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Li Y, Yu J, Li Q, Yu D, Song W, Liu Q, Gao D, Chen Q, Zhang H, Huo L, Wang J, Wang J, Yang H, Zeng G. Effect of Influenza Vaccination on Rate of Influenza Virus Infection in Chinese Military Personnel, 2015-2016: A Cluster Randomized Trial. Vaccines (Basel) 2023; 11:1439. [PMID: 37766116 PMCID: PMC10534408 DOI: 10.3390/vaccines11091439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023] Open
Abstract
Influenza is a major cause of morbidity and mortality. The protective effect of a trivalent influenza vaccine (TIV) is undetermined in military personnel. We conducted an open-label, cluster randomized trial on active-duty servicemen of Beijing, Tianjin, and Shijiazhuang, who were randomly assigned to receive either a single dose of TIV or no treatment, according to cluster randomized sampling. The subjects were then followed for a maximum of six months to assess the incidence of laboratory-confirmed influenza. A total of 5445 subjects in 114 clusters received one dose of TIV before the 2015/2016 influenza season. Laboratory-confirmed influenza was identified in 18 in the vaccine group compared with 87 in the control group (6031 subjects in 114 clusters), resulting in a vaccine effectiveness (VE) of 76.4% (95%CI: 60.7 to 85.8) against laboratory-confirmed influenza. Influenza-like illness was diagnosed in 132 in the vaccine group compared with 420 in the control group, resulting in a VE of 64.1% (95%CI: 56.2 to 70.6). The estimated VE against influenza B viruses was 80.5% (95%CI: 65.6 to 88.9) and 8.6% (95%CI: -241 to 75.5) against influenza A viruses. In conclusion, the trivalent influenza vaccine is moderately effective, highly immunogenic, and generally safe to use in healthy male military servicemen.
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Affiliation(s)
- Yapin Li
- Central Theater Command Center for Disease Control and Prevention, No. 66 Heishitou Road, Beijing 100042, China; (Y.L.); (Q.L.); (W.S.); (D.G.); (H.Z.); (J.W.)
| | - Jianxing Yu
- Sinovac Biotech Ltd., No. 39, Shangdi West Road, Beijing 100085, China; (J.Y.); (D.Y.); (Q.C.); (L.H.)
| | - Qingfeng Li
- Central Theater Command Center for Disease Control and Prevention, No. 66 Heishitou Road, Beijing 100042, China; (Y.L.); (Q.L.); (W.S.); (D.G.); (H.Z.); (J.W.)
| | - Dan Yu
- Sinovac Biotech Ltd., No. 39, Shangdi West Road, Beijing 100085, China; (J.Y.); (D.Y.); (Q.C.); (L.H.)
| | - Wenjing Song
- Central Theater Command Center for Disease Control and Prevention, No. 66 Heishitou Road, Beijing 100042, China; (Y.L.); (Q.L.); (W.S.); (D.G.); (H.Z.); (J.W.)
| | - Qi Liu
- Sinovac Life Sciences Ltd., Beijing 102601, China; (Q.L.); (J.W.)
| | - Dongqi Gao
- Central Theater Command Center for Disease Control and Prevention, No. 66 Heishitou Road, Beijing 100042, China; (Y.L.); (Q.L.); (W.S.); (D.G.); (H.Z.); (J.W.)
| | - Qiulan Chen
- Sinovac Biotech Ltd., No. 39, Shangdi West Road, Beijing 100085, China; (J.Y.); (D.Y.); (Q.C.); (L.H.)
| | - Haiyang Zhang
- Central Theater Command Center for Disease Control and Prevention, No. 66 Heishitou Road, Beijing 100042, China; (Y.L.); (Q.L.); (W.S.); (D.G.); (H.Z.); (J.W.)
| | - Liqun Huo
- Sinovac Biotech Ltd., No. 39, Shangdi West Road, Beijing 100085, China; (J.Y.); (D.Y.); (Q.C.); (L.H.)
| | - Jian Wang
- Central Theater Command Center for Disease Control and Prevention, No. 66 Heishitou Road, Beijing 100042, China; (Y.L.); (Q.L.); (W.S.); (D.G.); (H.Z.); (J.W.)
| | - Jiayi Wang
- Sinovac Life Sciences Ltd., Beijing 102601, China; (Q.L.); (J.W.)
| | - Huisuo Yang
- Central Theater Command Center for Disease Control and Prevention, No. 66 Heishitou Road, Beijing 100042, China; (Y.L.); (Q.L.); (W.S.); (D.G.); (H.Z.); (J.W.)
| | - Gang Zeng
- Sinovac Biotech Ltd., No. 39, Shangdi West Road, Beijing 100085, China; (J.Y.); (D.Y.); (Q.C.); (L.H.)
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Aoun T, Borrow R, Arkwright PD. Immunogenicity and safety of seasonal influenza vaccines in children under 3 years of age. Expert Rev Vaccines 2023; 22:226-242. [PMID: 36800932 DOI: 10.1080/14760584.2023.2181797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Despite children aged 6-35 months developing more severe influenza infections, not all countries include influenza vaccines in their national immunization programs. AREAS COVERED This literature review examines the efficacy, immunogenicity, and safety of seasonal trivalent influenza vaccines (TIVs) and quadrivalent influenzae vaccines (QIVs) in children 6-35 months old to determine if greater valency promotes greater protection while maintaining a similar safety profile. EXPERT OPINION TIVs and QIVs are safe for children under 3 years old. TIVs and QIVs provided good seroprotection, and immunogenicity (GMT, SCR, and SPR) meeting recommended levels set by CHMP (European) and CBER (USA). However, as QIVs carry two influenza B strains and TIVs only one, QIVs has an overall higher seroprotection against particularly influenza B. Vaccines containing adjuncts had better immunogenicity, particularly after the first dose. Seroprotection of all vaccines lasted 12 months. Increasing the dosage from 0.25 mL to 0.5 mL did not cause more systemic or local side-effects. Further comparisons of efficacy, and wider promotion of influenza vaccines in general are required in preschool children.
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Affiliation(s)
- Tia Aoun
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - Ray Borrow
- Vaccine Evaluation Unit, UK Health Security Agency, Manchester Royal Infirmary, Manchester, UK
| | - Peter D Arkwright
- Royal Manchester Children's Hospital, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
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Sarkar S, Bokade C, Garg K, Kumar R, Sanmukhani J, Mittal R. Immunogenicity and safety of the first indigenously developed Indian tetravalent influenza vaccine (split virion) in healthy children (6 months to 17 years of age): a randomized, multicenter, phase III clinical trial. Hum Vaccin Immunother 2021; 17:681-689. [PMID: 32845782 PMCID: PMC7993130 DOI: 10.1080/21645515.2020.1794683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This phase III clinical trial was conducted to evaluate the immunogenicity and safety of the Tetravalent Influenza Vaccine (Split virion) I.P. (TetIV), containing two strains each of influenza A and B, developed indigenously in the country for the first time by M/s Cadila Healthcare Limited, India for use in the pediatric population (6 months -17 years of age), and compare it to that of a licensed seasonal Trivalent Influenza Vaccine (TriIV) of Sanofi Pasteur India Private Limited, containing two influenza A and one influenza B strains. Three hundred six subjects of either sex, 6 months to 17 years of age, were randomized in a 1:1 ratio to receive either TetIV or TriIV. Immunogenicity assessments (antibodies against A/H1N1, A/H3N2, B/Phuket, and B/Brisbane) were performed using the hemagglutination inhibition assay at baseline and 28 days after the last vaccination. TetIV was found to fulfill the criteria set by the United States Food and Drug Administration on the requirements of clinical data for licensure of seasonal inactivated influenza vaccines for the pediatric population. The seroconversion rates with TetIV were 94.6% for A/H1N1, 93.9% for A/H3N2, 91.2% for B/Brisbane, and 87.2% for B/Phuket strains. TetIV showed non-inferiority and superiority in immune response, as compared to TriIV, against the shared strains and an additional B strain, respectively. Both the vaccines were tolerated well by all the study participants, and an addition of the fourth strain in TetIV did not compromise the safety as compared to that of TriIV. The most common adverse event reported in both groups was fever.
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Affiliation(s)
- Sumantra Sarkar
- Department of Pediatrics, IPGMER & SSKM Hospital, Kolkata, India
| | - Chandrakant Bokade
- Department of Pediatrics, Government Medical College and Hospital, Medical College Square, Nagpur, India
| | - Kapil Garg
- Department of Paediatrics, Jay Kay Lon Hospital SMS Medical College, Jaipur, India
| | - Ravi Kumar
- Department of Pediatrics, Niloufer Hospital (Affiliated to Osmania Medical College), Hyderabad, India
| | - Jayesh Sanmukhani
- Department of Clinical Research and Regulatory Affairs, Cadila Healthcare Limited, India
| | - Ravindra Mittal
- Department of Clinical Research and Regulatory Affairs, Cadila Healthcare Limited, India
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Luo C, Jiang Y, Du J, Tong J, Huang J, Lo Re V, Ellenberg SS, Poland GA, Tao C, Chen Y. Prediction of post-vaccination Guillain-Barré syndrome using data from a passive surveillance system. Pharmacoepidemiol Drug Saf 2021; 30:602-609. [PMID: 33533072 PMCID: PMC8014460 DOI: 10.1002/pds.5196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/11/2021] [Indexed: 01/21/2023]
Abstract
Purpose Severe adverse events (AEs), such as Guillain‐Barré syndrome (GBS) occur rarely after influenza vaccination. We identify highly associated AEs with GBS and develop prediction models for GBS using the US Vaccine Adverse Event Reporting System (VAERS) reports following trivalent influenza vaccination (FLU3). Methods This study analyzed 80 059 reports from the US VAERS between 1990 and 2017. Several AEs were identified as highly associated with GBS and were used to develop the prediction model. Some common and mild AEs that were suspected to be underreported when GBS occurred simultaneously were removed from the final model. The analyses were validated using European influenza vaccine AEs data from EudraVigilance. Results Of the 80 059 reports, 1185 (1.5%) were annotated as GBS related. Twenty‐four AEs were identified as having strong association with GBS. The full prediction model, using age, sex, and all 24 AEs achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 85.4% (90% CI: [83.8%, 86.9%]). After excluding the nine (e.g., pruritus, rash, injection site pain) likely underreported AEs, the final AUC became 77.5% (90% CI: [75.5%, 79.6%]). Two hundred and one (0.25%) reports were predicted as of high risk of GBS (predicted probability >25%) and 84 actually developed GBS. Conclusion The prediction performance demonstrated the potential of developing risk‐prediction models utilizing the VAERS cohort. Excluding the likely underreported AEs sacrificed some prediction power but made the model more interpretable and feasible. The high absolute risk of even a small number of AE combinations suggests the promise of GBS prediction within the VAERS dataset.
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Affiliation(s)
- Chongliang Luo
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ying Jiang
- Department of Neurology and Multiple Sclerosis Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingcheng Du
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jiayi Tong
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jing Huang
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Vincent Lo Re
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Susan S Ellenberg
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gregory A Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, Minnesota, USA
| | - Cui Tao
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Yong Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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5
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Korem M, Orenbuch-Harroch E, Ben-Chetrit E, Israel S, Cohen MJ, Sviri S, Levin PD, Mandelboim M, Wolf DG. Intensive Care Admissions and Associated Severity of Influenza B Versus A During Influenza B Vaccine-mismatched Seasons. Clin Infect Dis 2020; 69:1049-1052. [PMID: 30715225 DOI: 10.1093/cid/ciz053] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/17/2019] [Indexed: 12/29/2022] Open
Abstract
Patients admitted to hospital with influenza B and A in Jerusalem, Israel, during the 2015-2016 and 2017-2018 influenza seasons demonstrated similar rates of intensive care unit (ICU) admission and associated disease severity. Most (63%) influenza B ICU patients received influenza B-mismatched trivalent vaccine. These findings call into question the equivalence of trivalent and quadrivalent vaccines in preventing severe influenza B.
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Affiliation(s)
- Maya Korem
- Clinical Virology Unit, Department of Clinical Microbiology and Infectious Diseases
| | - Efrat Orenbuch-Harroch
- Clinical Virology Unit, Department of Clinical Microbiology and Infectious Diseases.,Intensive Care Unit, Hadassah Hebrew University Medical Center
| | | | - Sarah Israel
- Department of Internal Medicine, Hadassah Mount-Scopus Hebrew University Medical Center
| | - Matan J Cohen
- Clalit Health Services, Shaare Zedek Medical Center, Jerusalem
| | - Sigal Sviri
- Intensive Care Unit, Hadassah Hebrew University Medical Center
| | - Phillip D Levin
- General Intensive Care Unit, Shaare Zedek Medical Center, Jerusalem
| | - Michal Mandelboim
- Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University
| | - Dana G Wolf
- Clinical Virology Unit, Department of Clinical Microbiology and Infectious Diseases.,The Lautenberg Center, the Hebrew University Faculty of Medicine, Jerusalem, Israel
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Hsu PS, Lian IB, Chao DY. A Population-Based Propensity Score-Matched Study to Assess the Impact of Repeated Vaccination on Vaccine Effectiveness for Influenza-Associated Hospitalization Among the Elderly. Clin Interv Aging 2020; 15:301-312. [PMID: 32184579 PMCID: PMC7060795 DOI: 10.2147/cia.s238786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/17/2020] [Indexed: 12/20/2022] Open
Abstract
Background Influenza is a major cause of morbidity and mortality in the elderly worldwide. Influenza vaccination can prevent morbidity/mortality from influenza infection. A gap of 1–2 years, before an epidemic strain is recommended by the World Health Organization (WHO) to be the vaccine strain in Southeast Asia, has been reported; this results in a high rate of vaccine mismatch and excess influenza-associated morbidity. The aim of the current study was to evaluate the effect of repeated vaccination on vaccine effectiveness (VE) among the elderly in Taiwan, during years with and without early appearance of antigenically drifted strains. Methods A historical cohort study was conducted to evaluate the impact of repeated vaccination on the reduction of influenza-associated hospitalization among persons older than 64 years over two influenza seasons: 2007–08, with all circulating virus strains mismatched, and 2008–09, with all virus strains matched with the vaccine strains, considering four exposure effects, namely current vaccine effect, sequential vaccination effect, residual protection effect and no vaccination effect. Propensity score matching on vaccination status was performed to ensure similar baseline characteristics between the groups that received and did not receive vaccination. Results Only current-year vaccination in combination with prior history of annual revaccination significantly reduced the risk of hospitalization, with adjusted hazard ratios of 0.68 (95% CI: 0.54, 0.85) and 0.74 (95% CI: 0.57, 0.95) during the 2007–08 and 2008–09 influenza seasons, respectively. Further stratification showed that even during the 2007–08 influenza season, when all vaccinations were mismatched with the circulating strains, sequential vaccinations still significantly reduced influenza-associated hospitalization in the female population aged 68–74 and 75–84 years, with adjusted VE of 25.2% (95% CI: −9.6, 49.0%) and 36.9% (95% CI: 17.1, 52.0%), respectively. Conclusion Our study supports the recommendation of annual revaccination against influenza in the elderly, even though the circulating strain of influenza virus was antigenically mismatched with the vaccine strains.
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Affiliation(s)
- Pi-Shan Hsu
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.,Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Ie-Bin Lian
- Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua, Taiwan.,Department of Applied Math, National Chung-Hsing University, Taichung, Taiwan
| | - Day-Yu Chao
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan
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7
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Kuniyoshi Y, Obara T, Ishikuro M, Matsubara H, Nagai M, Murakami K, Noda A, Kikuya M, Kure S, Kuriyama S. Effectiveness of seasonal inactivated influenza vaccination in Japanese schoolchildren: an epidemiologic study at the community level. Hum Vaccin Immunother 2019; 16:295-300. [PMID: 31424311 DOI: 10.1080/21645515.2019.1655833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Influenza vaccination is the most effective method for preventing influenza virus infection. The incidence of influenza is higher in schoolchildren than other age groups. This study evaluated the effectiveness of seasonal inactivated influenza vaccination (IIV) in a community population of schoolchildren during two seasons. This study was a cross-sectional survey of public schoolchildren based on data collected in the 2012/2013 and 2014/2015 seasons. The questionnaire was distributed to all public schoolchildren of target grade in a survey area, and 7945 respondents were included in the analysis. The vaccination status and influenza onset were defined based on the self-reported questionnaire by parents or guardians. Generalized linear mixed models were used to adjust clustering within schools and individual covariates and calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between vaccination status and influenza onset. The influenza incidence was higher in the 2015 than the 2013 survey (25% versus 17%), although the vaccination rates were comparable between the two seasons. Receiving one- or two-dose vaccination was more protective against influenza than non-vaccination in both the 2013 (OR, 0.77; 95%CI, 0.65-0.92) and 2015 (OR, 0.88; 95%CI, 0.75-1.02) surveys. Full vaccination was also more protective in both the 2013 (OR, 0.75; 95%CI, 0.62-0.89) and 2015 (OR, 0.86; 95%CI, 0.74-1.00) surveys. Seasonal IIV was protective against influenza for Japanese schoolchildren in a community-based real-world setting. The difference in clinical effectiveness of IIV between the two seasons was likely due to the antigenic mismatch between the circulating and vaccine strains.
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Affiliation(s)
- Yasutaka Kuniyoshi
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Hiroko Matsubara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Masato Nagai
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Pediatrics, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.,Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
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8
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Kolarov C, Löbermann M, Fritzsche C, Hemmer C, Mlynski R, Reisinger EC. Bilateral deafness two days following influenza vaccination: a case report. Hum Vaccin Immunother 2018; 15:107-108. [PMID: 30118641 DOI: 10.1080/21645515.2018.1509657] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE We report a case of deafness occurring in a temporal context of an influenza vaccination in a 79-year-old woman. METHODS Case report and review of the literature on influenza causing deafness. RESULTS A 79-year-old woman with normal hearing developed acute bilateral sensorineural hearing loss two days after a seasonal influenza vaccination, other obvious reasons for acute hearing loss were excluded. CONCLUSION This patient appears to be the first reported case of bilateral deafness following a trivalent seasonal influenza vaccination.
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Affiliation(s)
- Claudia Kolarov
- a Department of Tropical Medicine, Infectious Diseases and Nephrology , Rostock University Medical Center , Rostock , Germany
| | - Micha Löbermann
- a Department of Tropical Medicine, Infectious Diseases and Nephrology , Rostock University Medical Center , Rostock , Germany
| | - Carlos Fritzsche
- a Department of Tropical Medicine, Infectious Diseases and Nephrology , Rostock University Medical Center , Rostock , Germany
| | - Christoph Hemmer
- a Department of Tropical Medicine, Infectious Diseases and Nephrology , Rostock University Medical Center , Rostock , Germany
| | - Robert Mlynski
- b Department of Otorhinolaryngology, Head and Neck Surgery ``Otto Koerner`` , Rostock University Medical Center , Rostock , Germany
| | - Emil Christian Reisinger
- a Department of Tropical Medicine, Infectious Diseases and Nephrology , Rostock University Medical Center , Rostock , Germany
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9
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Cruz-Valdez A, Valdez-Zapata G, Patel SS, Castelli FV, Garcia MG, Jansen WT, Arora AK, Heijnen E. MF59-adjuvanted influenza vaccine (FLUAD®) elicits higher immune responses than a non-adjuvanted influenza vaccine (Fluzone®): A randomized, multicenter, Phase III pediatric trial in Mexico. Hum Vaccin Immunother 2018; 14:386-395. [PMID: 28925801 PMCID: PMC5806633 DOI: 10.1080/21645515.2017.1373227] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/31/2017] [Accepted: 08/25/2017] [Indexed: 01/22/2023] Open
Abstract
The poor immune response elicited by trivalent influenza vaccines (TIVs) in children can be enhanced by the addition of adjuvants. This observer-blind, randomized Phase III trial assessed the immunogenicity and safety of the MF59-adjuvanted trivalent influenza vaccine FLUAD® (aTIV) and a non-adjuvanted TIV, in healthy children (aged 6 to <72 months) from 3 centers in Mexico, during the 2014-2015 season. The primary objectives were to assess the non-inferiority of aTIV to TIV, measured by geometric mean titers (GMTs), and the safety of aTIV and TIV. Seroconversion was one of several secondary objectives. In total, 287 children were enrolled. The non-inferiority criteria for GMTs and seroconversion were met for aTIV for all 3 vaccine strains. Lower bounds of the 95% confidence intervals for all 3 aTIV:TIV vaccine ratios were >2, showing that the immunogenicity of aTIV was superior to that of TIV for all 3 strains. Solicited adverse events (AEs) were experienced more frequently with aTIV than TIV by younger children (aged 6 to <36 months), but were more frequent with TIV than aTIV in older children (aged 36 to <72 months) who had been vaccinated previously. More unsolicited AEs were associated with aTIV than the TIV. All AEs were of mild or moderate severity. No deaths, serious AEs, or AEs leading to premature withdrawal were reported. Overall, aTIV was highly immunogenic and was well tolerated in healthy children 6 to <72 months of age. These results indicate that aTIV may be a beneficial addition to national pediatric vaccination programs.
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Affiliation(s)
- Aurelio Cruz-Valdez
- Center of Investigation of Public Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | | | - Sanjay S. Patel
- Influenza Vaccines Development, Novartis Influenza Vaccines, Cambridge, MA, USA
| | | | | | - Wim T. Jansen
- Department of BioStatistics GSK, Amsterdam, The Netherlands
| | | | - Esther Heijnen
- Seasonal Influenza Vaccines, Seqirus, Amsterdam, The Netherlands
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Jensen TL, Frasketi M, Conway K, Villarroel L, Hill H, Krampis K, Goll JB. RSEQREP: RNA-Seq Reports, an open-source cloud-enabled framework for reproducible RNA-Seq data processing, analysis, and result reporting. F1000Res 2017; 6:2162. [PMID: 30026912 PMCID: PMC6039931 DOI: 10.12688/f1000research.13049.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 12/31/2022] Open
Abstract
RNA-Seq is increasingly being used to measure human RNA expression on a genome-wide scale. Expression profiles can be interrogated to identify and functionally characterize treatment-responsive genes. Ultimately, such controlled studies promise to reveal insights into molecular mechanisms of treatment effects, identify biomarkers, and realize personalized medicine. RNA-Seq Reports (RSEQREP) is a new open-source cloud-enabled framework that allows users to execute start-to-end gene-level RNA-Seq analysis on a preconfigured RSEQREP Amazon Virtual Machine Image (AMI) hosted by AWS or on their own Ubuntu Linux machine via a Docker container or installation script. The framework works with unstranded, stranded, and paired-end sequence FASTQ files stored locally, on Amazon Simple Storage Service (S3), or at the Sequence Read Archive (SRA). RSEQREP automatically executes a series of customizable steps including reference alignment, CRAM compression, reference alignment QC, data normalization, multivariate data visualization, identification of differentially expressed genes, heatmaps, co-expressed gene clusters, enriched pathways, and a series of custom visualizations. The framework outputs a file collection that includes a dynamically generated PDF report using R, knitr, and LaTeX, as well as publication-ready table and figure files. A user-friendly configuration file handles sample metadata entry, processing, analysis, and reporting options. The configuration supports time series RNA-Seq experimental designs with at least one pre- and one post-treatment sample for each subject, as well as multiple treatment groups and specimen types. All RSEQREP analyses components are built using open-source R code and R/Bioconductor packages allowing for further customization. As a use case, we provide RSEQREP results for a trivalent influenza vaccine (TIV) RNA-Seq study that collected 1 pre-TIV and 10 post-TIV vaccination samples (days 1-10) for 5 subjects and two specimen types (peripheral blood mononuclear cells and B-cells).
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Affiliation(s)
- Travis L Jensen
- Vaccine and Infectious Disease Department , The Emmes Corporation, Rockville, MD, USA
| | | | - Kevin Conway
- IT Operations, The Emmes Corporation, Rockville, MD, USA
| | | | - Heather Hill
- Vaccine and Infectious Disease Department , The Emmes Corporation, Rockville, MD, USA
| | - Konstantinos Krampis
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Johannes B Goll
- Vaccine and Infectious Disease Department , The Emmes Corporation, Rockville, MD, USA
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11
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Du J, Cai Y, Chen Y, He Y, Tao C. Analysis of Individual Differences in Vaccine Pharmacovigilance Using VAERS Data and MedDRA System Organ Classes: A Use Case Study With Trivalent Influenza Vaccine. Biomed Inform Insights 2017; 9:1178222617700627. [PMID: 28469434 PMCID: PMC5391193 DOI: 10.1177/1178222617700627] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 02/09/2017] [Indexed: 12/21/2022]
Abstract
Personalized and precision vaccination requires consideration of an individual’s sex and age. This article proposed systematic methods to study individual differences in adverse reactions following vaccination and chose trivalent influenza vaccine as a use case. Data were extracted from the Vaccine Adverse Event Reporting System from years 1990 to 2014. We first grouped symptoms into the Medical Dictionary for Regulatory Activities System Organ Classes (SOCs). We then applied zero-truncated Poisson regression and logistic regression to identify reporting differences among different individual groups over the SOCs. After that, we further studied detailed symptoms of 4 selected SOCs. In all, 19 of the 26 SOCs and 17 of the 434 symptoms under the 4 selected SOCs show significant reporting differences based on sex and/or age. In addition to detecting previously reported associations among sex, age group, and symptoms, our approach also enabled the detection of new associations.
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Affiliation(s)
- Jingcheng Du
- School of Biomedical Informatics, The University of Texas, Houston, TX, USA
| | - Yi Cai
- Pieces Technology, Dallas, TX, USA
| | - Yong Chen
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Yongqun He
- Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Cui Tao
- School of Biomedical Informatics, The University of Texas, Houston, TX, USA
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12
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Abstract
A split-virion trivalent inactivated influenza vaccine produced according to the Chinese pharmacopeia (Shz-IIV3) has been commercially available in China since 2014. Here, we describe the results of a phase IV open-label trial to describe the immunogenicity and safety of the 2014–2015 Northern Hemisphere formulation of Shz-IIV3 in individuals ≥ 6 months of age. Subjects 6–35 months of age received 2 half-doses of Shz-IIV3 (0.25 ml) 28 d apart, and subjects ≥ 3 y of age received a single full dose (0.5 ml). The study included 602 subjects. Except for the A (H3N2) strain in subjects 3–17 years, geometric mean hemagglutination inhibition titer ratios were ≥ 10 and rates of seroconversion/significant increase in titer were ≥ 78% in all age groups. For the H3N2 strain in subjects 3–17 years, the geometric mean titer ratio was 3.8 and the rate of seroconversion/significant increase was 56%. Post-vaccination seroprotection rates were ≥ 88% for all strains in all age groups. The most common solicited reactions were injection-site pain/tenderness and fever, most of which were grade 1 and resolved within 3 d. Vaccine-related unsolicited adverse events were reported only by subjects 6–23 months, most of which were mild abnormal crying and irritability. No vaccine-related serious adverse events and no deaths were reported. No new safety signals or unexpected safety events occurred, although an immediate anaphylactic skin reaction occurred in one subject. This study confirmed that the 2014–2015 Northern Hemisphere formulation of Shz-IIV3 was well tolerated and highly immunogenic in subjects ≥ 6 months of age.
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Affiliation(s)
- Zhaojun Mo
- a Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control , Guangxi , China
| | - Yi Nong
- a Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control , Guangxi , China
| | - Shuzhen Liu
- b National Institutes for Food and Drug Control , Beijing , China
| | - Ming Shao
- b National Institutes for Food and Drug Control , Beijing , China
| | | | - Kerry Go
- d Sanofi Pasteur , Swiftwater , PA , US
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13
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Brogan AJ, Talbird SE, Davis AE, Thommes EW, Meier G. Cost-effectiveness of seasonal quadrivalent versus trivalent influenza vaccination in the United States: A dynamic transmission modeling approach. Hum Vaccin Immunother 2016; 13:533-542. [PMID: 27780425 PMCID: PMC5360116 DOI: 10.1080/21645515.2016.1242541] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Trivalent inactivated influenza vaccines (IIV3s) protect against 2 A strains and one B lineage; quadrivalent versions (IIV4s) protect against an additional B lineage. The objective was to assess projected health and economic outcomes associated with IIV4 versus IIV3 for preventing seasonal influenza in the US. A cost-effectiveness model was developed to interact with a dynamic transmission model. The transmission model tracked vaccination, influenza cases, infection-spreading interactions, and recovery over 10 y (2012–2022). The cost-effectiveness model estimated influenza-related complications, direct and indirect costs (2013–2014 US$), health outcomes, and cost-effectiveness. Inputs were taken from published/public sources or estimated using regression or calibration. Outcomes were discounted at 3% per year. Scenario analyses tested the reliability of the results. Seasonal vaccination with IIV4 versus IIV3 is predicted to reduce annual influenza cases by 1,973,849 (discounted; 2,325,644 undiscounted), resulting in 12–13% fewer cases and influenza-related complications and deaths. These reductions are predicted to translate into 18,485 more quality-adjusted life years (QALYs) accrued annually for IIV4 versus IIV3. Increased vaccine-related costs ($599 million; 5.7%) are predicted to be more than offset by reduced influenza treatment costs ($699 million; 12.2%), resulting in direct medical cost saving annually ($100 million; 0.6%). Including indirect costs, savings with IIV4 are predicted to be $7.1 billion (5.6%). Scenario analyses predict IIV4 to be cost-saving in all scenarios tested apart from low infectivity, where IIV4 is predicted to be cost-effective. In summary, seasonal influenza vaccination in the US with IIV4 versus IIV3 is predicted to improve health outcomes and reduce costs.
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Affiliation(s)
- Anita J Brogan
- a RTI Health Solutions , Research Triangle Park , NC , USA
| | | | - Ashley E Davis
- a RTI Health Solutions , Research Triangle Park , NC , USA
| | - Edward W Thommes
- b Medical Division, GSK Inc , Mississauga , ON , Canada.,c University of Guelph , Guelph , ON , Canada
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14
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Abstract
Influenza is a very common disease among infants and young children, with a considerable clinical and socioeconomic impact. A significant number of health authorities presently recommend universal influenza vaccination for the pediatric population, but a large number of European health authorities is still reluctant to include influenza vaccination in their national vaccination programs. The reasons for this reluctance include the fact that the protection offered by the currently available vaccines is considered poor. This review shows that although future research could lead to an increase in the immunogenicity and potential efficacy of influenza vaccines, the available vaccines, even with their limits, assure sufficient protection in most subjects aged ≥ 6 months, thus reducing the total burden of influenza in young children and justifying the recommendation for the universal vaccination of the whole pediatric population. For younger subjects, the vaccination of their mother during pregnancy represents an efficacious strategy.
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Affiliation(s)
- Nicola Principi
- a Pediatric Highly Intensive Care Unit; Department of Pathophysiology and Transplantation ; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico ; Milan , Italy
| | - Laura Senatore
- a Pediatric Highly Intensive Care Unit; Department of Pathophysiology and Transplantation ; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico ; Milan , Italy
| | - Susanna Esposito
- a Pediatric Highly Intensive Care Unit; Department of Pathophysiology and Transplantation ; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico ; Milan , Italy
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15
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Crépey P, de Boer PT, Postma MJ, Pitman R. Retrospective public health impact of a quadrivalent influenza vaccine in the United States. Influenza Other Respir Viruses 2016; 9 Suppl 1:39-46. [PMID: 26256294 PMCID: PMC4549101 DOI: 10.1111/irv.12318] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2015] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Vaccination is an effective preventive strategy against influenza. However, current trivalent influenza vaccines (TIVs) contain only one of the two influenza B lineages that circulate each year. Vaccine mismatches are frequent because predicting which one will predominate is difficult. Recently licensed quadrivalent influenza vaccines (QIVs) containing the two B lineages should address this issue. Our study estimates their impact by assessing what would have been the US public health benefit of routinely vaccinating with QIV in 2000-2013. METHODS We developed a dynamic compartmental model that accounts for interactions between influenza B lineages (natural or vaccine-induced) and simulates the multiyear influenza dynamics for 2000-2013. Age-structured population dynamics, vaccine efficacy (VE) per strain, and weekly ramp-up of vaccination coverage are modeled. Sensitivity analyses were performed on VE, duration of immunity, and levels of vaccine-induced cross-protection between B lineages. RESULTS Assuming a cross-protection of 70% of the VE of the matched vaccine, the model predicts 16% more B lineage cases prevented by QIV. Elderly (≥65 years) and young seniors (50-64 years) benefit most from QIV, with 21% and 18% reductions in B lineage cases. Reducing cross-protection to 50%, 30%, and 0% of the VE of the matched vaccine improves the relative benefit of QIV to 25%, 30%, and 34% less B lineage cases. CONCLUSION Using a dynamic retrospective framework with real-life vaccine mismatch, our analysis shows that QIV routine vaccination in the United States has the potential to substantially reduce the number of influenza infections, even with relatively high estimates of TIV-induced cross-protection.
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Affiliation(s)
- Pascal Crépey
- EHESP Rennes, Sorbonne Paris-cité, Paris, France.,Aix-Marseille Univ, UMR EPV Emergence des Pathologies Virales-190, Marseille, France
| | - Pieter T de Boer
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Maarten J Postma
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands.,Institute of Science in Healthy Aging & health caRE (SHARE), University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
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16
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Nougarede N, Bisceglia H, Rozières A, Goujon C, Boudet F, Laurent P, Vanbervliet B, Rodet K, Hennino A, Nicolas JF. Nine μg intradermal influenza vaccine and 15 μg intramuscular influenza vaccine induce similar cellular and humoral immune responses in adults. Hum Vaccin Immunother 2016; 10:2713-20. [PMID: 25483667 PMCID: PMC4977438 DOI: 10.4161/hv.29695] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Intanza® 9 μg (Sanofi Pasteur), a trivalent split-virion vaccine administered by intradermal (ID) injection, was approved in Europe in 2009 for the prevention of seasonal influenza in adults 18 to 59 years. Here, we examined the immune responses induced in adults by the ID 9 μg vaccine and the standard trivalent intramuscular (IM) vaccine (Vaxigrip® 15 μg, Sanofi Pasteur). This trial was a randomized, controlled, single-center, open-label study in healthy adults 18 to 40 years of age during the 2007/8 influenza season. Subjects received a single vaccination with the ID 9 μg (n=38) or IM 15 μg (n=42) vaccine. Serum, saliva, and peripheral blood mononuclear cells were collected up to 180 days post-vaccination. Geometric mean hemagglutination inhibition titers, seroprotection rates, seroconversion rates, and pre-vaccination-to-post-vaccination ratios of geometric mean hemagglutination inhibition titers did not differ between the two vaccines. Compared with pre-vaccination, the vaccines induced similar increases in vaccine-specific circulating B cells at day 7 but did not induce significant increases in vaccine-specific memory B cells at day 180. Cell-mediated immunity to all three vaccine strains, measured in peripheral blood mononuclear cells, was high at baseline and not increased by either vaccine. Neither vaccine induced a mucosal immune response. These results show that the humoral and cellular immune responses to the ID 9 μg vaccine are similar to those to the standard IM 15 μg vaccine.
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Key Words
- BSA, bovine serum albumin
- CHMP, Committee for Medicinal Products for Human Use
- ELISA, enzyme-linked immunosorbent assay
- ELISPOT, enzyme-linked immunospot
- HI, hemagglutination inhibition
- ID, intradermal
- IM, intramuscular
- Ig, immunoglobulin
- PBMC, peripheral blood mononuclear cells
- PBS, phosphate-buffered saline
- adult
- immunogenicity
- intradermal influenza vaccine
- intramuscular vaccination
- trivalent influenza vaccine
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17
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Abstract
Trivalent influenza vaccine (TIV) selects one of the 2 co-circulating influenza B lineages whereas quadrivalent influenza vaccine (QIV) includes both lineages. We examined potential cost-effectiveness of QIV versus TIV from perspectives of healthcare provider and society of Hong Kong. A decision tree was designed to simulate the outcomes of QIV vs. TIV in 6 age groups: 0-4 years, 5-9 years, 10-14 years, 15-64 years, 65-79 y and ≥80 years. Direct cost alone, direct and indirect costs, and quality-adjusted life-years (QALYs) loss due to TIV-unmatched influenza B infection were simulated for each study arm. Outcome measure was incremental cost per QALY (ICER). In base-case analysis, QIV was more effective than TIV in all-age population with additional direct cost per QALY (ICER-direct cost) and additional total cost per QALY (ICER-total cost) of USD 22,603 and USD 12,558, respectively. Age-stratified analysis showed that QIV was cost-effective in age groups 6 months to 9 y and ≥80 years from provider's perspective, and it was cost-effective in all age group except 15-64 y from societal perspective. Percentage of TIV-unmatched influenza B in circulation and additional vaccine cost of QIV were key influential factors. From perspectives of healthcare provider and society, QIV was the preferred option in 52.77% and 66.94% of 10,000 Monte Carlo simulations, respectively. QIV appears to be cost-effective in Hong Kong population, except for age group 15-64 years, from societal perspective. From healthcare provider's perspective, QIV seems to be cost-effective in very young (6 months-9 years) and older (≥80 years) age groups.
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Affiliation(s)
- Joyce H S You
- a School of Pharmacy; The Chinese University of Hong Kong ; Shatin , NT , Hong Kong, China
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18
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Moolasart V, Manosuthi W, Ausavapipit J, Chottanapund S, Likanonsakul S, Uttayamakul S, Srisopha S, Lerdsamran H, Puthavathana P. Long-term seroprotective response of trivalent seasonal influenza vaccine in HIV-infected children, regardless of immunogenicity before immunisation. Int J STD AIDS 2015; 27:761-8. [PMID: 26138900 DOI: 10.1177/0956462415594061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/08/2015] [Indexed: 02/06/2023]
Abstract
Influenza vaccination can reduce disease in HIV-infected children. The durability of the antibody response after trivalent influenza vaccine is important for management. The aim of this prospective study was to assess the durability of seroprotection for trivalent influenza vaccine strains and the factors effecting seroprotective response regardless of immunogenicity before trivalent influenza vaccine at one and six months after immunisation. Hemagglutination inhibition assay was done at one and six months. Seventy-five HIV-infected children were enrolled after vaccination. Four children were lost to follow-up. None of the children had confirmed influenza infection between immunisation and hemagglutination inhibition at six months after influenza vaccination. Seventy-one children were included in the final analysis and immunogenicity of trivalent influenza vaccine strains at one and six months. Of these, 27 (38%) had complete seroprotection (Group A) and 44 (62%) had non-complete seroprotection (Group B). Sex, age and the body mass index of both groups were not different from each other (p > 0.05). There was a higher mean CD4 level and more children with RNA ≤40 copies/mL among Group A compared with Group B (p < 0.05). Other factors did not differ significantly. The durability of the seroprotective response after trivalent influenza vaccine was associated with a high CD4 level and virological suppression before vaccination.
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Affiliation(s)
- Visal Moolasart
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Weerawat Manosuthi
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Jarurnsook Ausavapipit
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Suthat Chottanapund
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Sirirat Likanonsakul
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Sumonmal Uttayamakul
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Somkid Srisopha
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Hatairat Lerdsamran
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pilaipan Puthavathana
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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19
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Regan AK, Blyth CC, Mak DB, Richmond PC, Effler PV. Using SMS to monitor adverse events following trivalent influenza vaccination in pregnant women. Aust N Z J Obstet Gynaecol 2014; 54:522-8. [PMID: 25306915 DOI: 10.1111/ajo.12266] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 08/29/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Trivalent influenza vaccine (TIV) has been recommended for pregnant women in Australia for more than a decade and funded since 2009, yet vaccination coverage remains low. Misperceptions of the safety of TIV in pregnancy have been identified as a major contributor to low vaccination rates. Ongoing safety monitoring with dissemination of results could help improve antenatal influenza vaccine uptake. AIM To implement a real-time safety monitoring program for TIV administered to pregnant women. MATERIALS AND METHODS Between March and July 2013, a cohort of 3,173 pregnant women who received the 2013 TIV agreed to follow-up regarding possible adverse events following immunisation (AEFI); 3,047 (96%) provided a mobile telephone number and were sent a short message service (SMS) inquiring whether they had experienced an AEFI; attempts were made to contact the remaining 126 (4%) women by voice telephone call. RESULTS Responses were obtained from 2,885 (90.9%) women, 413 (14.3%) of whom reported a suspected AEFI. Local reactions were the most frequently reported AEFI (4.9%), followed by headache (3.3%), fever (2.7%), fatigue (2.5%), diarrhoea (2.5%) and malaise (1.2%); 39 women (1.4%) sought medical advice and no serious vaccine-related AEFIs were identified. Response rates were higher for SMS compared to telephone (84% vs 63%; P < 0.001). CONCLUSIONS These findings support the safety of TIV in pregnant women. Mobile phone technology proved an efficient method for timely surveillance of adverse events following vaccination. The low level of AEFI observed should be reassuring to antenatal patients and their providers and help promote TIV uptake.
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Affiliation(s)
- Annette K Regan
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
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20
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Blyth CC, Jacoby P, Effler PV, Kelly H, Smith DW, Robins C, Willis GA, Levy A, Keil AD, Richmond PC. Effectiveness of trivalent flu vaccine in healthy young children. Pediatrics 2014; 133:e1218-25. [PMID: 24753525 DOI: 10.1542/peds.2013-3707] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There are few studies evaluating the effectiveness of trivalent influenza vaccination (TIV) in young children, particularly in children <2 years. The Western Australian Influenza Vaccine Effectiveness Study commenced in 2008 to evaluate a program providing TIV to children aged 6 to 59 months. METHODS An observational study enrolling children with influenza-like illness presenting to a tertiary pediatric hospital was conducted (2008-2012). Vaccination status was determined by parental questionnaire and confirmed via the national immunization register and/or vaccine providers. Respiratory virus polymerase chain reaction and culture were performed on nasopharyngeal samples. The test-negative design was used to estimate vaccine effectiveness (VE) by using 2 control groups: all influenza test-negative subjects and other-virus-detected (OVD) subjects. Adjusted odds ratios were estimated from models with season, month of disease onset, age, gender, indigenous status, prematurity, and comorbidities as covariates. Subjects enrolled in 2009 were excluded from VE calculations. RESULTS Of 2001 children enrolled, influenza was identified in 389 (20.4%) children. Another respiratory virus was identified in 1134 (59.6%) children. Overall, 295 of 1903 (15.5%) children were fully vaccinated and 161 of 1903 (8.4%) children were partially vaccinated. Vaccine uptake was significantly lower in 2010-2012 after increased febrile adverse events observed in 2010. Using test-negative controls, VE was 64.7% (95% confidence interval [CI]: 33.7%-81.2%). No difference in VE was observed with OVD controls (65.8%; 95% CI: 32.1%-82.8%). The VE for children <2 years was 85.8% (95% CI: 37.9%-96.7%). CONCLUSIONS This study reveals the effectiveness of TIV in young children over 4 seasons by using test-negative and OVD controls. TIV was effective in children aged <2 years. Despite demonstrated vaccine effectiveness, uptake of TIV remains suboptimal.
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Affiliation(s)
- Christopher C Blyth
- School of Paediatrics and Child Health and Princess Margaret Hospital for Children, Perth, Australia; Telethon Institute of Child Health Research, West Perth, Australia; PathWest Laboratory Medicine, Nedlands, Australia;
| | - Peter Jacoby
- Telethon Institute of Child Health Research, West Perth, Australia
| | - Paul V Effler
- Communicable Disease Control Directorate, Department of Health, Perth, Australia
| | - Heath Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia; and Australian National University, Australian Capital Territory, Australia
| | - David W Smith
- PathWest Laboratory Medicine, Nedlands, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
| | - Christine Robins
- Telethon Institute of Child Health Research, West Perth, Australia
| | | | - Avram Levy
- PathWest Laboratory Medicine, Nedlands, Australia
| | | | - Peter C Richmond
- School of Paediatrics and Child Health and Princess Margaret Hospital for Children, Perth, Australia; Telethon Institute of Child Health Research, West Perth, Australia
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Liu Y, Wu JY, Wang X, Chen JT, Xia M, Hu W, Zou Y, Yin WD. Review of 10 years of clinical experience with Chinese domestic trivalent influenza vaccine Anflu®. Hum Vaccin Immunother 2013; 10:73-82. [PMID: 24104060 DOI: 10.4161/hv.26715] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Influenza viruses cause annual winter epidemics globally and influenza vaccination is most effective way to prevent the disease or severe outcomes from the illness, especially in developing countries. However, the majority of the world's total production capacity of influenza vaccine is concentrated in several large multinational manufacturers. A safe and effective preventive vaccine for the developing countries is urgent. Anflu®, a Chinese domestic preservative-free, split-virus trivalent influenza vaccine (TIV), was introduced by Sinovac Biotech Ltd. in 2006. Until now, 20.6 million doses worldwide of Anflu® were sold. Since 2003, 13 company-sponsored clinical studies investigating the immunogenicity and safety of Anflu® have been completed, in which 6642 subjects participated and were vaccinated by Anflu®. Anflu® was generally well tolerated in all age groups, and highly immunogenic in healthy adults and elderly and exceeded the licensure criteria in Europe. This review presents and discusses the experience with Anflu® during the past decade. A new Chinese domestic, preservative-free, unadjuvanted, inactivated split-virus trivalent influenza vaccine (TIV), Anflu®, was introduced into human clinical trials in 2003 and then licensed in China in 2006. The vaccine contains 15 µg/0.5 ml hemagglutinin from each of the 3 influenza virus strains (including an H1N1 influenza A virus subtype, an H3N2 influenza A virus subtype, and an influenza B virus) that are expected to be circulating in the up-coming influenza season. The clinical data pertaining to Anflu® will be reviewed and compared with other TIVs available at present.
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Affiliation(s)
- Yan Liu
- Sinovac Biotech Co. Ltd.; Beijing, PR China
| | - Jun-Yu Wu
- Sinovac Biotech Co. Ltd.; Beijing, PR China
| | - Xu Wang
- Sinovac Biotech Co. Ltd.; Beijing, PR China
| | | | - Ming Xia
- Sinovac Biotech Co. Ltd.; Beijing, PR China
| | - Wei Hu
- Sinovac Biotech Co. Ltd.; Beijing, PR China
| | - Yong Zou
- Sinovac Biotech Co. Ltd.; Beijing, PR China
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Kafatos G, Pebody R, Andrews N, Durnall H, Barley M, Fleming D. Effectiveness of seasonal influenza vaccine in preventing medically attended influenza infection in England and Wales during the 2010/2011 season: a primary care-based cohort study. Influenza Other Respir Viruses 2013; 7:1175-80. [PMID: 24103037 PMCID: PMC4634295 DOI: 10.1111/irv.12163] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 11/26/2022] Open
Abstract
Background Estimates of seasonal influenza vaccine effectiveness (VE) are affected by factors such as the strain of the current circulating influenza virus and characteristics of the host. Objective The objective of this study was to provide VE estimates for the 2010/2011 seasonal trivalent influenza vaccine (TIV) in preventing medically attended influenza in England and Wales for the season 2010/2011. Methods A cohort study design was employed using electronic health records extracted from 104 GP practices in the Royal College of General Practitioners (RCGP) primary care sentinel network. Endpoints included influenza‐like illness (ILI), lower respiratory tract infection (LTRI) as well as PCR‐confirmed influenza from patients swabbed from practices participating in a swabbing scheme. Adjustment was made for age, month, underlying chronic condition, region and number of consultations in the 12 months prior to the study period. In addition to the cohort analysis, a nested test‐negative case–control analysis (TNCC) was carried out using the swab‐negative results as controls. Results In the cohort analysis, VE against LRTI was −0·5% [95% CI: (−7·0%, 7·5%)], against ILI was 37·8% [95% CI: (32·3%, 43·0%)] and against PCR‐confirmed influenza was 50·0% [95% CI:(25·9%, 65·6%)] for type A and 44·4% [95% CI: (10·1%, 65·6%)] for type B. Using the TNCC design, the type A VE was 56·5% [95% CI: (30·4%, 72·7%)] and for type B was 54·0% [95% CI: (21·0%, 73·3%)]. Conclusions This study shows that the 2010/2011 TIV provided moderate protection against the circulating influenza strains for the 2010/2011 season. It also suggests that VE against the less specific diagnosis of ILI can be found, but less specific endpoints such as LRTI are not useful.
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Principi N, Marchisio P, Terranova L, Zampiero A, Baggi E, Daleno C, Tirelli S, Pelucchi C, Esposito S. Impact of vitamin D administration on immunogenicity of trivalent inactivated influenza vaccine in previously unvaccinated children. Hum Vaccin Immunother 2013; 9:969-74. [PMID: 23324599 DOI: 10.4161/hv.23540] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
As vitamin D (VD) has a significant regulatory effect on innate and adaptive immunity, the aim of this prospective, randomized, single-blinded, placebo-controlled study was to measure the impact of VD administration on the immune response to trivalent influenza vaccination (TIV). A total of 116 children (61 males, 52.6%; mean age 3.0 ± 1.0 y) with a history of recurrent acute otitis media (AOM), who had not been previously vaccinated against influenza, were randomized to receive daily VD 1,000 IU or placebo by mouth for four months. All of them received two doses of TIV (Fluarix, GlaxoSmithKline Biologicals) one month apart, with the first dose administered when VD supplementation was started. There was no difference in seroconversion or seroprotection rates, or antibody titers, in relation to any of the three influenza vaccine antigens between the VD and placebo groups, independently of baseline and post-treatment VD levels. The safety profile was also similar in the two groups. These data indicate that the daily administration of VD 1,000 IU for four months from the time of the injection of the first dose of TIV does not significantly modify the antibody response evoked by influenza vaccine.
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Affiliation(s)
- Nicola Principi
- Pediatric Clinic 1; Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milan, Italy
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