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Stein A, Pendrey C, Muscatello D, Van Buynder P, Fielding J, Menche J, Sullivan S. Estimates of Seasonal Influenza Burden That Could Be Averted by Improved Influenza Vaccines in the Australian Population Aged Under 65 Years, 2015-2019. Influenza Other Respir Viruses 2024; 18:e13289. [PMID: 38637994 PMCID: PMC11026859 DOI: 10.1111/irv.13289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The interpretation of relative vaccine effectiveness (rVE) of improved influenza vaccines is complex. Estimation of burden averted is useful to contextualise their potential impact across different seasons. For the population aged under 65 years in Australia, this study estimated the additional morbidity and mortality that could be averted using improved influenza vaccines. METHODS We used observed, season-specific (2015-2019) influenza notification and influenza-coded hospitalisation frequencies and published modelled estimates of influenza-associated hospitalisations and deaths that occurred under the prevailing influenza vaccination coverage scenario. After back-calculating to the estimated burden in the population without vaccination, we applied published standard influenza vaccine effectiveness and coverage estimates to calculate the burden potentially averted by standard and improved influenza vaccines. A plausible range of rVE values were used, assuming 50% coverage. RESULTS The percentage point difference in absolute vaccine effectiveness (VE) of an improved vaccine compared to a standard vaccine is directly proportional to its rVE and inversely proportional to the effectiveness of the standard vaccine. The incremental burden averted by an improved vaccine is a function of both its difference in absolute VE and the severity of the influenza season. Assuming an rVE of 15% with 50% coverage, the improved vaccine was estimated to additionally avert 1517 to 12,641 influenza notifications, 287 to 1311 influenza-coded hospitalisations and 9 to 33 modelled all-cause influenza deaths per year compared to the standard vaccine. CONCLUSIONS Improved vaccines can have substantial clinical and population impact, particularly when the effectiveness of standard vaccines is low, and burden is high.
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Affiliation(s)
| | - Catherine G. A. Pendrey
- WHO Collaborating Centre for Reference and Research on InfluenzaRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraAustralia
| | | | | | - James E. Fielding
- Victorian Infectious Diseases Reference Laboratoryat the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | | | - Sheena G. Sullivan
- WHO Collaborating Centre for Reference and Research on InfluenzaRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Department of Infectious DiseasesUniversity of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Department of EpidemiologyUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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2
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Martins JP, Santos M, Martins A, Felgueiras M, Santos R. Seasonal Influenza Vaccine Effectiveness in Persons Aged 15-64 Years: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1322. [PMID: 37631889 PMCID: PMC10459161 DOI: 10.3390/vaccines11081322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Influenza is a respiratory disease caused by the influenza virus, which is highly transmissible in humans. This paper presents a systematic review and meta-analysis of randomized controlled trials (RCTs) and test-negative designs (TNDs) to assess the vaccine effectiveness (VE) of seasonal influenza vaccines (SIVs) in humans aged 15 to 64 years. An electronic search to identify all relevant studies was performed. The outcome measure of interest was VE on laboratory-confirmed influenza (any strain). Quality assessment was performed using the Cochrane risk-of-bias tool for RCTs and the ROBINS-I tool for TNDs. The search identified a total of 2993 records, but only 123 studies from 73 papers were included in the meta-analysis. Of these studies, 9 were RCTs and 116 were TNDs. The pooled VE was 48% (95% CI: 42-54) for RCTs, 55.4% (95% CI: 43.2-64.9) when there was a match between the vaccine and most prevalent circulating strains and 39.3% (95% CI: 23.5-51.9) otherwise. The TNDs' adjusted VE was equal to 39.9% (95% CI: 31-48), 45.1 (95% CI: 38.7-50.8) when there was a match and 35.1 (95% CI: 29.0-40.7) otherwise. The match between strains included in the vaccine and strains in circulation is the most important factor in the VE. It increases by more than 25% when there is a match with the most prevalent circulating strains. The laboratorial method for confirmation of influenza is a possible source of bias when estimating VE.
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Affiliation(s)
- João Paulo Martins
- Escola Superior de Saúde, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- CEAUL—Centro de Estatística e Aplicações, Faculdade de Ciências, Campo Grande, Universidade de Lisboa, 1749-016 Lisboa, Portugal; (M.F.); (R.S.)
| | - Marlene Santos
- Escola Superior de Saúde, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- Centro de Investigação em Saúde e Ambiente, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
| | - André Martins
- Centro de Investigação em Saúde e Ambiente, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
| | - Miguel Felgueiras
- CEAUL—Centro de Estatística e Aplicações, Faculdade de Ciências, Campo Grande, Universidade de Lisboa, 1749-016 Lisboa, Portugal; (M.F.); (R.S.)
- Escola Superior de Tecnologia e Gestão, Instituto Politécnico de Leiria, Campus 2, Morro do Lena—Alto do Vieiro, Apartado 4163, 2411-901 Leiria, Portugal
| | - Rui Santos
- CEAUL—Centro de Estatística e Aplicações, Faculdade de Ciências, Campo Grande, Universidade de Lisboa, 1749-016 Lisboa, Portugal; (M.F.); (R.S.)
- Escola Superior de Tecnologia e Gestão, Instituto Politécnico de Leiria, Campus 2, Morro do Lena—Alto do Vieiro, Apartado 4163, 2411-901 Leiria, Portugal
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3
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Kang M, Zanin M, Wong SS. Subtype H3N2 Influenza A Viruses: An Unmet Challenge in the Western Pacific. Vaccines (Basel) 2022; 10:vaccines10010112. [PMID: 35062773 PMCID: PMC8778411 DOI: 10.3390/vaccines10010112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023] Open
Abstract
Subtype H3N2 influenza A viruses (A(H3N2)) have been the dominant strain in some countries in the Western Pacific region since the 2009 influenza A(H1N1) pandemic. Vaccination is the most effective way to prevent influenza; however, low vaccine effectiveness has been reported in some influenza seasons, especially for A(H3N2). Antigenic mismatch introduced by egg-adaptation during vaccine production between the vaccine and circulating viral stains is one of the reasons for low vaccine effectiveness. Here we review the extent of this phenomenon, the underlying molecular mechanisms and discuss recent strategies to ameliorate this, including new vaccine platforms that may provide better protection and should be considered to reduce the impact of A(H3N2) in the Western Pacific region.
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Affiliation(s)
- Min Kang
- School of Public Health, Southern Medical University, Guangzhou 510515, China;
- Guangdong Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Mark Zanin
- State Key Laboratory for Respiratory Diseases and National Clinical Research Centre for Respiratory Disease, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou 511436, China;
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, China
| | - Sook-San Wong
- State Key Laboratory for Respiratory Diseases and National Clinical Research Centre for Respiratory Disease, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou 511436, China;
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, China
- Correspondence: ; Tel.: +86-178-2584-6078
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4
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Leung VKY, Wong JY, Barnes R, Kelso J, Milne GJ, Blyth CC, Cowling BJ, Moore HC, Sullivan SG. Excess respiratory mortality and hospitalizations associated with influenza in Australia, 2007-2015. Int J Epidemiol 2021; 51:458-467. [PMID: 34333637 DOI: 10.1093/ije/dyab138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Influenza is the most common vaccine-preventable disease in Australia, causing significant morbidity and mortality. We assessed the burden of influenza across all ages in terms of influenza-associated mortality and hospitalizations using national mortality, hospital-discharge and influenza surveillance data. METHODS Influenza-associated excess respiratory mortality and hospitalization rates from 2007 to 2015 were estimated using generalized additive models with a proxy of influenza activity based on syndromic and laboratory surveillance data. Estimates were made for each age group and year. RESULTS The estimated mean annual influenza-associated excess respiratory mortality was 2.6 per 100 000 population [95% confidence interval (CI): 1.8, 3.4 per 100 000 population]. The excess annual respiratory hospitalization rate was 57.4 per 100 000 population (95% CI: 32.5, 82.2 per 100 000 population). The highest mortality rates were observed among those aged ≥75 years (35.11 per 100 000 population; 95% CI: 19.93, 50.29 per 100 000 population) and hospitalization rates were also highest among older adults aged ≥75 years (302.95 per 100 000 population; 95% CI: 144.71, 461.19 per 100 000 population), as well as children aged <6 months (164.02 per 100 000 population; 95% CI: -34.84, 362.88 per 100 000 population). Annual variation was apparent, ranging from 1.0 to 3.9 per 100 000 population for mortality and 24.2 to 94.28 per 100 000 population for hospitalizations. Influenza A contributed to almost 80% of the average excess respiratory hospitalizations and 60% of the average excess respiratory deaths. CONCLUSIONS Influenza causes considerable burden to all Australians. Expected variation was observed among age groups, years and influenza type, with the greatest burden falling to older adults and young children. Understanding the current burden is useful for understanding the potential impact of mitigation strategies, such as vaccination.
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Affiliation(s)
- Vivian K Y Leung
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Jessica Y Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, PR China
| | - Roseanne Barnes
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Joel Kelso
- Department of Computer Science, University of Western Australia, Perth, Australia
| | - George J Milne
- Department of Computer Science, University of Western Australia, Perth, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,PathWest Laboratory Medicine WA, QE11 Medical Centre, Perth, Western Australia, Australia.,Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, PR China
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia.,Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.,Department of Epidemiology, University of California, Los Angeles, USA
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5
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Carlson SJ, Blyth CC, Beard FH, Hendry AJ, Cheng AC, Quinn HE, Leask J, Macartney K. Influenza disease and vaccination in children in Australia. Med J Aust 2021; 215:64-67.e1. [PMID: 34053066 DOI: 10.5694/mja2.51100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA.,University of Sydney, Sydney, NSW
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
| | - Frank H Beard
- University of Sydney, Sydney, NSW.,National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, NSW
| | - Alexandra J Hendry
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, NSW
| | | | - Helen E Quinn
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, NSW
| | | | - Kristine Macartney
- University of Sydney, Sydney, NSW.,National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, NSW
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6
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Okoli GN, Racovitan F, Abdulwahid T, Hyder SK, Lansbury L, Righolt CH, Mahmud SM, Nguyen-Van-Tam JS. Decline in Seasonal Influenza Vaccine Effectiveness With Vaccination Program Maturation: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2021; 8:ofab069. [PMID: 33738320 PMCID: PMC7953658 DOI: 10.1093/ofid/ofab069] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Evidence suggests that repeated influenza vaccination may reduce vaccine effectiveness (VE). Using influenza vaccination program maturation (PM; number of years since program inception) as a proxy for population-level repeated vaccination, we assessed the impact on pooled adjusted end-season VE estimates from outpatient test-negative design studies. METHODS We systematically searched and selected full-text publications from January 2011 to February 2020 (PROSPERO: CRD42017064595). We obtained influenza vaccination program inception year for each country and calculated PM as the difference between the year of deployment and year of program inception. We categorized PM into halves (cut at the median), tertiles, and quartiles and calculated pooled VE using an inverse-variance random-effects model. The primary outcome was pooled VE against all influenza. RESULTS We included 72 articles from 11 931 citations. Across the 3 categorizations of PM, a lower pooled VE against all influenza for all patients was observed with PM. Substantially higher reductions were observed in older adults (≥65 years). We observed similar results for A(H1N1)pdm09, A(H3N2), and influenza B. CONCLUSIONS The evidence suggests that influenza VE declines with vaccination PM. This study forms the basis for further discussions and examinations of the potential impact of vaccination PM on seasonal VE.
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Affiliation(s)
- George N Okoli
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Florentin Racovitan
- Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tiba Abdulwahid
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Syed K Hyder
- Department of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, United Kingdom
| | - Louise Lansbury
- Department of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, United Kingdom
| | - Christiaan H Righolt
- Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada
- Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin M Mahmud
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, Manitoba, Canada
- Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan S Nguyen-Van-Tam
- Department of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, United Kingdom
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7
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Okoli GN, Racovitan F, Abdulwahid T, Righolt CH, Mahmud SM. Variable seasonal influenza vaccine effectiveness across geographical regions, age groups and levels of vaccine antigenic similarity with circulating virus strains: A systematic review and meta-analysis of the evidence from test-negative design studies after the 2009/10 influenza pandemic. Vaccine 2021; 39:1225-1240. [PMID: 33494964 DOI: 10.1016/j.vaccine.2021.01.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND We examined the influence of some factors on seasonal influenza vaccine effectiveness (VE) from test-negative design (TND) studies. METHODS We systematically searched for full-text publications of VE against laboratory-confirmed influenza from TND studies in outpatient settings after the 2009/10 influenza pandemic. Two reviewers independently selected and extracted data from the included studies. We calculated pooled adjusted VE across geographical regions, age groups and levels of vaccine antigenic similarity with circulating virus strains, using an inverse variance, random-effects model. RESULTS We included 76 full-text articles from 11,931 citations. VE estimates against A(H1N1)pdm09, A(H3N2), influenza B, and all influenza were homogenous and point pooled VE higher in the Southern hemisphere compared with the Northern hemisphere. The difference in pooled VE between the Southern and Northern hemispheres was statistically significant for A(H3N2), influenza B, and all influenza. A consistent pattern was observed in pooled VE across both hemispheres and continents, with the highest point pooled VE being against A(H1N1)pdm09, followed by influenza B, and lowest against A(H3N2). A nearly consistent pattern was observed in pooled VE across age groups in the Northern hemisphere, with pooled VE mostly decreasing with age. Point pooled VE against A(H3N2), influenza B, and all influenza were statistically significantly higher when vaccine was antigenically similar to circulating virus strains compared with when antigenically dissimilar. Similar pattern was observed in the Northern hemisphere, but there was a lack of data from the Southern hemisphere. CONCLUSION Consistent patterns appear to exist in seasonal influenza VE across regions, age groups, and levels of vaccine antigenic similarity with circulating virus strains, with best vaccine performance against A(H1N1)pdm09 and worst against A(H3N2). The evidence highlights the need to consider geographical location, age, and vaccine antigenic similarity with circulating virus strains when designing and evaluating influenza VE studies.
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Affiliation(s)
- G N Okoli
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, MB, Canada
| | - F Racovitan
- Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, MB, Canada
| | - T Abdulwahid
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - C H Righolt
- Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, MB, Canada; Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - S M Mahmud
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Vaccine and Drug Evaluation Centre, University of Manitoba, Winnipeg, MB, Canada; Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
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8
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Deng J, Lu C, Liu C, Oveissi S, Fairlie WD, Lee EF, Bilsel P, Puthalakath H, Chen W. Influenza A virus infection-induced macroautophagy facilitates MHC class II-restricted endogenous presentation of an immunodominant viral epitope. FEBS J 2020; 288:3164-3185. [PMID: 33830641 DOI: 10.1111/febs.15654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/27/2020] [Accepted: 12/02/2020] [Indexed: 12/15/2022]
Abstract
CD4+ T cells recognize peptides presented by major histocompatibility complex class II molecules (MHC-II). These peptides are generally derived from exogenous antigens. Macroautophagy has been reported to promote endogenous antigen presentation in viral infections. However, whether influenza A virus (IAV) infection-induced macroautophagy also leads to endogenous antigen presentation through MHC-II is still debated. In this study, we show that IAV infection leads to endogenous presentation of an immunodominant viral epitope NP311-325 by MHC-II to CD4+ T cells. Mechanistically, such MHC-II-restricted endogenous IAV antigen presentation requires de novo protein synthesis as it is inhibited by the protein synthesis inhibitor cycloheximide, and a functional ER-Golgi network as it is totally blocked by Brefeldin A. These results indicate that MHC-II-restricted endogenous IAV antigen presentation is dependent on de novo antigen and/or MHC-II synthesis, and transportation through the ER-Golgi network. Furthermore, such endogenous IAV antigen presentation by MHC-II is enhanced by TAP deficiency, indicating some antigenic peptides are of cytosolic origin. Most importantly, the bulk of such MHC-II-restricted endogenous IAV antigen presentation is blocked by autophagy inhibitors (3-MA and E64d) and deletion of autophagy-related genes, such as Beclin1 and Atg7. We have further demonstrated that in dendritic cells, IAV infection prevents autophagosome-lysosome fusion and promotes autophagosome fusion with MHC class II compartment (MIIC), which likely promotes endogenous IAV antigen presentation by MHC-II. Our results provide strong evidence that IAV infection-induced autophagosome formation facilitates endogenous IAV antigen presentation by MHC-II to CD4+ T cells. The implication for influenza vaccine design is discussed.
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Affiliation(s)
- Jieru Deng
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia
| | - Chunni Lu
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia.,School of Medicine, Deakin University, Waurn Ponds, Vic., Australia
| | - Chuanxin Liu
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia
| | - Sara Oveissi
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia
| | - W Douglas Fairlie
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, Vic., Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Vic., Australia
| | - Erinna F Lee
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, Vic., Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Vic., Australia
| | | | - Hamsa Puthalakath
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia
| | - Weisan Chen
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Vic., Australia
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9
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Okoli GN, Racovitan F, Righolt CH, Mahmud SM. Variations in Seasonal Influenza Vaccine Effectiveness due to Study Characteristics: A Systematic Review and Meta-analysis of Test-Negative Design Studies. Open Forum Infect Dis 2020; 7:ofaa177. [PMID: 32704509 PMCID: PMC7367680 DOI: 10.1093/ofid/ofaa177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/19/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Study characteristics influence vaccine effectiveness (VE) estimation. We examined the influence of some of these on seasonal influenza VE estimates from test-negative design (TND) studies. METHODS We systematically searched bibliographic databases and websites for full-text publications of TND studies on VE against laboratory-confirmed seasonal influenza in outpatients after the 2009 pandemic influenza. We followed the Cochrane Handbook for Systematic Reviews of Interventions guidelines. We examined influence of source of vaccination information, respiratory specimen swab time, and covariate adjustment on VE. We calculated pooled adjusted VE against H1N1 and H3N2 influenza subtypes, influenza B, and all influenza using an inverse-variance random-effects model. RESULTS We included 70 full-text articles. Pooled VE against H1N1 and H3N2 influenza subtypes, influenza B, and all influenza was higher for studies that used self-reported vaccination than for those that used medical records. Pooled VE was higher with respiratory specimen collection within ≤7 days vs ≤4 days of symptom onset, but the opposite was observed for H1N1. Pooled VE was higher for studies that adjusted for age but not for medical conditions compared with those that adjusted for both. There was, however, a lack of statistical significance in almost all differences in pooled VE between compared groups. CONCLUSIONS The available evidence is not strong enough to conclude that influenza VE from TND studies varies by source of vaccination information, respiratory specimen swab time, or adjustment for age/medical conditions. The evidence is, however, indicative that these factors ought to be considered while designing or evaluating TND studies of influenza VE.
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Affiliation(s)
- George N Okoli
- George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Vaccine and Drug Evaluation Centre, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Florentin Racovitan
- Vaccine and Drug Evaluation Centre, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Christiaan H Righolt
- Vaccine and Drug Evaluation Centre, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Salaheddin M Mahmud
- Vaccine and Drug Evaluation Centre, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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10
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Leite JA, Resende P, Araya JL, Barrera GB, Baumeister E, Caicedo AB, Coppola L, de Mello WA, de Mora D, Cordeiro dos Santos M, Fasce R, Fernández J, Goñi N, Martínez IL, Mayhua JO, Motta F, Nuñez MCH, Ojeda J, Ortega MJ, Ospitia E, de Paiva TM, Pontoriero A, Porras HB, Quinonez JAD, Ramas V, Ramírez JB, Santos KCDO, Siqueira MM, Vàzquez C, Palekar R. Genetic evolution of influenza viruses among selected countries in Latin America, 2017-2018. PLoS One 2020; 15:e0227962. [PMID: 32155152 PMCID: PMC7064222 DOI: 10.1371/journal.pone.0227962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 01/03/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Since the 2009 influenza pandemic, Latin American (LA) countries have strengthened their influenza surveillance systems. We analyzed influenza genetic sequence data from the 2017 through 2018 Southern Hemisphere (SH) influenza season from selected LA countries, to map the availability of influenza genetic sequence data from, and to describe, the 2017 through 2018 SH influenza seasons in LA. METHODS We analyzed influenza A/H1pdm09, A/H3, B/Victoria and B/Yamagata hemagglutinin sequences from clinical samples from 12 National Influenza Centers (NICs) in ten countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Paraguay, Peru and Uruguay) with a collection date from epidemiologic week (EW) 18, 2017 through EW 43, 2018. These sequences were generated by the NIC or the WHO Collaborating Center (CC) at the U.S Centers for Disease Control and Prevention, uploaded to the Global Initiative on Sharing All Influenza Data (GISAID) platform, and used for phylogenetic reconstruction. FINDINGS Influenza hemagglutinin sequences from the participating countries (A/H1pdm09 n = 326, A/H3 n = 636, B n = 433) were highly concordant with the genetic groups of the influenza vaccine-recommended viruses for influenza A/H1pdm09 and influenza B. For influenza A/H3, the concordance was variable. CONCLUSIONS Considering the constant evolution of influenza viruses, high-quality surveillance data-specifically genetic sequence data, are important to allow public health decision makers to make informed decisions about prevention and control strategies, such as influenza vaccine composition. Countries that conduct influenza genetic sequencing for surveillance in LA should continue to work with the WHO CCs to produce high-quality genetic sequence data and upload those sequences to open-access databases.
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Affiliation(s)
- Juliana Almeida Leite
- Pan American Health Organization (PAHO/WHO), Washington, DC, United States of America
| | - Paola Resende
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jenny Lara Araya
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Gisela Badillo Barrera
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
| | - Elsa Baumeister
- Instituto Nacional de Enfermedades Infecciosas—Administración Nacional de Laboratorios e Institutos de Salud (INEI-ANLIS) "Dr. Carlos G. Malbran", Buenos Aires, Argentina
| | - Alfredo Bruno Caicedo
- Instituto Nacional de Investigación en Salud Pública (INSPI), Guayaquil, Guayas, Ecuador
| | - Leticia Coppola
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | | | - Domenica de Mora
- Instituto Nacional de Investigación en Salud Pública (INSPI), Guayaquil, Guayas, Ecuador
| | | | - Rodrigo Fasce
- Instituto de Salud Pública de Chile (ISPCH), Santiago, Santiago, Chile
| | - Jorge Fernández
- Instituto de Salud Pública de Chile (ISPCH), Santiago, Santiago, Chile
| | - Natalia Goñi
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | - Irma López Martínez
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
| | | | - Fernando Motta
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jenny Ojeda
- Ministerio de Salud Pública, Quito, Pichincha, Ecuador
| | - María José Ortega
- Laboratorio Central de Salud Pública (LCSP), Ascuncion, Distrito Capital, Paraguay
| | - Erika Ospitia
- Instituto Nacional de Salud (INS), Bogota, Cundinamarca, Colombia
| | | | - Andrea Pontoriero
- Instituto Nacional de Enfermedades Infecciosas—Administración Nacional de Laboratorios e Institutos de Salud (INEI-ANLIS) "Dr. Carlos G. Malbran", Buenos Aires, Argentina
| | - Hebleen Brenes Porras
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Jose Alberto Diaz Quinonez
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
- Division of Postgraduate Studies, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Viviana Ramas
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | | | | | - Marilda Mendonça Siqueira
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cynthia Vàzquez
- Laboratorio Central de Salud Pública (LCSP), Ascuncion, Distrito Capital, Paraguay
| | - Rakhee Palekar
- Pan American Health Organization (PAHO/WHO), Washington, DC, United States of America
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Chua H, Feng S, Lewnard JA, Sullivan SG, Blyth CC, Lipsitch M, Cowling BJ. The Use of Test-negative Controls to Monitor Vaccine Effectiveness: A Systematic Review of Methodology. Epidemiology 2020; 31:43-64. [PMID: 31609860 PMCID: PMC6888869 DOI: 10.1097/ede.0000000000001116] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The test-negative design is an increasingly popular approach for estimating vaccine effectiveness (VE) due to its efficiency. This review aims to examine published test-negative design studies of VE and to explore similarities and differences in methodological choices for different diseases and vaccines. METHODS We conducted a systematic search on PubMed, Web of Science, and Medline, for studies reporting the effectiveness of any vaccines using a test-negative design. We screened titles and abstracts and reviewed full texts to identify relevant articles. We created a standardized form for each included article to extract information on the pathogen of interest, vaccine(s) being evaluated, study setting, clinical case definition, choices of cases and controls, and statistical approaches used to estimate VE. RESULTS We identified a total of 348 articles, including studies on VE against influenza virus (n = 253), rotavirus (n = 48), pneumococcus (n = 24), and nine other pathogens. Clinical case definitions used to enroll patients were similar by pathogens of interest but the sets of symptoms that defined them varied substantially. Controls could be those testing negative for the pathogen of interest, those testing positive for nonvaccine type of the pathogen of interest, or a subset of those testing positive for alternative pathogens. Most studies controlled for age, calendar time, and comorbidities. CONCLUSIONS Our review highlights similarities and differences in the application of the test-negative design that deserve further examination. If vaccination reduces disease severity in breakthrough infections, particular care must be taken in interpreting vaccine effectiveness estimates from test-negative design studies.
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Affiliation(s)
- Huiying Chua
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shuo Feng
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joseph A Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher C Blyth
- Division of Paediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Marc Lipsitch
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
- Center for Communicable Disease Dynamics, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Benjamin J Cowling
- From the World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
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12
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Costantino V, Trent M, MacIntyre CR. Modelling of optimal timing for influenza vaccination as a function of intraseasonal waning of immunity and vaccine coverage. Vaccine 2019; 37:6768-6775. [PMID: 31521411 DOI: 10.1016/j.vaccine.2019.08.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/14/2019] [Accepted: 08/27/2019] [Indexed: 02/08/2023]
Abstract
The influenza season in Australia usually peaks in August. Vaccination is recommended beginning in March-April. Recent studies suggest that vaccine effectiveness may wane over a given influenza season, leading to reduced effectiveness at the peak of the season. We aimed to quantify how changes in timing of influenza vaccination and declining vaccine coverage could change the percentages of prevented cases. Results from a systematic review were used to inform calculation of a waning function over time from vaccination. Age specific notification data and vaccine effectiveness and coverage estimates from 2007 to 2016 (2009 influenza pandemic year excluded) were used to model a new notification series where vaccine effectiveness is shifted in time to account for delayed vaccination by month from March to August. A sensitivity analysis was done on possible vaccine coverage changes and considering time gap between vaccine uptake and recommendation. Delaying vaccination from March to end of May prevents more cases over a season, but the variation in cases prevented by month of vaccination is not large. If delaying vaccination results in missed or forgotten vaccination and decrease coverage, delaying vaccination could have a net negative impact. Furthermore, considering a time gap between recommendation and uptake, earlier recommendation is more effective in preventing cases. The results are sensitive to assumptions of intra-seasonal waning of effectiveness. More research is required on intra-seasonal vaccine effectiveness waning and the effect of delayed vaccination on overall uptake to inform any potential changes to current vaccine scheduling recommendations.
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Affiliation(s)
- Valentina Costantino
- Biosecurity Program, Kirby Institute, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
| | - Mallory Trent
- Biosecurity Program, Kirby Institute, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
| | - C Raina MacIntyre
- Biosecurity Program, Kirby Institute, Faculty of Medicine, The University of New South Wales, Sydney, Australia; College of Public Service and Community Solutions, Arizona State University, Arizona, USA.
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13
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Patterns of influenza B circulation in Latin America and the Caribbean, 2010-2017. PLoS One 2019; 14:e0219595. [PMID: 31393886 PMCID: PMC6687279 DOI: 10.1371/journal.pone.0219595] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE There are limited published data about the circulation of influenza B/Victoria and B/Yamagata in Latin America and the Caribbean (LAC) and most countries have a vaccine policy that includes the use of the trivalent influenza vaccine. We analyzed influenza surveillance data to inform decision-making in LAC about prevention strategies, such as the use of the quadrivalent influenza vaccine. METHODS There are a total of 28 reference laboratories and National Influenza Centers in LAC that conduct influenza virologic surveillance according to global standards, and on a weekly basis upload their surveillance data to the open-access World Health Organization (WHO) platform FluNet. These data include the number of specimens tested for influenza and the number of specimens positive for influenza by type, subtype and lineage, all by the epidemiologic week of specimen collection. We invited these laboratories to provide additional epidemiologic data about the hospitalized influenza B cases. We conducted descriptive analyses of patterns of influenza circulation and characteristics of hospitalized cases. We compared the predominant B lineage each season to the lineage in the vaccine applied, to determine vaccine mismatch. A Chi-square and Wilcoxan statistic were used to assess the statistical significance of differences in proportions and medians at the P<0.05 level. FINDINGS During 2010-2017, the annual number of influenza B cases in LAC was ~4500 to 7000 cases. Since 2011, among the LAC-laboratories reporting influenza B lineage using molecular methods, both B/Victoria and B/Yamagata were detected annually. Among the hospitalized influenza B cases, there were statistically significant differences observed between B/Victoria and B/Yamagata cases when comparing age and the proportion with underlying co-morbid conditions and with history of oseltamivir treatment (P<0.001). The proportion deceased among B/Victoria and B/Yamagata hospitalized cases did not differ significantly. When comparing the predominant influenza B lineage detected, as part of surveillance activities during 63 seasons among 19 countries, to the lineage of the influenza B virus included in the trivalent influenza vaccine used during that season, there was a vaccine mismatch noted during 32% of the seasons analyzed. CONCLUSIONS Influenza B is important in LAC with both B/Victoria and B/Yamagata circulating annually in all sub regions. During approximately one-third of the seasons, an influenza B vaccine mismatch was identified. Further analyses are needed to better characterize the medical and economic burden of each influenza B lineage, to examine the potential cross-protection of one vaccine lineage against the other circulating virus lineage, and to determine the potential impact and cost-effectiveness of using the quadrivalent vaccine rather than the trivalent influenza vaccine.
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14
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Regan AK, Fielding JE, Chilver MB, Carville KS, Minney-Smith CA, Grant KA, Thomson C, Hahesy T, Deng YM, Stocks N, Sullivan SG. Intraseason decline in influenza vaccine effectiveness during the 2016 southern hemisphere influenza season: A test-negative design study and phylogenetic assessment. Vaccine 2019; 37:2634-2641. [PMID: 30952499 DOI: 10.1016/j.vaccine.2019.02.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND We estimated the effectiveness of seasonal inactivated influenza vaccine and the potential influence of timing of immunization on vaccine effectiveness (VE) using data from the 2016 southern hemisphere influenza season. METHODS Data were pooled from three routine syndromic sentinel surveillance systems in general practices in Australia. Each system routinely collected specimens for influenza testing from patients presenting with influenza-like illness. Next generation sequencing was used to characterize viruses. Using a test-negative design, VE was estimated based on the odds of vaccination among influenza-positive cases as compared to influenza-negative controls. Subgroup analyses were used to estimate VE by type, subtype and lineage, as well as age group and time between vaccination and symptom onset. RESULTS A total of 1085 patients tested for influenza in 2016 were included in the analysis, of whom 447 (41%) tested positive for influenza. The majority of detections were influenza A/H3N2 (74%). One-third (31%) of patients received the 2016 southern hemisphere formulation influenza vaccine. Overall, VE was estimated at 40% (95% CI: 18-56%). VE estimates were highest for patients immunized within two months prior to symptom onset (VE: 60%; 95% CI: 26-78%) and lowest for patients immunized >4 months prior to symptom onset (VE: 19%; 95% CI: -73-62%). DISCUSSION Overall, the 2016 influenza vaccine showed good protection against laboratory-confirmed infection among general practice patients. Results by duration of vaccination suggest a significant decline in effectiveness during the 2016 influenza season, indicating immunization close to influenza season offered optimal protection.
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Affiliation(s)
- Annette K Regan
- School of Public Health, Texas A&M University, 212 Adriance Drive, College Station, TX 77843, United States; School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; Communicable Disease Control Directorate, Department of Health Western Australia, 227 Stubbs Terrace, Shenton Park, WA 6008, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6008, Australia.
| | - James E Fielding
- Victorian Infectious Diseases Reference Laboratory, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC 3010, Australia
| | - Monique B Chilver
- Discipline of General Practice, University of Adelaide, North Terrace, Adelaide, SA 5005, Australia
| | - Kylie S Carville
- Victorian Infectious Diseases Reference Laboratory, 792 Elizabeth Street, Melbourne, VIC 3000, Australia
| | - Cara A Minney-Smith
- PathWest Laboratory Medicine WA, Locked Bag 2009, Nedlands, WA 6909, Australia
| | - Kristina A Grant
- Victorian Infectious Diseases Reference Laboratory, 792 Elizabeth Street, Melbourne, VIC 3000, Australia
| | - Chloe Thomson
- Communicable Disease Control Directorate, Department of Health Western Australia, 227 Stubbs Terrace, Shenton Park, WA 6008, Australia
| | - Trish Hahesy
- SA Pathology, Frome Road, Adelaide, SA 5000, Australia
| | - Yi-Mo Deng
- WHO Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia
| | - Nigel Stocks
- Discipline of General Practice, University of Adelaide, North Terrace, Adelaide, SA 5005, Australia
| | - Sheena G Sullivan
- Victorian Infectious Diseases Reference Laboratory, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC 3010, Australia; WHO Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Dr South, Los Angeles, CA 90095, United States
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15
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Estimating influenza vaccine effectiveness using data routinely available in electronic primary care records. Vaccine 2019; 37:755-762. [DOI: 10.1016/j.vaccine.2018.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 11/20/2018] [Accepted: 12/04/2018] [Indexed: 12/22/2022]
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A severe 2017 influenza season dominated by influenza A(H3N2), Victoria, Australia. Western Pac Surveill Response J 2018; 9:18-26. [PMID: 31832250 PMCID: PMC6902654 DOI: 10.5365/wpsar.2018.9.5.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Surveillance for influenza-like illness (ILI) and laboratory-confirmed influenza in Victoria, Australia is undertaken jointly by the Victorian Infectious Diseases Reference Laboratory and the Victorian Government Department of Health and Human Services from May to October each year. Surveillance data comprise notifiable laboratory-confirmed influenza and ILI reporting from from two sources – a general practice sentinel surveillance programme and a locum service. The magnitude of the 2017 influenza season was high in Victoria with widespread circulation of influenza type A(H3N2), which peaked in September. A record number of laboratory-confirmed influenza cases were notified, and the proportion of ILI cases to total consultations from both the general practice and locum service were higher than previous years. Notified cases of influenza A were older than influenza B cases with 25% compared to 17% aged more than 65 years, respectively. The proportion of swabs that were positive for influenza peaked at 58%. Antigenic characterization suggested a good match between the circulating and vaccine strains of influenza A(H3N2). Most of the increases observed in notified cases of laboratory-confirmed influenza in recent years in Victoria have been attributed to increases in testing. However, that cases of ILI also increased in Victoria in 2017 is suggestive that 2017 was a relatively severe season. The dominance of influenza type A(H3N2), the extended duration of elevated activity, and a potential phylogenetic mismatch of vaccine to circulating strains are likely to have contributed to the relative severity of the 2017 season. Victoria is Australia’s second most populous state and is the mainland’s southernmost state. It has a temperate climate with an influenza season usually occurring in the cooler months between May and October. The Victorian Infectious Diseases Reference Laboratory (VIDRL), in partnership with the Victorian Government Department of Health and Human Services (DHHS), coordinates influenza-like illness (ILI) and laboratory-confirmed influenza surveillance in Victoria. There are three data sources included in the influenza surveillance system.
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17
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Zhang L, Pan Y, Hackert V, van der Hoek W, Meijer A, Krafft T, Yang P, Wang Q. The 2015-2016 influenza epidemic in Beijing, China: Unlike elsewhere, circulation of influenza A(H3N2) with moderate vaccine effectiveness. Vaccine 2018; 36:4993-5001. [PMID: 30017144 DOI: 10.1016/j.vaccine.2018.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/05/2018] [Accepted: 07/10/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND While the 2015-2016 influenza season in the northern hemisphere was dominated by A(H1N1)pdm09 and B/Victoria viruses, in Beijing, China, there was also significant circulation of influenza A(H3N2) virus. In this report we estimate vaccine effectiveness (VE) against influenza A(H3N2) and other circulating viruses, and describe further characteristics of the 2015-2016 influenza season in Beijing. METHODS We estimated VE of the 2015-2016 trivalent inactivated vaccine (TIV) against laboratory-confirmed influenza virus infection using the test-negative study design. The effect of prior vaccination on current VE was also examined. RESULTS Of 11,000 eligible patients included in the study, 2969 (27.0%) were influenza positive. Vaccination coverage was 4.2% in both cases and controls. Adjusted VE against all influenza was 8% (95% CI: -16% to 27%): 18% (95% CI: -38% to 52%) for influenza A(H1N1)pdm09, 54% (95% CI: 16% to 74%) for influenza A(H3N2), and -8% (95% CI: -40% to 18%) for influenza B/Victoria. The overall VE for receipt of 2015-2016 vaccination only, 2014-2015 vaccination only, and vaccinations in both seasons was -15% (95% CI: -63% to 19%), -25% (95% CI: -78% to 13%), and 18% (95% CI: -11% to 40%), respectively. CONCLUSIONS Overall the 2015-2016 TIV was protective against influenza infection in Beijing, with higher VE against the A(H3N2) viruses compared to A(H1N1)pdm09 and B viruses.
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Affiliation(s)
- Li Zhang
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China
| | - Yang Pan
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China
| | - Volker Hackert
- Public Health Service South Limburg, Department of Sexual Health, Infectious Diseases, and Environmental Health, Sittard-Geleen, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Adam Meijer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Thomas Krafft
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Peng Yang
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China; School of Public Health, Capital Medical University, Beijing, China.
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Beijing, China; Beijing Research Center for Preventive Medicine, Beijing, China.
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Sheridan SL, Patel C, Macartney K, Cheng AC. New enhanced influenza vaccines for older Australians: what promise do they hold? Med J Aust 2018; 209:110-112. [PMID: 29996744 DOI: 10.5694/mja18.00334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 06/22/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Sarah L Sheridan
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, NSW
| | - Cyra Patel
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, NSW
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, NSW
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19
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Influenza vaccine effectiveness in hospitalised Hong Kong children: Feasibility of estimates from routine surveillance data. Vaccine 2018; 36:3477-3485. [DOI: 10.1016/j.vaccine.2018.04.081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/05/2018] [Accepted: 04/26/2018] [Indexed: 01/23/2023]
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20
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Sullivan SG, Chilver MB, Carville KS, Deng YM, Grant KA, Higgins G, Komadina N, Leung VK, Minney-Smith CA, Teng D, Tran T, Stocks N, Fielding JE. Low interim influenza vaccine effectiveness, Australia, 1 May to 24 September 2017. Euro Surveill 2017; 22:17-00707. [PMID: 29090681 PMCID: PMC5718387 DOI: 10.2807/1560-7917.es.2017.22.43.17-00707] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 10/26/2017] [Indexed: 11/20/2022] Open
Abstract
In 2017, influenza seasonal activity was high in the southern hemisphere. We present interim influenza vaccine effectiveness (VE) estimates from Australia. Adjusted VE was low overall at 33% (95% confidence interval (CI): 17 to 46), 50% (95% CI: 8 to 74) for A(H1)pdm09, 10% (95% CI: -16 to 31) for A(H3) and 57% (95% CI: 41 to 69) for influenza B. For A(H3), VE was poorer for those vaccinated in the current and prior seasons.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Australia/epidemiology
- Child
- Child, Preschool
- Female
- Humans
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/genetics
- Influenza B virus/immunology
- Influenza B virus/isolation & purification
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/immunology
- Influenza, Human/epidemiology
- Influenza, Human/prevention & control
- Influenza, Human/virology
- Laboratories
- Male
- Middle Aged
- Outcome Assessment, Health Care
- RNA, Viral/genetics
- Seasons
- Sentinel Surveillance
- Sequence Analysis, DNA
- Vaccination/statistics & numerical data
- Vaccine Potency
- Vaccines, Inactivated/administration & dosage
- Vaccines, Inactivated/immunology
- Young Adult
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Affiliation(s)
- Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia
- School of Global and Population Health, University of Melbourne, Australia
- Discipline of General Practice, University of Adelaide, Australia
| | | | - Kylie S Carville
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
| | - Yi-Mo Deng
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia
| | - Kristina A Grant
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
| | | | - Naomi Komadina
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia
| | - Vivian Ky Leung
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia
| | | | - Don Teng
- School of Biomedical Sciences, Monash University, Melbourne, Australia
| | - Thomas Tran
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
| | - Nigel Stocks
- Discipline of General Practice, University of Adelaide, Australia
| | - James E Fielding
- School of Global and Population Health, University of Melbourne, Australia
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
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Kim JI, Lee I, Park S, Bae JY, Yoo K, Cheong HJ, Noh JY, Hong KW, Lemey P, Vrancken B, Kim J, Nam M, Yun SH, Cho WI, Song JY, Kim WJ, Park MS, Song JW, Kee SH, Song KJ, Park MS. Phylogenetic relationships of the HA and NA genes between vaccine and seasonal influenza A(H3N2) strains in Korea. PLoS One 2017; 12:e0172059. [PMID: 28257427 PMCID: PMC5336230 DOI: 10.1371/journal.pone.0172059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/30/2017] [Indexed: 11/18/2022] Open
Abstract
Seasonal influenza is caused by two influenza A subtype (H1N1 and H3N2) and two influenza B lineage (Victoria and Yamagata) viruses. Of these antigenically distinct viruses, the H3N2 virus was consistently detected in substantial proportions in Korea during the 2010/11-2013/14 seasons when compared to the other viruses and appeared responsible for the influenza-like illness rate peak during the first half of the 2011/12 season. To further scrutinize possible causes for this, we investigated the evolutionary and serological relationships between the vaccine and Korean H3N2 strains during the 2011/12 season for the main antigenic determinants of influenza viruses, the hemagglutinin (HA) and neuraminidase (NA) genes. In the 2011/12 season, when the number of H3N2 cases peaked, the majority of the Korean strains did not belong to the HA clade of A/Perth/16/2009 vaccine, and no Korean strains were of this lineage in the NA segment. In a serological assay, post-vaccinated human sera exhibited much reduced hemagglutination inhibition antibody titers against the non-vaccine clade Korean H3N2 strains. Moreover, Korean strains harbored several amino acid differences in the HA antigenic sites and in the NA with respect to vaccine lineages during this season. Of these, the HA antigenic site C residues 45 and 261 and the NA residue 81 appeared to be the signatures of positive selection. In subsequent seasons, when H3N2 cases were lower, the HA and NA genes of vaccine and Korean strains were more phylogenetically related to each other. Combined, our results provide indirect support for using phylogenetic clustering patterns of the HA and possibly also the NA genes in the selection of vaccine viruses and the assessment of vaccine effectiveness.
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Affiliation(s)
- Jin Il Kim
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ilseob Lee
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sehee Park
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Joon-Yong Bae
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kirim Yoo
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyung Wook Hong
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Philippe Lemey
- Department of Microbiology and Immunology, Rega Institute, KU Leuven-University of Leuven, Leuven, Belgium
| | - Bram Vrancken
- Department of Microbiology and Immunology, Rega Institute, KU Leuven-University of Leuven, Leuven, Belgium
| | - Juwon Kim
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Misun Nam
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Soo-Hyeon Yun
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Woo In Cho
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Mee Sook Park
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Jin-Won Song
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sun-Ho Kee
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ki-Joon Song
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Man-Seong Park
- Department of Microbiology, the Institute of Viral Diseases, College of Medicine, Korea University, Seoul, Republic of Korea
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