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Drori Y, Pando R, Sefty H, Rosenberg A, Mendelson E, Keinan-Boker L, Shohat T, Mandelboim M, Glatman-Freedman A. Influenza vaccine effectiveness against laboratory-confirmed influenza in a vaccine-mismatched influenza B-dominant season. Vaccine 2020; 38:8387-8395. [PMID: 33243633 DOI: 10.1016/j.vaccine.2020.10.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The 2017-2018 influenza season in Israel was characterized by the predominance of influenza B Yamagata, with a lesser circulation of influenza A(H1N1)pdm09 and influenza A(H3N2). We estimated vaccine effectiveness (VE) of the inactivated influenza vaccine which was selected for use that season. METHODS End-of-season VE and 95% confidence intervals (CI) against laboratory-confirmed influenza-like illness (ILI) were estimated by means of the test-negative design. Age-specific VE analysis was carried out using a moving age interval. RESULTS Specimen were obtained from 1,453 community ILI patients; 610 (42.0%) were influenza-positive, among which 69.7% were B, 17.2% A(H1N1)pdm09 and 13.4% A(H3N2). A 98.6% of molecularly characterized influenza B belonged to the Yamagata lineage. Of the sampled individuals, 1320 were suitable for VE analysis. Of those vaccinated, 90.6% received the inactivated trivalent influenza vaccine (TIV) containing a Victoria lineage influenza B-like virus. VE against influenza A differed by age, with the highest VE of 72.9% (95%CI 31.9-89.2%) observed in children 0.5-14 years old, while all ages VE was 46.6% (95%CI 10.4-68.2%). All ages VE against influenza B was 23.2% (95%CI -10.1-46.4%) with age-specific analysis showing non-significant VE estimates. Utilizing a moving age interval of 15 years, afforded a detailed age-specific insight into influenza VE against the influenza viruses circulating during the 2017-2018 season. CONCLUSIONS The moderate-high 2017-2018 influenza A VE among children and adolescents, supports seasonal influenza vaccination at a young age. The low VE against influenza B in Israel, is most likely the result of influenza B/TIV-mismatch.
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Affiliation(s)
- Y Drori
- Central Virology Laboratory, Chaim Sheba Medical Center, Israel Ministry of Health, Tel-Hashomer, Ramat Gan, Israel
| | - R Pando
- Central Virology Laboratory, Chaim Sheba Medical Center, Israel Ministry of Health, Tel-Hashomer, Ramat Gan, Israel; Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - H Sefty
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - A Rosenberg
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - E Mendelson
- Central Virology Laboratory, Chaim Sheba Medical Center, Israel Ministry of Health, Tel-Hashomer, Ramat Gan, Israel; School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Keinan-Boker
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel; School of Public Health, University of Haifa, Haifa, Israel
| | - T Shohat
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel; School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Mandelboim
- Central Virology Laboratory, Chaim Sheba Medical Center, Israel Ministry of Health, Tel-Hashomer, Ramat Gan, Israel; School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Glatman-Freedman
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel; School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Cohen R, Babushkin F, Geller K, Finn T. Characteristics of hospitalized adult patients with laboratory documented Influenza A, B and Respiratory Syncytial Virus - A single center retrospective observational study. PLoS One 2019; 14:e0214517. [PMID: 30921408 PMCID: PMC6438521 DOI: 10.1371/journal.pone.0214517] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/15/2019] [Indexed: 01/20/2023] Open
Abstract
Introduction The epidemiology, clinical features and outcomes of hospitalized adult patients with Influenza A (FluA), Influenza B (FluB) and Respiratory Syncytial Virus (RSV) have not been thoroughly compared. The aim of this study was to describe the differences between these viruses during 3 winter seasons. Methods A retrospective observational study was conducted consisting of all the polymerase chain reaction (PCR)-based diagnoses of FluA, FluB and RSV among adults during 2015–2018, in one regional hospital. Epidemiology, clinical symptoms and outcome-related data were comparatively analyzed. Results Between November 2015 and April 2018, 759 patients were diagnosed with FluA, FluB or RSV. Study cohort included 539 adult patients (306 FluA, 148 FluB and 85 RSV). FluB was predominant during the winter of 2017–18. RSV caused 15.7% of hospitalizations with diagnosed viral infection and in comparison to influenza, had distinct epidemiological, clinical features and outcomes, including older age (74.2 vs 66.2, p = 0.001) and higher rates of co-morbidities; complications including bacterial pneumonia (31 vs 18%, p = 0.02), mechanical ventilation (20 vs 7%, p = 0.001), and viral-related death (13 vs 6.6%, p = 0.04). FluA and FluB had similar epidemiology, clinical symptoms and outcomes, but vaccinated patients were less prone to be hospitalized with FluB as compared with FluA (3 vs 14%, p = 0.001). Paroxysmal atrial fibrillation and falls were common (8.7 and 8.5% respectively). Conclusions FluA and FluB had similar epidemiological, clinical features and contributed equally to hospitalization burden and complications. RSV had a major impact on hospitalizations, occurring among the more elderly and sick populations and causing significantly worse outcomes, when compared to influenza patients. Vaccination appeared as a protective factor against hospitalizations with FluB as compared with FluA.
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Affiliation(s)
- Regev Cohen
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
- * E-mail: ,
| | - Frida Babushkin
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
| | - Keren Geller
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
| | - Talya Finn
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Neytanya, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
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