenza vaccination, in line with national and international recommendations.
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Affiliation(s)
- Clara Mazagatos
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús Oliva
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Alin Gherasim
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
- National Centre of Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
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48
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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49
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Kissling E, Valenciano M, Pozo F, Vilcu AM, Reuss A, Rizzo C, Larrauri A, Horváth JK, Brytting M, Domegan L, Korczyńska M, Meijer A, Machado A, Ivanciuc A, Višekruna Vučina V, van der Werf S, Schweiger B, Bella A, Gherasim A, Ferenczi A, Zakikhany K, O Donnell J, Paradowska-Stankiewicz I, Dijkstra F, Guiomar R, Lazar M, Kurečić Filipović S, Johansen K, Moren A. 2015/16 I-MOVE/I-MOVE+ multicentre case-control study in Europe: Moderate vaccine effectiveness estimates against influenza A(H1N1)pdm09 and low estimates against lineage-mismatched influenza B among children. Influenza Other Respir Viruses 2018; 12:423-437. [PMID: 29125681 PMCID: PMC6005601 DOI: 10.1111/irv.12520] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 12/31/2022] Open
Abstract
Background During the 2015/16 influenza season in Europe, the cocirculating influenza viruses were A(H1N1)pdm09 and B/Victoria, which was antigenically distinct from the B/Yamagata component in the trivalent influenza vaccine. Methods We used the test‐negative design in a multicentre case‐control study in twelve European countries to measure 2015/16 influenza vaccine effectiveness (VE) against medically attended influenza‐like illness (ILI) laboratory‐confirmed as influenza. General practitioners swabbed a systematic sample of consulting ILI patients and a random sample of influenza‐positive swabs was sequenced. We calculated adjusted VE against influenza A(H1N1)pdm09, A(H1N1)pdm09 genetic group 6B.1 and influenza B overall and by age group. Results We included 11 430 ILI patients, of which 2272 were influenza A(H1N1)pdm09 and 2901 were influenza B cases. Overall VE against influenza A(H1N1)pdm09 was 32.9% (95% CI: 15.5‐46.7). Among those aged 0‐14, 15‐64 and ≥65 years, VE against A(H1N1)pdm09 was 31.9% (95% CI: −32.3 to 65.0), 41.4% (95% CI: 20.5‐56.7) and 13.2% (95% CI: −38.0 to 45.3), respectively. Overall VE against influenza A(H1N1)pdm09 genetic group 6B.1 was 32.8% (95% CI: −4.1 to 56.7). Among those aged 0‐14, 15‐64 and ≥65 years, VE against influenza B was −47.6% (95% CI: −124.9 to 3.1), 27.3% (95% CI: −4.6 to 49.4) and 9.3% (95% CI: −44.1 to 42.9), respectively. Conclusions Vaccine effectiveness (VE) against influenza A(H1N1)pdm09 and its genetic group 6B.1 was moderate in children and adults, and low among individuals ≥65 years. Vaccine effectiveness (VE) against influenza B was low and heterogeneous among age groups. More information on effects of previous vaccination and previous infection is needed to understand the VE results against influenza B in the context of a mismatched vaccine.
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Affiliation(s)
| | | | - Francisco Pozo
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana-Maria Vilcu
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Annicka Reuss
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Caterina Rizzo
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Amparo Larrauri
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.,Ciber Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Lisa Domegan
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Monika Korczyńska
- National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Adam Meijer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ausenda Machado
- Instituto Nacional de Saúde, Dr Ricardo Jorge, Lisbon, Portugal
| | - Alina Ivanciuc
- Development for Microbiology and Immunology, Cantacuzino Institute, National Institute of Research, Bucharest, Romania
| | | | | | - Brunhilde Schweiger
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Antonino Bella
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Alin Gherasim
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Joan O Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Frederika Dijkstra
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Raquel Guiomar
- Instituto Nacional de Saúde, Dr Ricardo Jorge, Lisbon, Portugal
| | - Mihaela Lazar
- Development for Microbiology and Immunology, Cantacuzino Institute, National Institute of Research, Bucharest, Romania
| | | | - Kari Johansen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Rondy M, Larrauri A, Casado I, Alfonsi V, Pitigoi D, Launay O, Syrjänen RK, Gefenaite G, Machado A, Vučina VV, Horváth JK, Paradowska-Stankiewicz I, Marbus SD, Gherasim A, Díaz-González JA, Rizzo C, Ivanciuc AE, Galtier F, Ikonen N, Mickiene A, Gomez V, Kurečić Filipović S, Ferenczi A, Korcinska MR, van Gageldonk-Lafeber R, Valenciano M. 2015/16 seasonal vaccine effectiveness against hospitalisation with influenza A(H1N1)pdm09 and B among elderly people in Europe: results from the I-MOVE+ project. ACTA ACUST UNITED AC 2018; 22:30580. [PMID: 28797322 PMCID: PMC5553054 DOI: 10.2807/1560-7917.es.2017.22.30.30580] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/08/2017] [Indexed: 11/20/2022]
Abstract
We conducted a multicentre test-negative case-control study in 27 hospitals of 11 European countries to measure 2015/16 influenza vaccine effectiveness (IVE) against hospitalised influenza A(H1N1)pdm09 and B among people aged ≥ 65 years. Patients swabbed within 7 days after onset of symptoms compatible with severe acute respiratory infection were included. Information on demographics, vaccination and underlying conditions was collected. Using logistic regression, we measured IVE adjusted for potential confounders. We included 355 influenza A(H1N1)pdm09 cases, 110 influenza B cases, and 1,274 controls. Adjusted IVE against influenza A(H1N1)pdm09 was 42% (95% confidence interval (CI): 22 to 57). It was 59% (95% CI: 23 to 78), 48% (95% CI: 5 to 71), 43% (95% CI: 8 to 65) and 39% (95% CI: 7 to 60) in patients with diabetes mellitus, cancer, lung and heart disease, respectively. Adjusted IVE against influenza B was 52% (95% CI: 24 to 70). It was 62% (95% CI: 5 to 85), 60% (95% CI: 18 to 80) and 36% (95% CI: -23 to 67) in patients with diabetes mellitus, lung and heart disease, respectively. 2015/16 IVE estimates against hospitalised influenza in elderly people was moderate against influenza A(H1N1)pdm09 and B, including among those with diabetes mellitus, cancer, lung or heart diseases.
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Affiliation(s)
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | - Itziar Casado
- CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain.,Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain
| | | | | | - Odile Launay
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, APHP, CIC Cochin-Pasteur, Paris, France
| | - Ritva K Syrjänen
- Impact Assessment Unit, National Institute for Health and Welfare, Tampere, Finland
| | - Giedre Gefenaite
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ausenda Machado
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - 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
| | - Alin Gherasim
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | | | | | | | - Florence Galtier
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,CIC de Montpellier, Hôpital Saint-Eloi, CHU de Montpellier, Montpellier, France
| | - Niina Ikonen
- Viral Infections Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Aukse Mickiene
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Veronica Gomez
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | - Monika R Korcinska
- National institute of Public Health - National Institute of Hygiene, Department of Epidemiology, Warsaw, Poland
| | - 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
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- The I-MOVE+ hospital working group is listed at the end of the article
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