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de Waure C, Gärtner BC, Lopalco PL, Puig-Barbera J, Nguyen-Van-Tam JS. Real world evidence for public health decision-making on vaccination policies: perspectives from an expert roundtable. Expert Rev Vaccines 2024; 23:27-38. [PMID: 38084895 DOI: 10.1080/14760584.2023.2290194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Influenza causes significant morbidity and mortality, but influenza vaccine uptake remains below most countries' targets. Vaccine policy recommendations vary, as do procedures for reviewing and appraising the evidence. AREAS COVERED During a series of roundtable discussions, we reviewed procedures and methodologies used by health ministries in four European countries to inform vaccine recommendations. We review the type of evidence currently recommended by each health ministry and the range of approaches toward considering randomized controlled trials (RCTs) and real-world evidence (RWE) studies when setting influenza vaccine recommendations. EXPERT OPINION Influenza vaccine recommendations should be based on data from both RCTs and RWE studies of efficacy, effectiveness, and safety. Such data should be considered alongside health-economic, cost-effectiveness, and budgetary factors. Although RCT data are more robust and less prone to bias, well-designed RWE studies permit timely evaluation of vaccine benefits, effectiveness comparisons over multiple seasons in large populations, and detection of rare adverse events, under real-world conditions. Given the variability of vaccine effectiveness due to influenza virus mutations and increasing diversification of influenza vaccines, we argue that consideration of both RWE and RCT evidence is the best approach to more nuanced and timely updates of influenza vaccine recommendations.
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Affiliation(s)
- Chiara de Waure
- Public Health, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Barbara C Gärtner
- Department and Institute of Microbiology, Saarland University Hospital, Homburg, Germany
| | | | - Joan Puig-Barbera
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Region, Valencia, Spain
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2
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Meng Z, Guo S, Zhou Y, Li M, Wang M, Ying B. Applications of laboratory findings in the prevention, diagnosis, treatment, and monitoring of COVID-19. Signal Transduct Target Ther 2021; 6:316. [PMID: 34433805 PMCID: PMC8386162 DOI: 10.1038/s41392-021-00731-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 02/07/2023] Open
Abstract
The worldwide pandemic of coronavirus disease 2019 (COVID-19) presents us with a serious public health crisis. To combat the virus and slow its spread, wider testing is essential. There is a need for more sensitive, specific, and convenient detection methods of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Advanced detection can greatly improve the ability and accuracy of the clinical diagnosis of COVID-19, which is conducive to the early suitable treatment and supports precise prophylaxis. In this article, we combine and present the latest laboratory diagnostic technologies and methods for SARS-CoV-2 to identify the technical characteristics, considerations, biosafety requirements, common problems with testing and interpretation of results, and coping strategies of commonly used testing methods. We highlight the gaps in current diagnostic capacity and propose potential solutions to provide cutting-edge technical support to achieve a more precise diagnosis, treatment, and prevention of COVID-19 and to overcome the difficulties with the normalization of epidemic prevention and control.
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Affiliation(s)
- Zirui Meng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Shuo Guo
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yanbing Zhou
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Mengjiao Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Minjin Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Binwu Ying
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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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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4
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Kissling E, Rose A, Emborg HD, Gherasim A, Pebody R, Pozo F, Trebbien R, Mazagatos C, Whitaker H, Valenciano M. Interim 2018/19 influenza vaccine effectiveness: six European studies, October 2018 to January 2019. ACTA ACUST UNITED AC 2020; 24. [PMID: 30808440 PMCID: PMC6446950 DOI: 10.2807/1560-7917.es.2019.24.1900121] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Influenza A(H1N1)pdm09 and A(H3N2) viruses both circulated in Europe in October 2018–January 2019. Interim results from six studies indicate that 2018/19 influenza vaccine effectiveness (VE) estimates among all ages in primary care was 32–43% against influenza A; higher against A(H1N1)pdm09 and lower against A(H3N2). Among hospitalised older adults, VE estimates were 34–38% against influenza A and slightly lower against A(H1N1)pdm09. Influenza vaccination is of continued benefit during the ongoing 2018/19 influenza season.
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Affiliation(s)
- Esther Kissling
- These authors contributed equally to the study and manuscript writing.,EpiConcept, Paris, France
| | - Angela Rose
- These authors 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
| | | | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, 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
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5
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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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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] [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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7
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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: 81] [Impact Index Per Article: 20.3] [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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8
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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] [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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9
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Yaron-Yakoby H, Sefty H, Pando R, Dichtiar R, Katz MA, Stein Y, Mandelboim M, Mendelson E, Shohat T, Glatman-Freedman A. Effectiveness of influenza vaccine in preventing medically-attended influenza virus infection in primary care, Israel, influenza seasons 2014/15 and 2015/16. ACTA ACUST UNITED AC 2019; 23. [PMID: 29471622 PMCID: PMC5824129 DOI: 10.2807/1560-7917.es.2018.23.7.17-00026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Influenza vaccine is recommended for the entire population in Israel. We assessed influenza vaccine effectiveness (VE) for the 2014/15 and 2015/16 seasons in Israel, for the first time. Methods: Combined nose and throat swab specimens were collected from patients with influenza-like illness (ILI) presenting to sentinel primary care clinics and tested for influenza virus by RT-PCR. VE of the trivalent inactivated vaccine (TIV) was assessed using test-negative case–control design. Results: During the 2014/15 season 1,142 samples were collected; 327 (28.6%) were positive for influenza, 83.8% A(H3N2), 5.8% A(H1N1)pdm09, 9.2% B and 1.2% A un-subtyped. Adjusted VE against all influenza viruses for this influenza season was −4.8% (95% confidence interval (CI): −54.8 to 29.0) and against influenza A(H3N2), it was −15.8% (95% CI: −72.8 to 22.4). For the 2015/16 season, 1,919 samples were collected; 853 (44.4%) were positive for influenza, 43.5% A(H1N1)pdm09, 57% B, 0.7% A(H3N2) and 11 samples positive for both A(H1N1)pdm09 and B. Adjusted VE against all influenza viruses for this influenza season was 8.8% (95% CI: −25.1 to 33.5), against influenza A(H1N1)pdm09, it was 32.3% (95% CI: (−4.3 to 56.1) and against influenza B, it was −2.2% (95% CI: (−47.0 to 29.0). Conclusions: Using samples from patients with ILI visiting sentinel clinics in Israel, we demonstrated the feasibility of influenza VE estimation in Israel.
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Affiliation(s)
- Hamutal Yaron-Yakoby
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Hanna Sefty
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Rakefet Pando
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Mark A Katz
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States.,Ben Gurion University, Beer Sheva, Israel
| | - Yaniv Stein
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Michal Mandelboim
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Aharona Glatman-Freedman
- Departments of Pediatrics and Family and Community Medicine, New York Medical College, Valhalla, New York, United States.,Israel Center for Disease Control, Israel Ministry of Health, Tel Hashomer, Ramat Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
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- The members of the group are listed at the end of the paper
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10
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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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11
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Ma C, Pan Y, Zhang L, Zhang Y, Wu S, Sun Y, Duan W, Zhang M, Wang Q, Yang P. Influenza vaccine effectiveness against medically attended influenza illness in Beijing, China, 2014/15 season. Hum Vaccin Immunother 2018; 13:2379-2384. [PMID: 28846480 DOI: 10.1080/21645515.2017.1359364] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Influenza vaccination is the most effective way of preventing influenza infections but its coverage is extremely low in China. Poor influenza vaccine effectiveness (VE) was reported in the 2014/15 season in some Northern Hemisphere countries with a predominance of H3N2 viruses belonging to the 3C.2a clade. However, there is limited information regarding the preventive effect of influenza vaccination for the same season in China, in which H3N2 viruses belonging to the 3C.3a clade predominated. Through influenza virological surveillance in Beijing, China during the 2014/15 season, we estimated the influenza VE against medically attended influenza-like illness (ILI) associated with laboratory-confirmed influenza virus infection using a test-negative design, and the effect of prior vaccination on current vaccination was examined. In total, 9297 patients with ILI were enrolled in this study. Among them, 3434 (36.9%) tested positive for influenza viruses: 2167 (63.1%) for A(H3N2), 1261 (36.7%) for influenza B, and 3 (0.1%) for A(H1N1)pdm09. The adjusted VE was estimated as -25% (95% CI: -70%, 8%) against A(H3N2) and -8% (95% CI: -50%, 23%) against B, with an overall VE of -18% (95% CI: -49%, 6%). The overall VE estimate for patients who received 2014/15 vaccination only was -12% (-57%, 20%), while VE for patients who received both 2013/14 and 2014/15 vaccinations was -27% (-72%, 7%). There was no evidence that the influenza vaccine protected vaccinees against medically attended influenza in Beijing, China during the 2014/15 season.
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Affiliation(s)
- Chunna Ma
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Yang Pan
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China.,c School of Public Health, Capital Medical University , Beijing , China
| | - Li Zhang
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Yi Zhang
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Shuangsheng Wu
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Ying Sun
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Wei Duan
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Man Zhang
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Quanyi Wang
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China
| | - Peng Yang
- a Beijing Center for Disease Prevention and Control , Beijing , China.,b Beijing Research Center for Preventive Medicine , Beijing , China.,c School of Public Health, Capital Medical University , Beijing , China
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Ana-Sosa-Batiz F, Johnston APR, Hogarth PM, Wines BD, Barr I, Wheatley AK, Kent SJ. Antibody-dependent phagocytosis (ADP) responses following trivalent inactivated influenza vaccination of younger and older adults. Vaccine 2017; 35:6451-6458. [PMID: 29029940 DOI: 10.1016/j.vaccine.2017.09.062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/14/2017] [Accepted: 09/19/2017] [Indexed: 01/10/2023]
Abstract
Globally the most commonly utilised immunisation against influenza is the trivalent inactivated influenza vaccine (TIV) derived from an A/H1N1, an A/H3N2 and aB type influenza virus. Vaccine effectiveness of TIV varies year to year, depending on how well antigenically matched the strains in the vaccine are compared to circulating strains [1,2]. Moreover, vaccine effectiveness can vary within certain subpopulations such as HIV-positive, young children and the elderly. Decreased vaccine effectiveness in the elderly is associated with impaired Ab production, as measured by standard hemagglutination inhibition (HAI) assays. We investigated the level of Antibody Dependent Phagocytosis (ADP)-mediating Abs induced by the 2008-TIV in healthy Australian adults aged over and under 60years to determine if this immune function was also reduced in the elderly. We utilised an ADP assay that measures the uptake of IgG-opsonised HA-coated fluorescent microspheres by a monocytic cell line. We also measured HA-specific Abs that are close enough to bind to dimeric FcγRIIa ectodomains in an ELISA-based assay. Furthermore, we compared the extent of cross-reactive recognition of diverse influenza strains by ADP-mediating Abs found in pre- and post-vaccination sera in both of these groups. We found that young adults and older adults mounted similar ADP activity against HAs contained in the 2008-TIV, despite older adults have diminished HI responses. The level of cross-reactive antibodies against other HAs was limited in both groups. We conclude that seasonal influenza vaccination elicits limited cross-reactive ADP to HA in both young and older adults. New influenza vaccination strategies that elicit cross-reactive and polyfunctional antibodies are needed.
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Affiliation(s)
- Fernanda Ana-Sosa-Batiz
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia
| | - Angus P R Johnston
- Drug Delivery, Disposition and Dynamics Laboratory, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia; ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash University, Parkville, Australia
| | - P Mark Hogarth
- Burnett Institute, 85 Commercial Rd, Melbourne, VIC 3004, Australia
| | - Bruce D Wines
- Burnett Institute, 85 Commercial Rd, Melbourne, VIC 3004, Australia
| | - Ian Barr
- 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
| | - Adam K Wheatley
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Parkville, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia; Melbourne Sexual Health Centre, Central Clinical School, Monash University, 580 Swanston Street, Carlton, VIC 3053, Melbourne, Australia; ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, University of Melbourne, Parkville, Australia.
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Effect of previous and current vaccination against influenza A(H1N1)pdm09, A(H3N2), and B during the post-pandemic period 2010-2016 in Spain. PLoS One 2017; 12:e0179160. [PMID: 28614376 PMCID: PMC5470701 DOI: 10.1371/journal.pone.0179160] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/24/2017] [Indexed: 11/26/2022] Open
Abstract
Background Recent studies suggest that the protective effect of the current influenza vaccine could be influenced by vaccination in previous seasons. We estimated the combined effect of the previous and current influenza vaccines from the 2010–2011 season to the 2015–2016 season in Spain. Methods We performed a test-negative case-control study in patients ≥9 years old. We estimated the influenza vaccine effectiveness (IVE) against influenza A(H1N1)pdm09, A(H3N2), and B virus. Results We included 1206 influenza A(H1N1)pdm09 cases, 1358 A(H3N2) cases and 1079 B cases. IVE against A(H1N1)pdm09 virus in the pooled-season analysis was 53% (95% Confidence Interval (CI): 21% to 72%) for those vaccinated only in the current season and 50% (95%CI: 23% to 68%) for those vaccinated in the both current and previous seasons. Against the influenza A(H3N2) virus, IVE was 17% (95%CI: -43% to 52%) for those vaccinated only in the current season and 3% (95%CI: -33% to 28%) for those vaccinated in both seasons. Regarding influenza B, we obtained similar IVEs for those vaccinated only in the current and those vaccinated in both seasons: 57% (95%CI: 12% to 79%) and 56% (95%CI: 36% to 70%), respectively. Conclusion Our results suggested no interference between the previous and current influenza vaccines against A(H1N1)pdm09 and B viruses, but a possible negative interference against A(H3N2) virus.
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Waning protection of influenza vaccine against mild laboratory confirmed influenza A(H3N2) and B in Spain, season 2014–15. Vaccine 2016; 34:2371-7. [DOI: 10.1016/j.vaccine.2016.03.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/29/2016] [Accepted: 03/14/2016] [Indexed: 11/21/2022]
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Qin Y, Zhang Y, Wu P, Feng S, Zheng J, Yang P, Pan Y, Wang Q, Feng L, Pang X, Puig-Barberà J, Yu H, Cowling BJ. Influenza vaccine effectiveness in preventing hospitalization among Beijing residents in China, 2013-15. Vaccine 2016; 34:2329-33. [PMID: 27026147 DOI: 10.1016/j.vaccine.2016.03.068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/10/2016] [Accepted: 03/18/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Estimates of influenza vaccination effectiveness (VE) are valuable for populations where the vaccine has been promoted in order to support vaccination policy and to permit evaluation of vaccination strategies. Such studies would be important for China due to limited data available during seasons when the vaccine strains matched or mismatched the circulating viruses. METHODS We conducted a test-negative study in hospitals in Beijing. Patients admitted to five hospitals in the city were enrolled during the winter influenza seasons of 2013-14 and 2014-15. Influenza virus infections were determined by PCR, and influenza vaccination records were extracted from a centralized electronic immunization registry. Influenza VE was estimated by logistic regression adjusting for age group, sex and chronic conditions, and matched by calendar week. RESULTS A total of 2368 inpatients were recruited during the study period with a vaccination coverage in the control group of 12.8%. The overall estimate of influenza VE was 46.9% (95% CI: -20.4%, 76.6%) for the 2013-14 season and 5.0% (95% CI: -53.0%, 41.0%) for the 2014-15 season. Estimates of VE were relatively higher in children aged 6-17 years than older persons across two influenza seasons while estimates of VE for both adults and elderly were relatively low. CONCLUSIONS Our findings were consistent with expected influenza vaccination effectiveness in seasons when the vaccine matched or mismatched circulating viruses. Strategies to increase influenza vaccine coverage could provide a public health benefit.
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Affiliation(s)
- Ying Qin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zhang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Peng Wu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Shuo Feng
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jiandong Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Yang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yang Pan
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xinghuo Pang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Joan Puig-Barberà
- Foundation for the Promotion of Health and Biomedical Research in the Valencia Region FISABIO - Public Health, Valencia, Spain
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Benjamin J Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
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