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Ezpeleta G, Navascués A, Viguria N, Herranz-Aguirre M, Juan Belloc SE, Gimeno Ballester J, Muruzábal JC, García-Cenoz M, Trobajo-Sanmartín C, Echeverria A, Martínez-Baz I, Vera-Punzano N, Casado I, López-Mendoza H, Ezpeleta C, Castilla J. Effectiveness of Nirsevimab Immunoprophylaxis Administered at Birth to Prevent Infant Hospitalisation for Respiratory Syncytial Virus Infection: A Population-Based Cohort Study. Vaccines (Basel) 2024; 12:383. [PMID: 38675765 PMCID: PMC11054679 DOI: 10.3390/vaccines12040383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Respiratory syncytial virus (RSV) infection is a frequent cause of hospitalisation in the first few months of life; however, this risk rapidly decreases with age. Nirsevimab immunoprophylaxis was approved in the European Union for the prevention of RSV-associated lower respiratory tract disease in infants during their first RSV season. We evaluated the effectiveness of nirsevimab in preventing hospitalisations for confirmed RSV infection and the impact of a strategy of immunisation at birth. A population-based cohort study was performed in Navarre, Spain, where nirsevimab was offered at birth to all children born from October to December 2023. Cox regression was used to estimate the hazard ratio of hospitalisation for PCR-confirmed RSV infection between infants who received and did not receive nirsevimab. Of 1177 infants studied, 1083 (92.0%) received nirsevimab. The risk of hospitalisation for RSV was 8.5% (8/94) among non-immunised infants versus 0.7% (8/1083) in those that were immunised. The estimated effectiveness of nirsevimab was 88.7% (95% confidence interval, 69.6-95.8). Immunisation at birth of infants born between October and December 2023 prevented one hospitalisation for every 15.3 immunised infants. Immunisation of children born from September to January might prevent 77.5% of preventable hospitalisations for RSV in infants born in 2023-2024. These results support the recommendation of nirsevimab immunisation at birth to children born during the RSV epidemic or in the months immediately before to prevent severe RSV infections and alleviate the overload of paediatric hospital resources.
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Affiliation(s)
- Guillermo Ezpeleta
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
| | - Ana Navascués
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
| | - Natividad Viguria
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- Paediatrics Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Mercedes Herranz-Aguirre
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- Paediatrics Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | | | | | - Juan Carlos Muruzábal
- Gynecology and Obstetrics Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Manuel García-Cenoz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Aitziber Echeverria
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Noelia Vera-Punzano
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
| | - Héctor López-Mendoza
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
| | - Carmen Ezpeleta
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (G.E.); (I.M.-B.); (H.L.-M.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain (M.H.-A.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 31003 Pamplona, Spain
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Trobajo-Sanmartín C, Navascués A, Fernández-Huerta M, Martínez-Baz I, Casado I, Ezpeleta C, Castilla J. Prevalence of Respiratory Viral Infections in Deceased Persons during the COVID-19 Pandemic Season 2021-2022: A Population-Based Observational Study. Viruses 2024; 16:533. [PMID: 38675876 PMCID: PMC11053769 DOI: 10.3390/v16040533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Although the omicron variant of SARS-CoV-2 circulated intensely during the 2021-2022 season, many patients with severe acute respiratory disease tested negative for COVID-19. The aim of this study was to assess the presence of different respiratory viruses in deceased persons. The proportion of deceased persons with respiratory viral infections in the 2021-2022 season in Navarre, Spain, was estimated considering all deaths caused by confirmed COVID-19 according to the epidemiological surveillance and the results of multiplex PCR tests for respiratory viruses performed in a sample of deceased persons with a cause of death other than COVID-19. Of 3578 deaths, 324 (9.1%) were initially reported as caused by pre-mortem confirmed COVID-19. A sample of 242 persons who died by causes other than COVID-19 were tested post-mortem; 64 (26.4%) of them were positive for any respiratory virus: 11.2% for SARS-CoV-2, 5.8% for rhinovirus, 3.7% for human coronavirus, 2.5% for metapneumovirus, 1.7% for respiratory syncytial virus, 1.7% for parainfluenza, 1.2% for influenza, and less than 1% each for adenovirus and bocavirus. Combining both approaches, we estimated that 34.4% of all deceased persons during the study period had a respiratory viral infection and 19.2% had SARS-CoV-2. Only 33.3% (9/27) of SARS-CoV-2 and 5.0% (2/40) of other viruses detected post-mortem had previously been confirmed pre-mortem. In a period with very intense circulation of SARS-CoV-2 during the pandemic, other respiratory viruses were also frequently present in deceased persons. Some SARS-CoV-2 infections and most other viral infections were not diagnosed pre-mortem. Several respiratory viruses may contribute to excess mortality in winter.
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Affiliation(s)
- Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain (I.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (A.N.); (M.F.-H.); (C.E.)
| | - Ana Navascués
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (A.N.); (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Miguel Fernández-Huerta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (A.N.); (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain (I.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (A.N.); (M.F.-H.); (C.E.)
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain (I.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (A.N.); (M.F.-H.); (C.E.)
| | - Carmen Ezpeleta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (A.N.); (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain (I.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (A.N.); (M.F.-H.); (C.E.)
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Lanièce Delaunay C, Martínez-Baz I, Sève N, Domegan L, Mazagatos C, Buda S, Meijer A, Kislaya I, Pascu C, Carnahan A, Oroszi B, Ilić M, Maurel M, Melo A, Sandonis Martín V, Trobajo-Sanmartín C, Enouf V, McKenna A, Pérez-Gimeno G, Goerlitz L, de Lange M, Rodrigues AP, Lazar M, Latorre-Margalef N, Túri G, Castilla J, Falchi A, Bennett C, Gallardo V, Dürrwald R, Eggink D, Guiomar R, Popescu R, Riess M, Horváth JK, Casado I, García MDC, Hooiveld M, Machado A, Bacci S, Kaczmarek M, Kissling E. COVID-19 vaccine effectiveness against symptomatic infection with SARS-CoV-2 BA.1/BA.2 lineages among adults and adolescents in a multicentre primary care study, Europe, December 2021 to June 2022. Euro Surveill 2024; 29:2300403. [PMID: 38551095 PMCID: PMC10979526 DOI: 10.2807/1560-7917.es.2024.29.13.2300403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/14/2023] [Indexed: 04/01/2024] Open
Abstract
BackgroundScarce European data in early 2021 suggested lower vaccine effectiveness (VE) against SARS-CoV-2 Omicron lineages than previous variants.AimWe aimed to estimate primary series (PS) and first booster VE against symptomatic BA.1/BA.2 infection and investigate potential biases.MethodsThis European test-negative multicentre study tested primary care patients with acute respiratory symptoms for SARS-CoV-2 in the BA.1/BA.2-dominant period. We estimated PS and booster VE among adults and adolescents (PS only) for all products combined and for Comirnaty alone, by time since vaccination, age and chronic condition. We investigated potential bias due to correlation between COVID-19 and influenza vaccination and explored effect modification and confounding by prior SARS-CoV-2 infection.ResultsAmong adults, PS VE was 37% (95% CI: 24-47%) overall and 60% (95% CI: 44-72%), 43% (95% CI: 26-55%) and 29% (95% CI: 13-43%) < 90, 90-179 and ≥ 180 days post vaccination, respectively. Booster VE was 42% (95% CI: 32-51%) overall and 56% (95% CI: 47-64%), 22% (95% CI: 2-38%) and 3% (95% CI: -78% to 48%), respectively. Primary series VE was similar among adolescents. Restricting analyses to Comirnaty had little impact. Vaccine effectiveness was higher among older adults. There was no signal of bias due to correlation between COVID-19 and influenza vaccination. Confounding by previous infection was low, but sample size precluded definite assessment of effect modification.ConclusionPrimary series and booster VE against symptomatic infection with BA.1/BA.2 ranged from 37% to 42%, with similar waning post vaccination. Comprehensive data on previous SARS-CoV-2 infection would help disentangle vaccine- and infection-induced immunity.
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Affiliation(s)
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Noémie Sève
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Lisa Domegan
- Health Protection Surveillance Centre, Dublin, Ireland
| | - Clara Mazagatos
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Silke Buda
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Irina Kislaya
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Catalina Pascu
- Cantacuzino National Military Medical Institute for Research and Development, Bucharest, Romania
| | | | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Maja Ilić
- Croatian Institute of Public Health (CIPH), Zagreb, Croatia
| | | | - Aryse Melo
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Vincent Enouf
- Institut Pasteur, Pasteur International Bioresources network (PIBnet), Plateforme de Microbiologie Mutualisée (P2M), Paris, France
- Institut Pasteur, Centre National de Référence Virus des Infections Respiratoires (CNR VIR), Paris, France
| | - Adele McKenna
- Health Protection Surveillance Centre, Dublin, Ireland
| | - Gloria Pérez-Gimeno
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Luise Goerlitz
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Mihaela Lazar
- Cantacuzino National Military Medical Institute for Research and Development, Bucharest, Romania
| | | | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Charlene Bennett
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Virtudes Gallardo
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Sevilla, Spain
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Dirk Eggink
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | | | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mª Del Carmen García
- Subdirección de Epidemiología, Dirección General de Salud Pública, Servicio Extremeño de Salud, Mérida, Spain
| | | | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Marlena Kaczmarek
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Martínez-Baz I, Trobajo-Sanmartín C, Miqueleiz A, Egüés N, García Cenoz M, Casado I, Navascués A, Fernández-Huerta M, Echeverría A, Guevara M, Ezpeleta C, Castilla J. Hospitalisations and Deaths Averted by COVID-19 Vaccination in Navarre, Spain, 2021-2022. Vaccines (Basel) 2024; 12:58. [PMID: 38250871 PMCID: PMC10818920 DOI: 10.3390/vaccines12010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
In 2021-2022, most of the Spanish population received COVID-19 vaccines and a high proportion of them had SARS-CoV-2 infection. We estimated the rate of hospitalisations and deaths that were averted by risk reduction among vaccinated COVID-19 cases. Hospitalisations and deaths were analysed among COVID-19 cases confirmed in 2021 and 2022 in Navarre, Spain. To calculate the number of prevented outcomes by sex, age, comorbidities, and semester, the difference in the risk of each outcome between unvaccinated and vaccinated cases was multiplied by the number of vaccinated cases. COVID-19 vaccination coverage with any dose reached 88%, 86% with full vaccination, and 56% with a booster dose. The cumulative rates per 1000 inhabitants were 382 COVID-19 confirmed cases, 6.70 hospitalisations, and 1.15 deaths from COVID-19. The estimated rates of prevented events by vaccination were 16.33 hospitalisations and 3.39 deaths per 1000 inhabitants, which was 70.9% and 74.7% of expected events without vaccination, respectively. People aged 80 years and older or with major chronic conditions accounted for the majority of hospitalizations and deaths prevented by COVID-19 vaccination. One hospitalisation and death due to COVID-19 were averted for every 53 and 258 people vaccinated, respectively. The high COVID-19 vaccine effect in reducing the risk of severe outcomes and the high vaccination coverage in risk populations prevented three out of four hospitalisations and deaths due to COVID-19 during a period of intense circulation of SARS-CoV-2.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Ana Miqueleiz
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Nerea Egüés
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Ana Navascués
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Miguel Fernández-Huerta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Aitziber Echeverría
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Carmen Ezpeleta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (M.G.C.)
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
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Martínez-Baz I, Fernández-Huerta M, Navascués A, Pozo F, Trobajo-Sanmartín C, Casado I, Echeverria A, Ezpeleta C, Castilla J. Influenza Vaccine Effectiveness in Preventing Laboratory-Confirmed Influenza Cases and Hospitalizations in Navarre, Spain, 2022-2023. Vaccines (Basel) 2023; 11:1478. [PMID: 37766154 PMCID: PMC10534462 DOI: 10.3390/vaccines11091478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
We estimated influenza vaccine effectiveness (IVE) in preventing outpatient and hospitalized cases in the 2022-2023 season. A test-negative design included a representative sample of outpatients and all hospitalized patients with influenza-like illness (ILI) from October 2022 to May 2023 in Navarre, Spain. ILI patients were tested by PCR for influenza virus. Influenza vaccination status was compared between confirmed influenza cases and test-negative controls. Among 3321 ILI patients tested, IVE to prevent influenza cases was 34% (95% confidence interval (CI): 16 to 48) overall, 85% (95%CI: 63 to 94) against influenza B, and 28% (95%CI: 3 to 46) against A(H3N2). Among 558 outpatients, 222 (40%) were confirmed for influenza: 55% A(H3N2), 11% A(H1N1), and 31% B. Overall, IVE to prevent outpatient cases was 48% (95%CI: 8 to 70), 88% (95%CI: 3 to 98) against influenza B, and 50% (95%CI: -4 to 76) against A(H3N2). Of 2763 hospitalized patients, 349 (13%) were positive for influenza: 64% A(H3N2), 17% A(H1N1), and 8% B. IVE to prevent hospitalization was 24% (95%CI: -1 to 42) overall, 82% (95%CI: 49 to 93) against influenza B, and 16% (95%CI: -17 to 40) against A(H3N2). No IVE was observed in preventing influenza A(H1N1). IVE was high to prevent influenza B, moderate against A(H3N2) and null against A(H1N1). A lower proportion of influenza B cases may explain the smaller IVE in hospitalized patients than in outpatients. The null IVE against A(H1N1) was consistent with the observed antigenic drift and supports the new composition of the 2023-2024 influenza vaccine.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Miguel Fernández-Huerta
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Ana Navascués
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Francisco Pozo
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Aitziber Echeverria
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
| | - Carmen Ezpeleta
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
- Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain; (I.M.-B.); (C.T.-S.); (I.C.); (A.E.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain; (M.F.-H.); (C.E.)
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6
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Casado I, García Cenoz M, Egüés N, Burgui C, Martínez-Baz I, Castilla J. [COVID-19 infections, hospitalizations, and mortality in Navarre (Spain) between February 2020 and September 2022]. An Sist Sanit Navar 2023; 46:e1044. [PMID: 37594061 PMCID: PMC10498135 DOI: 10.23938/assn.1044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Between February 2020 and September 2022, SARS-CoV-2 has circulated uninterruptedly throughout Spain. This study analyses COVID-19 infections, hospitalizations, and deaths in Navarre. METHODS Enhanced epidemiological surveillance and results of seroepidemiological surveys were used to analyze COVID-19 infections, hospitalizations, and deaths, based on the vaccination coverage and other preventive measures applied from February 2020 to September 2022. RESULTS A total of 295,424 COVID-19 cases were confirmed (45% of the population in Navarre); 8,594 required hospital admission (1.3%), 832 were admitted to intensive care units (1.3‰) and 1,725 died (2.6‰). Over the first wave of the pandemic, there were 1,934 hospitalizations and 529 deaths from confirmed COVID-19 cases over a few weeks; these figures dropped rapidly following lockdown. Until October 2021, SARS-CoV-2 circulation was modulated by non-pharmacological preventive measures. The subsequent relaxation of these measures led to a wide circulation of the omicron variant, increasing the number of cases by three-fold. The high vaccination coverage against COVID-19 introduced decisive changes in the epidemiology of the disease, reducing to less than 2%, 0.1%, and 0.5% the cases requiring hospitalization, intensive care unit admission, or that died, respectively. CONCLUSIONS Initial lockdown and non-pharmacological preventive measures helped control SARS-CoV-2 transmission until vaccination was extended. Vaccination achieved a decisive reduction of the COVID-19 severity and lethality.
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7
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Martínez-Baz I, Miqueleiz A, Egüés N, Casado I, Burgui C, Echeverría A, Navascués A, Fernández-Huerta M, García Cenoz M, Trobajo-Sanmartín C, Guevara M, Ezpeleta C, Castilla J. Effect of COVID-19 vaccination on the SARS-CoV-2 transmission among social and household close contacts: A cohort study. J Infect Public Health 2023; 16:410-417. [PMID: 36724697 PMCID: PMC9876028 DOI: 10.1016/j.jiph.2023.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND COVID-19 vaccination was expected to reduce SARS-CoV-2 transmission, but the relevance of this effect remains unclear. We aimed to estimate the effectiveness of COVID-19 vaccination of the index cases and their close contacts in reducing the probability of SARS-CoV-2 transmission. METHODS Transmission of SARS-CoV-2 infection was evaluated in two cohorts of adult close contacts of COVID-19 confirmed cases (social and household settings) by COVID-19 vaccination status of the index case and the close contact, from April to November 2021 in Navarre, Spain. The effects of vaccination of the index case and the close contact were estimated as (1-adjusted relative risk) × 100%. RESULTS Among 19,631 social contacts, 3257 (17%) were confirmed with SARS-CoV-2. COVID-19 vaccination of the index case reduced infectiousness by 44% (95% CI, 27-57%), vaccination of the close contact reduced susceptibility by 69% (95% CI, 65-73%), and vaccination of both reduced transmissibility by 74% (95% CI, 70-78%) in social settings, suggesting some synergy of effects. Among 20,708 household contacts, 6269 (30%) were infected, and vaccine effectiveness estimates were 13% (95% CI, -5% to 28%), 61% (95% CI, 58-64%), and 52% (95% CI, 47-56%), respectively. These estimates were lower in older people and had not relevant differences between the Alpha (April-June) and Delta (July-November) variant periods. CONCLUSIONS COVID-19 vaccination reduces infectiousness and susceptibility; however, these effects are insufficient for complete control of SARS-CoV-2 transmission, especially in older people and household setting. Relaxation of preventive behaviors after vaccination may counteract part of the vaccine effect on transmission.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Miqueleiz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Nerea Egüés
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Ana Navascués
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Miguel Fernández-Huerta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain,CIBER Epidemiología y Salud Pública, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Carmen Ezpeleta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Irunlarrea, 31008 Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Spain; CIBER Epidemiología y Salud Pública, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
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8
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Martínez-Baz I, Trobajo-Sanmartín C, Miqueleiz A, Casado I, Navascués A, Burgui C, Ezpeleta C, Castilla J, Guevara M. Risk reduction of hospitalisation and severe disease in vaccinated COVID-19 cases during the SARS-CoV-2 variant Omicron BA.1-predominant period, Navarre, Spain, January to March 2022. Euro Surveill 2023; 28:2200337. [PMID: 36729113 PMCID: PMC9896606 DOI: 10.2807/1560-7917.es.2023.28.5.2200337] [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: 02/03/2023] Open
Abstract
BackgroundAs COVID-19 vaccine effectiveness against SARS-CoV-2 infection was lower for cases of the Omicron vs the Delta variant, understanding the effect of vaccination in reducing risk of hospitalisation and severe disease among COVID-19 cases is crucial.AimTo evaluate risk reduction of hospitalisation and severe disease in vaccinated COVID-19 cases during the Omicron BA.1-predominant period in Navarre, Spain.MethodsA case-to-case comparison included COVID-19 epidemiological surveillance data in adults ≥ 18 years from 3 January-20 March 2022. COVID-19 vaccination status was compared between hospitalised and non-hospitalised cases, and between severe (intensive care unit admission or death) and non-severe cases using logistic regression models.ResultsAmong 58,952 COVID-19 cases, 565 (1.0%) were hospitalised and 156 (0.3%) were severe. The risk of hospitalisation was reduced within the first 6 months after full COVID-19 vaccination (complete primary series) (adjusted odds ratio (aOR): 0.06; 95% CI: 0.04-0.09) and after 6 months (aOR: 0.16; 95% CI: 0.12-0.21; pcomparison < 0.001), as well as after a booster dose (aOR: 0.06: 95% CI: 0.04-0.07). Similarly, the risk of severe disease was reduced (aOR: 0.13, 0.18, and 0.06, respectively). Compared with cases fully vaccinated 6 months or more before a positive test, those who had received a booster dose had lower risk of hospitalisation (aOR: 0.38; 95% CI: 0.28-0.52) and severe disease (aOR: 0.38; 95% CI: 0.21-0.68).ConclusionsFull COVID-19 vaccination greatly reduced the risk of hospitalisation and severe outcomes in COVID-19 cases with the Omicron variant, and a booster dose improved this effect in people aged over 65 years.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Pamplona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Pamplona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Miqueleiz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Pamplona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Navascués
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Pamplona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Carmen Ezpeleta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Pamplona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Pamplona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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9
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Trobajo-Sanmartín C, Miqueleiz A, Guevara M, Fernández-Huerta M, Burgui C, Casado I, Baigorria F, Navascués A, Ezpeleta C, Castilla J. Comparison of the Risk of Hospitalization and Severe Disease Among Co-circulating Severe Acute Respiratory Syndrome Coronavirus 2 Variants. J Infect Dis 2023; 227:332-338. [PMID: 36179126 DOI: 10.1093/infdis/jiac385] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/18/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND We compare the risk of coronavirus disease 2019 (COVID-19) outcomes among co-circulating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants between January 2021 and May 2022 in Navarra, Spain. METHODS We compared the frequency of hospitalization and severe disease (intensive care unit admission or death) due to COVID-19 among the co-circulating variants. Variants analyzed were nonvariants of concern (non-VOCs), Alpha, Delta, Omicron BA.1, and Omicron BA.2. Logistic regression models were used to estimate adjusted odds ratio (aOR). RESULTS The Alpha variant had a higher risk of hospitalization (aOR, 1.86 [95 confidence interval {CI}, 1.282.71]) and severe disease (aOR, 2.40 [95 CI, 1.314.40]) than non-VOCs. The Delta variant did not show a significantly different risk of hospitalization (aOR, 0.73 [95 CI, .401.30]) and severe disease (aOR, 3.04 [95 CI, .5716.22]) compared to the Alpha variant. The Omicron BA.1 significantly reduced both risks relative to the Delta variant (aORs, 0.28 [95 CI, .16.47] and 0.23 [95 CI, .12.46], respectively). The Omicron BA.2 reduced the risk of hospitalization compared to BA.1 (aOR, 0.52 [95 CI, .29.95]). CONCLUSIONS The Alpha and Delta variants showed an increased risk of hospitalization and severe disease, which decreased considerably with the Omicron BA.1 and BA.2. Surveillance of variants can lead to important differences in severity.
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Affiliation(s)
- Camino Trobajo-Sanmartín
- Instituto de Salud Pblica de Navarra, Pamplona, Spain
- CIBER Epidemiologa y Salud Pblica, Madrid, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Ana Miqueleiz
- Navarra Institute for Health Research, Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pblica de Navarra, Pamplona, Spain
- CIBER Epidemiologa y Salud Pblica, Madrid, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Fernández-Huerta
- Navarra Institute for Health Research, Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pblica de Navarra, Pamplona, Spain
- CIBER Epidemiologa y Salud Pblica, Madrid, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pblica de Navarra, Pamplona, Spain
- CIBER Epidemiologa y Salud Pblica, Madrid, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | | | - Ana Navascués
- Navarra Institute for Health Research, Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Carmen Ezpeleta
- Navarra Institute for Health Research, Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pblica de Navarra, Pamplona, Spain
- CIBER Epidemiologa y Salud Pblica, Madrid, Spain
- Navarra Institute for Health Research, Pamplona, Spain
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10
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Kissling E, Pozo F, Martínez‐Baz I, Buda S, Vilcu A, Domegan L, Mazagatos C, Dijkstra F, Latorre‐Margalef N, Kurečić Filipović S, Machado A, Lazar M, Casado I, Dürrwald R, van der Werf S, O'Donnell J, Linares Dopido JA, Meijer A, Riess M, Višekruna Vučina V, Rodrigues AP, Mihai ME, Castilla J, Goerlitz L, Falchi A, Connell J, Castrillejo D, Hooiveld M, Carnahan A, Ilić M, Guiomar R, Ivanciuc A, Maurel M, Omokanye A, Valenciano M. Influenza vaccine effectiveness against influenza A subtypes in Europe: Results from the 2021-2022 I-MOVE primary care multicentre study. Influenza Other Respir Viruses 2022; 17:e13069. [PMID: 36702797 PMCID: PMC9835407 DOI: 10.1111/irv.13069] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 10/26/2022] [Accepted: 10/29/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In 2021-2022, influenza A viruses dominated in Europe. The I-MOVE primary care network conducted a multicentre test-negative study to measure influenza vaccine effectiveness (VE). METHODS Primary care practitioners collected information on patients presenting with acute respiratory infection. Cases were influenza A(H3N2) or A(H1N1)pdm09 RT-PCR positive, and controls were influenza virus negative. We calculated VE using logistic regression, adjusting for study site, age, sex, onset date, and presence of chronic conditions. RESULTS Between week 40 2021 and week 20 2022, we included over 11 000 patients of whom 253 and 1595 were positive for influenza A(H1N1)pdm09 and A(H3N2), respectively. Overall VE against influenza A(H1N1)pdm09 was 75% (95% CI: 43-89) and 81% (95% CI: 45-93) among those aged 15-64 years. Overall VE against influenza A(H3N2) was 29% (95% CI: 12-42) and 25% (95% CI: -41 to 61), 33% (95% CI: 14-49), and 26% (95% CI: -22 to 55) among those aged 0-14, 15-64, and over 65 years, respectively. The A(H3N2) VE among the influenza vaccination target group was 20% (95% CI: -6 to 39). All 53 sequenced A(H1N1)pdm09 viruses belonged to clade 6B.1A.5a.1. Among 410 sequenced influenza A(H3N2) viruses, all but eight belonged to clade 3C.2a1b.2a.2. DISCUSSION Despite antigenic mismatch between vaccine and circulating strains for influenza A(H3N2) and A(H1N1)pdm09, 2021-2022 VE estimates against circulating influenza A(H1N1)pdm09 were the highest within the I-MOVE network since the 2009 influenza pandemic. VE against A(H3N2) was lower than A(H1N1)pdm09, but at least one in five individuals vaccinated against influenza were protected against presentation to primary care with laboratory-confirmed influenza.
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Affiliation(s)
| | - Francisco Pozo
- National Centre for MicrobiologyInstitute of Health Carlos IIIMadridSpain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
| | - Iván Martínez‐Baz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,Instituto de Salud Pública de Navarra ‐ IdiSNAPamplonaSpain
| | | | - Ana‐Maria Vilcu
- INSERM, Sorbonne UniversitéInstitut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136)ParisFrance
| | - Lisa Domegan
- Health Service Executive‐Health Protection Surveillance CentreDublinIreland
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,National Centre for EpidemiologyInstitute of Health Carlos IIIMadridSpain
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | | | | | | | - Mihaela Lazar
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | - Itziar Casado
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,Instituto de Salud Pública de Navarra ‐ IdiSNAPamplonaSpain
| | | | - Sylvie van der Werf
- Unité de Génétique Moléculaire des Virus à ARN, Institut PasteurUniversité Paris Cité, UMR 3569 CNRSParisFrance,CNR virus des infections respiratoires, Institut PasteurParisFrance
| | - Joan O'Donnell
- Health Service Executive‐Health Protection Surveillance CentreDublinIreland
| | - Juan Antonio Linares Dopido
- Subdirección de Epidemiología, Dirección General de Salud Pública, Servicio Extremeño de SaludExtremaduraSpain
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | | | | | | | - Maria Elena Mihai
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,Instituto de Salud Pública de Navarra ‐ IdiSNAPamplonaSpain
| | | | | | - Jeff Connell
- National Virus Reference LaboratoryUniversity College DublinDublinIreland
| | - Daniel Castrillejo
- Servicio de Epidemiología, DGSP, Consejería de Políticas Sociales, Salud Pública y Bienestar Animal, Ciudad Autónoma de MelillaMelillaSpain
| | | | | | - Maja Ilić
- Croatian Institute of Public HealthZagrebCroatia
| | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo JorgeLisbonPortugal
| | - Alina Ivanciuc
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | | | - Ajibola Omokanye
- European Centre for Disease Prevention and ControlStockholmSweden
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11
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Castilla J, Lecea Ó, Martín Salas C, Quílez D, Miqueleiz A, Trobajo-Sanmartín C, Navascués A, Martínez-Baz I, Casado I, Burgui C, Egüés N, Ezpeleta G, Ezpeleta C. Seroprevalence of antibodies against SARS-CoV-2 and risk of COVID-19 in Navarre, Spain, May to July 2022. Euro Surveill 2022; 27:2200619. [PMID: 35983774 PMCID: PMC9389855 DOI: 10.2807/1560-7917.es.2022.27.33.2200619] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/18/2022] [Indexed: 06/08/2023] Open
Abstract
In Navarre, Spain, in May 2022, the seroprevalence of anti-nucleocapsid (N) and anti-spike (S) antibodies of SARS-CoV-2 was 58.9% and 92.7%, respectively. The incidence of confirmed COVID-19 thereafter through July was lower in people with anti-N antibodies (adjusted odds ratio (aOR) = 0.08; 95% confidence interval (CI): 0.05-0.13) but not with anti-S antibodies (aOR = 1.06; 95% CI: 0.47-2.38). Hybrid immunity, including anti-N antibodies induced by natural exposure to SARS-CoV-2, seems essential in preventing Omicron COVID-19 cases.
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Affiliation(s)
- Jesús Castilla
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Óscar Lecea
- Gerencia de Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Carmen Martín Salas
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Ana Miqueleiz
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Navascués
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Nerea Egüés
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Carmen Ezpeleta
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
- Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
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12
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Martínez-Baz I, Casado I, Miqueleiz A, Navascués A, Pozo F, Trobajo-Sanmartín C, Albéniz E, Elía F, Burgui C, Fernández-Huerta M, Ezpeleta C, Castilla J. Effectiveness of influenza vaccination in preventing influenza in primary care, Navarre, Spain, 2021/22. Euro Surveill 2022; 27. [PMID: 35775428 PMCID: PMC9248265 DOI: 10.2807/1560-7917.es.2022.27.26.2200488] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Compared with individuals unvaccinated in the current and three previous influenza seasons, in 2021/22, influenza vaccine effectiveness at primary care level was 37% (95% CI: 16 to 52) for current season vaccination, regardless of previous doses, and 35% (95% CI: −3 to 45) for only previous seasons vaccination. Against influenza A(H3N2), estimates were 39% (95% CI: 16 to 55) and 24% (95% CI: −8 to 47) suggesting moderate effectiveness of current season vaccination and possible remaining effect of prior vaccinations.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ana Miqueleiz
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Ana Navascués
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Francisco Pozo
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Esther Albéniz
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain.,Gerencia de Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Fernando Elía
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain.,Gerencia de Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Miguel Fernández-Huerta
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Carmen Ezpeleta
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
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13
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Kissling E, Hooiveld M, Martínez-Baz I, Mazagatos C, William N, Vilcu AM, Kooijman MN, Ilić M, Domegan L, Machado A, de Lusignan S, Lazar M, Meijer A, Brytting M, Casado I, Larrauri A, Murray JLK, Behillil S, de Gier B, Mlinarić I, O’Donnell J, Rodrigues AP, Tsang R, Timnea O, de Lange M, Riess M, Castilla J, Pozo F, Hamilton M, Falchi A, Knol MJ, Kurečić Filipović S, Dunford L, Guiomar R, Cogdale J, Cherciu C, Jansen T, Enkirch T, Basile L, Connell J, Gomez V, Sandonis Martín V, Bacci S, Rose AMC, Pastore Celentano L, Valenciano M. Effectiveness of complete primary vaccination against COVID-19 at primary care and community level during predominant Delta circulation in Europe: multicentre analysis, I-MOVE-COVID-19 and ECDC networks, July to August 2021. Euro Surveill 2022; 27:2101104. [PMID: 35620997 PMCID: PMC9137272 DOI: 10.2807/1560-7917.es.2022.27.21.2101104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IntroductionIn July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe.AimUsing a multicentre test-negative study, we measured COVID-19 vaccine effectiveness (VE) against symptomatic infection.MethodsIndividuals with COVID-19 or acute respiratory symptoms at primary care/community level in 10 European countries were tested for SARS-CoV-2. We measured complete primary course overall VE by vaccine brand and by time since vaccination.ResultsOverall VE was 74% (95% CI: 69-79), 76% (95% CI: 71-80), 63% (95% CI: 48-75) and 63% (95% CI: 16-83) among those aged 30-44, 45-59, 60-74 and ≥ 75 years, respectively. VE among those aged 30-59 years was 78% (95% CI: 75-81), 66% (95% CI: 58-73), 91% (95% CI: 87-94) and 52% (95% CI: 40-61), for Comirnaty, Vaxzevria, Spikevax and COVID-19 Vaccine Janssen, respectively. VE among people 60 years and older was 67% (95% CI: 52-77), 65% (95% CI: 48-76) and 83% (95% CI: 64-92) for Comirnaty, Vaxzevria and Spikevax, respectively. Comirnaty VE among those aged 30-59 years was 87% (95% CI: 83-89) at 14-29 days and 65% (95% CI: 56-71%) at ≥ 90 days between vaccination and onset of symptoms.ConclusionsVE against symptomatic infection with the SARS-CoV-2 Delta variant varied among brands, ranging from 52% to 91%. While some waning of the vaccine effect may be present (sample size limited this analysis to only Comirnaty), protection was 65% at 90 days or more between vaccination and onset.
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Affiliation(s)
| | | | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Ana-Maria Vilcu
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Marjolein N Kooijman
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Maja Ilić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Mihaela Lazar
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Amparo Larrauri
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Sylvie Behillil
- Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, France,CNR des virus des infections respiratoires, Institut Pasteur, Paris, France
| | - Brechje de Gier
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ivan Mlinarić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Joan O’Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Olivia Timnea
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | | | | - Mirjam J Knol
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Carmen Cherciu
- “Cantacuzino” National Military Medical Institute for Research and Development, Bucharest, Romania
| | | | | | - Luca Basile
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain,Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública, Catalunya, Spain
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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14
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Martínez-Baz I, Trobajo-Sanmartín C, Burgui C, Casado I, Castilla J. Transmission of SARS-CoV-2 infection and risk factors in a cohort of close contacts. Postgrad Med 2022; 134:230-238. [PMID: 35102793 DOI: 10.1080/00325481.2022.2037360] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Many factors might affect SARS-CoV-2 transmission, but their relevance is not well established. The objectives were to assess the secondary attack rate (SAR) and the risk factors for SARS-CoV-2 transmission from confirmed index cases to their close contacts in household and non-household settings. METHODS This cohort study included the close contacts of SARS-CoV-2 infected cases confirmed between May and December 2020 in Navarre, Spain. Epidemiological and clinical variables of the index case and close contacts were collected. The SAR was calculated, and the independent effect of each variable on the transmission risk was evaluated by logistic regression. RESULTS A total of 59,900 close contacts of 20,048 index cases were studied, and 53.6% were household contacts. SAR was 34.9% overall, 46.8% in household contacts and 21.1% in non-household contacts. The risk of transmission was higher in household setting (adjusted odds ratio (aOR) 2.96, 95% CI 2.84-3.07), from symptomatic index cases (aOR 1.50, 95% CI 1.43-1.58), immigrants (aOR 1.44, 95% CI 1.36-1.52), and increased with age. A higher susceptibility of close contacts was associated with 5-14 years of age, immigrants (aOR 1.54), very low or low-income level (aOR 1.27, and aOR, 1.17, respectively), healthcare work (aOR 1.21), and diagnosis of diabetes (aOR 1.14, 95%CI 1.03-1.25), chronic kidney disease (aOR 1.18, 95%CI 1.04-1.35), hypertension (aOR 1.11, 95% CI 1.03-1.19), and severe obesity (aOR 1.18, 95% CI 1.00-1.38). Transmission increased progressively from May to September 2020 as the B.1.177 variant became dominant. CONCLUSION The risk of SARS-CoV-2 infection was considerable among close contacts of infected persons. The higher risk associated with household contacts, immigrants, older index cases, close contacts with lower income level and comorbidities should be considered to address preventive interventions.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
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15
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Martínez-Baz I, Trobajo-Sanmartín C, Miqueleiz A, Guevara M, Fernández-Huerta M, Burgui C, Casado I, Portillo ME, Navascués A, Ezpeleta C, Castilla J. Product-specific COVID-19 vaccine effectiveness against secondary infection in close contacts, Navarre, Spain, April to August 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34596016 PMCID: PMC8485582 DOI: 10.2807/1560-7917.es.2021.26.39.2100894] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
COVID-19 vaccine effectiveness by product (two doses Comirnaty, Spikevax or Vaxzevria and one of Janssen), against infection ranged from 50% (95% CI: 42 to 57) for Janssen to 86% (70 to 93) for Vaxzevria-Comirnaty combination; among ≥ 60 year-olds, from 17% (−26 to 45) for Janssen to 68% (48 to 80) for Spikevax; and against hospitalisation from 74% (43 to 88) for Janssen to > 90% for other products. Two doses of vaccine were highly effective against hospitalisation, but suboptimal for infection control.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Ana Miqueleiz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Miguel Fernández-Huerta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - María Eugenia Portillo
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Ana Navascués
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Carmen Ezpeleta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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- Other members of the Working Group for the Study of COVID-19 in Navarre are listed in the Investigators tab
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Martínez-Baz I, Navascués A, Casado I, Aguinaga A, Ezpeleta C, Castilla J. Simple models to include influenza vaccination history when evaluating the effect of influenza vaccination. ACTA ACUST UNITED AC 2021; 26. [PMID: 34387185 PMCID: PMC8365179 DOI: 10.2807/1560-7917.es.2021.26.32.2001099] [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] [Indexed: 11/20/2022]
Abstract
Background Most reports of influenza vaccine effectiveness consider current-season vaccination only. Aim We evaluated a method to estimate the effect of influenza vaccinations (EIV) considering vaccination history. Methods We used a test-negative design with well-documented vaccination history to evaluate the average EIV over eight influenza seasons (2011/12–2018/19; n = 10,356). Modifying effect was considered as difference in effects of vaccination in current and previous seasons and current-season vaccination only. We also explored differences between current-season estimates excluding from the reference category people vaccinated in any of the five previous seasons and estimates without this exclusion or only for one or three previous seasons. Results The EIV was 50%, 45% and 38% in people vaccinated in the current season who had previously received none, one to two and three to five doses, respectively, and it was 30% and 43% for one to two and three to five prior doses only. Vaccination in at least three previous seasons reduced the effect of current-season vaccination by 12 percentage points overall, 31 among outpatients, 22 in 9–65 year-olds, and 23 against influenza B. Including people vaccinated in previous seasons only in the unvaccinated category underestimated EIV by 9 percentage points on average (31% vs 40%). Estimates considering vaccination of three or five previous seasons were similar. Conclusions Vaccine effectiveness studies should consider influenza vaccination in previous seasons, as it can retain effect and is often an effect modifier. Vaccination status in three categories (current season, previous seasons only, unvaccinated) reflects the whole EIV.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Ana Navascués
- Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Aitziber Aguinaga
- Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Carmen Ezpeleta
- Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Jesús Castilla
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
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17
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Kissling E, Hooiveld M, Sandonis Martín V, Martínez-Baz I, William N, Vilcu AM, Mazagatos C, Domegan L, de Lusignan S, Meijer A, Machado A, Brytting M, Casado I, Murray JLK, Belhillil S, Larrauri A, O'Donnell J, Tsang R, de Lange M, Rodrigues AP, Riess M, Castilla J, Hamilton M, Falchi A, Pozo F, Dunford L, Cogdale J, Jansen T, Guiomar R, Enkirch T, Burgui C, Sigerson D, Blanchon T, Martínez Ochoa EM, Connell J, Ellis J, van Gageldonk-Lafeber R, Kislaya I, Rose AM, Valenciano M. Vaccine effectiveness against symptomatic SARS-CoV-2 infection in adults aged 65 years and older in primary care: I-MOVE-COVID-19 project, Europe, December 2020 to May 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34296676 PMCID: PMC8299744 DOI: 10.2807/1560-7917.es.2021.26.29.2100670] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We measured COVID-19 vaccine effectiveness (VE) against symptomatic SARS-CoV-2 infection at primary care/outpatient level among adults ≥ 65 years old using a multicentre test-negative design in eight European countries. We included 592 SARS-CoV-2 cases and 4,372 test-negative controls in the main analysis. The VE was 62% (95% CI: 45–74) for one dose only and 89% (95% CI: 79–94) for complete vaccination. COVID-19 vaccines provide good protection against COVID-19 presentation at primary care/outpatient level, particularly among fully vaccinated individuals.
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Affiliation(s)
| | | | | | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Ana-Maria Vilcu
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Royal College of General Practitioners Research and Surveillance Centre, London, UK
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Itziar Casado
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Sylvie Belhillil
- Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, France.,CNR des virus des infections respiratoires, Institut Pasteur, Paris, France
| | - Amparo Larrauri
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Royal College of General Practitioners Research and Surveillance Centre, London, UK
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | | | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Cristina Burgui
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Thierry Blanchon
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Eva María Martínez Ochoa
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, La Rioja, Spain
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | | | - Irina Kislaya
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
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- The members of the I-MOVE-COVID-19 primary care study team are listed in the Investigators tab
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Martínez-Baz I, Navascués A, Casado I, Portillo ME, Guevara M, Gómez-Ibáñez C, Burgui C, Ezpeleta C, Castilla J. Effect of influenza vaccination in patients with asthma. CMAJ 2021; 193:E1120-E1128. [PMID: 34312165 PMCID: PMC8321300 DOI: 10.1503/cmaj.201757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND: Although annual influenza vaccination is recommended for persons with asthma, its effectiveness in this patient population is not well described. We evaluated the effect of influenza vaccination in the current and previous seasons in preventing influenza among people with asthma. METHODS: Using population health data from the Navarre region of Spain for the 2015/16 to 2019/20 influenza seasons, we conducted a test-negative case–control study to assess the effect of influenza vaccination in the current and 5 previous seasons. From patients presenting to hospitals and primary health care centres with influenza-like illness who underwent testing for influenza, we estimated the effects of influenza vaccination among patients with asthma overall and between those presenting as inpatients or outpatients, as well as between patients with and without asthma. RESULTS: Of 1032 patients who had asthma and were tested, we confirmed that 421 had influenza and the remaining 611 were test-negative controls. We found that the average effect of influenza vaccination was 43% (adjusted odds ratio [OR] 0.57, 95% confidence interval [CI] 0.40 to 0.80) for current-season vaccination regardless of previous doses, and 38% (adjusted OR 0.62, 95% CI 0.39 to 0.96) for vaccination in previous seasons only. Effects were similar for outpatients and inpatients. Among patients with asthma and confirmed influenza, current-season vaccination did not reduce the odds of hospital admission (adjusted OR 1.05, 95% CI 0.51 to 2.18). Influenza vaccination effects were similar for patients with and without asthma. INTERPRETATION: We estimated that, on average, current or previous influenza vaccination of people with asthma prevented almost half of influenza cases. These results support recommendations that people with asthma receive influenza vaccination.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - Ana Navascués
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - María Eugenia Portillo
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - Carlos Gómez-Ibáñez
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - Carmen Ezpeleta
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA (Martínez-Baz, Casado, Guevara, Gómez-Ibáñez, Burgui, Castilla); Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra - IdiSNA (Navascués, Portillo, Ezpeleta), Pamplona, Spain; CIBER Epidemiología y Salud Pública, (Martínez-Baz, Casado, Guevara, Burgui, Castilla) Madrid, Spain.
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Martínez-Baz I, Navascués A, Portillo ME, Casado I, Fresán U, Ezpeleta C, Castilla J. Effect of Influenza Vaccination in Preventing Laboratory-Confirmed Influenza Hospitalization in Patients With Diabetes Mellitus. Clin Infect Dis 2021; 73:107-114. [PMID: 32412600 DOI: 10.1093/cid/ciaa564] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 02/11/2020] [Accepted: 05/08/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND People with diabetes are at high risk of severe influenza complications. The influenza vaccination effect among diabetic patients remains inconclusive. We estimated the average effect of influenza vaccination status in the current and prior seasons in preventing laboratory-confirmed influenza hospitalization in diabetic patients. METHODS Patients attended in hospitals and primary healthcare centers with influenza-like illness were tested for influenza from the 2013-2014 to 2018-2019 seasons in Navarre, Spain. A test-negative case-control design in diabetic inpatients compared the influenza vaccination status in the current and 5 prior seasons between laboratory-confirmed influenza cases and negative controls. Vaccination status of influenza-confirmed cases was compared between diabetic inpatients and outpatients. Influenza vaccination effect was compared between diabetic patients and older (≥ 60 years) or chronic nondiabetic patients. RESULTS Of 1670 diabetic inpatients tested, 569 (34%) were confirmed for influenza and 1101 were test-negative controls. The average effect in preventing influenza hospitalization was 46% (95% confidence interval [CI], 28%-59%) for current-season vaccination and 44% (95% CI, 20%-61%) for vaccination in prior seasons only in comparison to unvaccinated patients in the current and prior seasons. Among diabetic patients with confirmed influenza, current-season vaccination reduced the probability of hospitalization (adjusted odds ratio, 0.35; 95% CI, .15-.79). In diabetic patients, vaccination effect against influenza hospitalizations was not inferior to that in older or chronic nondiabetic patients. CONCLUSIONS On average, influenza vaccination of diabetic population reduced by around half the risk of influenza hospitalization. Vaccination in prior seasons maintained a notable protective effect. These results reinforce the recommendation of influenza vaccination for diabetic patients.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana Navascués
- Clinical Microbiology Department, Complejo Hospitalario de Navarra - IdiSNA, Pamplona, Spain
| | - María Eugenia Portillo
- Clinical Microbiology Department, Complejo Hospitalario de Navarra - IdiSNA, Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ujué Fresán
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carmen Ezpeleta
- Clinical Microbiology Department, Complejo Hospitalario de Navarra - IdiSNA, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Martínez-Baz I, Miqueleiz A, Casado I, Navascués A, Trobajo-Sanmartín C, Burgui C, Guevara M, Ezpeleta C, Castilla J. Effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 infection and hospitalisation, Navarre, Spain, January to April 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34047271 PMCID: PMC8161727 DOI: 10.2807/1560-7917.es.2021.26.21.2100438] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
COVID-19 vaccine effectiveness was evaluated in close contacts of cases diagnosed during January–April 2021. Among 20,961 contacts, 7,240 SARS-CoV-2 infections were confirmed, with 5,467 being symptomatic and 559 leading to hospitalisations. Non-brand-specific one and two dose vaccine effectiveness were respectively, 35% (95% confidence interval (CI): 25 to 44) and 66% (95% CI: 57 to 74) against infections, 42% (95% CI: 31 to 52) and 82% (95% CI: 74 to 88) against symptomatic infection, and 72% (95% CI: 47 to 85) and 95% (95% CI: 62 to 99) against COVID-19 hospitalisation. The second dose significantly increased effectiveness. Findings support continuing complete vaccination.
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Affiliation(s)
- Iván Martínez-Baz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Ana Miqueleiz
- Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Itziar Casado
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Ana Navascués
- Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Camino Trobajo-Sanmartín
- Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Cristina Burgui
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Marcela Guevara
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Carmen Ezpeleta
- Clinical Microbiology Department, Complejo Hospitalario de Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Jesús Castilla
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
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- Members of the working group are listed under the Investigators tab
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21
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Kissling E, Hooiveld M, Brytting M, Vilcu AM, de Lange M, Martínez-Baz I, Sigerson D, Enkirch T, Belhillil S, Meijer A, Castilla J, William N, Carnahan A, Falchi A, Hendriksen J, Casado I, Murray J, Enouf V, Dijkstra F, Marques DFP, Valenciano M. Absence of association between 2019-20 influenza vaccination and COVID-19: Results of the European I-MOVE-COVID-19 primary care project, March-August 2020. Influenza Other Respir Viruses 2021; 15:429-438. [PMID: 33481344 PMCID: PMC8013620 DOI: 10.1111/irv.12839] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 12/22/2020] [Accepted: 01/03/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Claims of influenza vaccination increasing COVID-19 risk are circulating. Within the I-MOVE-COVID-19 primary care multicentre study, we measured the association between 2019-20 influenza vaccination and COVID-19. METHODS We conducted a multicentre test-negative case-control study at primary care level, in study sites in five European countries, from March to August 2020. Patients presenting with acute respiratory infection were swabbed, with demographic, 2019-20 influenza vaccination and clinical information documented. Using logistic regression, we measured the adjusted odds ratio (aOR), adjusting for study site and age, sex, calendar time, presence of chronic conditions. The main analysis included patients swabbed ≤7 days after onset from the three countries with <15% of missing influenza vaccination. In secondary analyses, we included five countries, using multiple imputation with chained equations to account for missing data. RESULTS We included 257 COVID-19 cases and 1631 controls in the main analysis (three countries). The overall aOR between influenza vaccination and COVID-19 was 0.93 (95% CI: 0.66-1.32). The aOR was 0.92 (95% CI: 0.58-1.46) and 0.92 (95% CI: 0.51-1.67) among those aged 20-59 and ≥60 years, respectively. In secondary analyses, we included 6457 cases and 69 272 controls. The imputed aOR was 0.87 (95% CI: 0.79-0.95) among all ages and any delay between swab and symptom onset. CONCLUSIONS There was no evidence that COVID-19 cases were more likely to be vaccinated against influenza than controls. Influenza vaccination should be encouraged among target groups for vaccination. I-MOVE-COVID-19 will continue documenting influenza vaccination status in 2020-21, in order to learn about effects of recent influenza vaccination.
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Affiliation(s)
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | | | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | | | | | - Sylvie Belhillil
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, Institut Pasteur, UMR 3568 CNRS, University of Paris, Paris, France
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jesus Castilla
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | | | | | | | - Janneke Hendriksen
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP, Pamplona, Spain
| | | | - Vincent Enouf
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, Institut Pasteur, UMR 3568 CNRS, University of Paris, Paris, France
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Diogo F P Marques
- Epiconcept, Paris, France.,Public Health Scotland, Glasgow, Scotland
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Martínez-Baz I, Navascués A, Casado I, Aguinaga A, Ezpeleta C, Castilla J. Remaining Effect of Influenza Vaccines Received in Prior Seasons. J Infect Dis 2020; 220:1136-1140. [PMID: 31107953 DOI: 10.1093/infdis/jiz266] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 03/18/2019] [Accepted: 05/18/2019] [Indexed: 11/14/2022] Open
Abstract
This study evaluates the remaining effect of influenza vaccines received in the 5 prior seasons. During 7 influenza seasons, 8933 patients were enrolled and 47% were confirmed for influenza. Compared with unvaccinated individuals in the current and 5 prior seasons, vaccination was protective when the last dose had been received in the current season (40% [95% confidence interval {CI}, 32%-47%]), and 1 (42% [95% CI, 27%-54%]), 2-3 (35% [95% CI, 16%-49%]), or 4-5 seasons (31% [95% CI, 4%-51%]) prior. This effect lasted for fewer seasons in the elderly and in patients with chronic conditions. On average, several recent prior doses were as protective as current-season vaccination.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid
| | - Ana Navascués
- Complejo Hospitalario de Navarra - IdiSNA, Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid
| | | | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA, Pamplona.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid
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23
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Rose AMC, Kissling E, Gherasim A, Casado I, Bella A, Launay O, Lazăr M, Marbus S, Kuliese M, Syrjänen R, Machado A, Kurečić Filipović S, Larrauri A, Castilla J, Alfonsi V, Galtier F, Ivanciuc A, Meijer A, Mickiene A, Ikonen N, Gómez V, Lovrić Makarić Z, Moren A, Valenciano M. Vaccine effectiveness against influenza A(H3N2) and B among laboratory-confirmed, hospitalised older adults, Europe, 2017-18: A season of B lineage mismatched to the trivalent vaccine. Influenza Other Respir Viruses 2020; 14:302-310. [PMID: 32022450 PMCID: PMC7182608 DOI: 10.1111/irv.12714] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/09/2019] [Accepted: 12/15/2019] [Indexed: 01/22/2023] Open
Abstract
Background Influenza A(H3N2), A(H1N1)pdm09 and B viruses co‐circulated in Europe in 2017‐18, predominated by influenza B. WHO‐recommended, trivalent vaccine components were lineage‐mismatched for B. The I‐MOVE hospital network measured 2017‐18 seasonal influenza vaccine effectiveness (IVE) against influenza A(H3N2) and B among hospitalised patients (≥65 years) in Europe. Methods Following the same generic protocol for test‐negative design, hospital teams in nine countries swabbed patients ≥65 years with recent onset (≤7 days) severe acute respiratory infection (SARI), collecting information on demographics, vaccination status and underlying conditions. Cases were RT‐PCR positive for influenza A(H3N2) or B; controls: negative for any influenza. “Vaccinated” patients had SARI onset >14 days after vaccination. We measured pooled IVE against influenza, adjusted for study site, age, sex, onset date and chronic conditions. Results We included 3483 patients: 376 influenza A(H3N2) and 928 B cases, and 2028 controls. Most (>99%) vaccinated patients received the B lineage‐mismatched trivalent vaccine. IVE against influenza A(H3N2) was 24% (95% CI: 2 to 40); 35% (95% CI: 6 to 55) in 65‐ to 79‐year‐olds and 14% (95% CI: −22 to 39) in ≥80‐year‐olds. Against influenza B, IVE was 30% (95% CI: 16 to 41); 37% (95% CI: 19 to 51) in 65‐ to 79‐year‐olds and 19% (95% CI: −7 to 38) in ≥80‐year‐olds. Conclusions IVE against influenza B was similar to A(H3N2) in hospitalised older adults, despite trivalent vaccine and circulating B lineage mismatch, suggesting some cross‐protection. IVE was lower in those ≥80 than 65‐79 years. We reinforce the importance of influenza vaccination in older adults as, even with a poorly matched vaccine, it still protects one in three to four of this population from severe influenza.
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Affiliation(s)
| | | | - Alin Gherasim
- National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III, Madrid, Spain
| | - Itziar Casado
- Navarra Public Health Institute, IdiSNA-CIBERESP, Pamplona, Spain
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Odile Launay
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,CIC Cochin Pasteur, université Paris Descartes, Sorbonne Paris Cité, hôpital Cochin, AP-HP, Paris, France
| | - Mihaela Lazăr
- National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Sierk Marbus
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Monika Kuliese
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ritva Syrjänen
- Finnish Institute for Health and Welfare, Tampere, Finland
| | - Ausenda Machado
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Sanja Kurečić Filipović
- Division for epidemiology of communicable diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Institute of Health Carlos III, Madrid, Spain
| | - Jesús Castilla
- Navarra Public Health Institute, IdiSNA-CIBERESP, Pamplona, Spain
| | - Valeria Alfonsi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Florence Galtier
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,CHU de Montpellier, Inserm CIC 1411, Hôpital Saint-Eloi, Montpellier, France
| | - Alina Ivanciuc
- National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Adam Meijer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aukse Mickiene
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Niina Ikonen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Verónica Gómez
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Zvjezdana Lovrić Makarić
- Division for epidemiology of communicable diseases, Croatian Institute of Public Health, Zagreb, Croatia
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Castilla J, Portillo ME, Casado I, Pozo F, Navascués A, Adelantado M, Gómez Ibáñez C, Ezpeleta C, Martínez-Baz I. Effectiveness of the current and prior influenza vaccinations in Northern Spain, 2018–2019. Vaccine 2020; 38:1925-1932. [DOI: 10.1016/j.vaccine.2020.01.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 10/25/2022]
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25
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Mar J, Ibarrondo O, Martínez-Baz I, Juanbeltz R, San Miguel R, Casado I, Arrospide A, Castilla J. Economic evaluation of a population strategy for the treatment of chronic hepatitis C with direct-acting antivirals. Rev Esp Enferm Dig 2019; 110:621-628. [PMID: 30032627 DOI: 10.17235/reed.2018.5605/2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The high initial cost of antivirals against hepatitis C prompted development of the "Strategic Plan for Tackling Chronic Hepatitis C in the Spanish National Health System". The objective of this study was the economic evaluation of the first two years of its application in Navarre, Spain. The change in the natural history of hepatitis C produced by the sustained virological response (SVR) was compared to an alternative without treatment and modeled with patient-level data. By means of a discrete events simulation model, the cost-effectiveness and the budget impact analysis of the treatment program were measured from the perspective of the Navarre Health Service. Of 656 patients treated, 98% had SVR. The average cost of the treatments was 18,743 euros per patient. The incremental cost-effectiveness ratio (ICER) with discount was 5,346 euros per quality-adjusted life years, which became more efficient as the stage of fibrosis increased until it reached levels of dominance in stage 4 fibrosis. The associated costs for chronic liver disease decreased as the benefit of the treatment was expressed. The implementation of the Strategic Plan is cost-effective, with an ICER well below the threshold, since the cost of treatment is largely compensated by savings in long-term health expenditure. The budgetary impact foresees a net saving from the third year on. The two key parameters were the decrease in the price of the treatment and the SVR in nearly 100% of the patients.
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Affiliation(s)
- Javier Mar
- Unidad Gestión Sanitaria, OSI Alto Deba, España
| | | | | | | | - Ramón San Miguel
- Departamento of Farmacia,, Complejo Hospitalario de Navarra - IdiSNA, , España
| | - Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA, España
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Mar J, Martínez-Baz I, Ibarrondo O, Juanbeltz R, San Miguel R, Casado I, O'Leary A, Castilla J. Survival and clinical events related to end-stage liver disease associated with HCV prior to the era of all oral direct-acting antiviral treatments. Expert Rev Gastroenterol Hepatol 2019; 13:699-708. [PMID: 28946785 DOI: 10.1080/17474124.2017.1383155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 01/05/2023]
Abstract
Background: The aim of this study was to describe the natural long-term course of end-stage liver disease associated with chronic hepatitis C (HCV) infection by measuring survival and complication rates in the era prior to the arrival of new direct-acting antiviral (DAA) drugs. Methods: A retrospective population-based cohort study was designed to establish the follow-up of patients hospitalized for a decompensated cirrhotic event or hepatocellular carcinoma using electronic records from hospital discharge databases from 2009 to 2015. Their survival was compared with a sex, age and non-liver mortality excess matched simulation of the general Spanish population. Results: A total of 253 patients were included in the study. Among those with decompensated cirrhosis (n = 151) the hospital admission rate was 1.88 per patient-year with a mortality rate of 0.16 per patient-year. Mean survival was 4.10 years for patients with decompensated cirrhosis, and 1.75 for non-transplanted hepatocellular carcinoma, compared to 18.39 years for the general population. Conclusion: Our results show the complexity and rapid progression of end-stage liver disease associated with HCV infection. The considerable loss of life expectancy associated with the development of decompensated cirrhosis in patients with chronic HCV infection in the absence of viral clearance through treatment is acutely evident.
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Affiliation(s)
- Javier Mar
- a Clinical Management Unit , Alto Deba Hospital , Mondragon , Spain.,b Health Services Research on Chronic Patients Network (REDISSEC) , Kronikgune Group , Bilbao , Spain.,c Biodonostia Health Research Institute , San Sebastian-Donostia , Spain
| | - Iván Martínez-Baz
- d Instituto de Salud Pública de Navarra , Pamplona , Spain.,e Navarra Institute for Health Research (IdiSNA) , Pamplona , Spain.,f CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Oliver Ibarrondo
- g AP-OSI Research Unit, Alto Deba Integrated Health Care Organization , Mondragon , Spain
| | - Regina Juanbeltz
- e Navarra Institute for Health Research (IdiSNA) , Pamplona , Spain.,f CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain.,h Department of Pharmacy , Complejo Hospitalario de Navarra , Pamplona , Spain
| | - Ramón San Miguel
- e Navarra Institute for Health Research (IdiSNA) , Pamplona , Spain.,h Department of Pharmacy , Complejo Hospitalario de Navarra , Pamplona , Spain
| | - Itziar Casado
- d Instituto de Salud Pública de Navarra , Pamplona , Spain.,e Navarra Institute for Health Research (IdiSNA) , Pamplona , Spain.,f CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Aisling O'Leary
- i National Centre for Pharmacoeconomics , St Jame's Hospital , Dublin , Ireland.,j School of Pharmacy , Royal College of Surgeons in Ireland , Dublin , Ireland
| | - Jesús Castilla
- d Instituto de Salud Pública de Navarra , Pamplona , Spain.,e Navarra Institute for Health Research (IdiSNA) , Pamplona , Spain.,f CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
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Castilla J, Navascués A, Casado I, Pérez-García A, Aguinaga A, Ezpeleta G, Pozo F, Ezpeleta C, Martínez-Baz I. Interim effectiveness of trivalent influenza vaccine in a season dominated by lineage mismatched influenza B, northern Spain, 2017/18. ACTA ACUST UNITED AC 2019; 23. [PMID: 29471624 PMCID: PMC5824126 DOI: 10.2807/1560-7917.es.2018.23.7.18-00057] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The 2017/18 interim estimate of trivalent influenza vaccine effectiveness (VE) was 39% (95% confidence interval: 20-54) in Navarre. Compared with individuals unvaccinated in the current and five previous seasons, VE against influenza B was 41% for current and any prior doses, 67% for current vaccination only, and 22% for any prior doses, and 43%, 51% and 54%, respectively against influenza A(H3N2). This suggests moderate VE despite predominance of lineage mismatched influenza B.
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Affiliation(s)
- Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Ana Navascués
- Servicio de Microbiología, Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Itziar Casado
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Alejandra Pérez-García
- Servicio de Microbiología, Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Aitziber Aguinaga
- Servicio de Microbiología, Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Guillermo Ezpeleta
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Francisco Pozo
- Centro Nacional de Microbiología (WHO National Influenza Centre - Madrid), Instituto de Salud Carlos III, Majadahonda, Spain
| | - Carmen Ezpeleta
- Servicio de Microbiología, Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Iván Martínez-Baz
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
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- The members of these networks are listed at the end of the article
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- The members of these networks are listed at the end of the article
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28
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Navascués A, Casado I, Pérez-García A, Aguinaga A, Martínez-Baz I, Floristán Y, Ezpeleta C, Castilla J. Detection of Respiratory Viruses in Deceased Persons, Spain, 2017. Emerg Infect Dis 2019; 24:1331-1334. [PMID: 29912695 PMCID: PMC6038767 DOI: 10.3201/eid2407.180162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
During the 2016–17 influenza season in Spain, we tested specimens from 57 elderly deceased persons for respiratory viruses. Influenza viruses were detected in 18% of the specimens and any respiratory virus in 47%. Only 7% of participants had received a diagnosis of infection with the detected virus before death.
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29
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Castilla J, Martínez-Baz I, Navascués A, Casado I, Aguinaga A, Díaz-González J, Delfrade J, Guevara M, Ezpeleta C. Comparison of influenza vaccine effectiveness in preventing outpatient and inpatient influenza cases in older adults, northern Spain, 2010/11 to 2015/16. ACTA ACUST UNITED AC 2019; 23. [PMID: 29338809 PMCID: PMC5770851 DOI: 10.2807/1560-7917.es.2018.23.2.16-00780] [Citation(s) in RCA: 10] [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: 11/20/2022]
Abstract
We compared trivalent inactivated influenza vaccine effectiveness (VE) in preventing outpatient and inpatient influenza cases in Navarre, Spain. Methods: During seasons 2010/11 to 2015/16, community-dwelling patients with influenza-like illness aged 50 years or older were tested for influenza when attended by sentinel general practitioners or admitted to hospitals. The test–negative design was used to estimate and compare the VE by healthcare setting. Results: We compared 1,242 laboratory-confirmed influenza cases (557 outpatient and 685 inpatient cases) and 1,641 test-negative controls. Influenza VE was 34% (95% confidence interval (CI): 6 to 54) in outpatients and 32% (95% CI: 15 to 45) in inpatients. VE in outpatients and inpatients was, respectively, 41% (95% CI: –1 to 65) and 36% (95% CI: 12 to 53) against A(H1N1)pdm09, 5% (95% CI: –58 to 43) and 22% (95% CI: –9 to 44) against A(H3N2), and 49% (95% CI, 6 to 73) and 37% (95% CI: 2 to 59) against influenza B. Trivalent inactivated influenza vaccine was not associated with a different probability of hospitalisation among influenza cases, apart from a 54% (95% CI: 10 to 76) reduction in hospitalisation of influenza A(H3N2) cases. Conclusions: On average, influenza VE was moderate and similar in preventing outpatient and inpatient influenza cases over six influenza seasons in patients above 50 years of age. In some instances of low VE, vaccination may still reduce the risk of hospitalisation in older adults with vaccine failure.
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Affiliation(s)
- Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Iván Martínez-Baz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Ana Navascués
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Itziar Casado
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Aitziber Aguinaga
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Jorge Díaz-González
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Josu Delfrade
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Marcela Guevara
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Carmen Ezpeleta
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
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- The members of the networks are listed at the end of the article
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- The members of the networks are listed at the end of the article
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30
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Casado I, Domínguez Á, Toledo D, Chamorro J, Astray J, Egurrola M, Fernández-Sierra MA, Martín V, Morales-Suárez-Varela M, Godoy P, Castilla J. Repeated influenza vaccination for preventing severe and fatal influenza infection in older adults: a multicentre case-control study. CMAJ 2018; 190:E3-E12. [PMID: 29311098 DOI: 10.1503/cmaj.170910] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The effectiveness of repeated vaccination for influenza to prevent severe cases remains unclear. We evaluated the effectiveness of influenza vaccination on preventing admissions to hospital for influenza and reducing disease severity. METHODS We conducted a case-control study in 20 hospitals in Spain during the 2013/14 and 2014/15 influenza seasons. Community-dwelling adults aged 65 years or older who were admitted to hospital for laboratory-confirmed influenza were matched with inpatient controls by sex, age, hospital and admission date. The effectiveness of vaccination in the current and 3 previous seasons in preventing influenza was estimated for inpatients with nonsevere influenza and for those with severe influenza who were admitted to intensive care units (ICUs) or who died. RESULTS We enrolled 130 inpatients with severe and 598 with nonsevere influenza who were matched to 333 and 1493 controls, respectively. Compared with patients who were unvaccinated in the current and 3 previous seasons, adjusted effectiveness of influenza vaccination in the current and any previous season was 31% (95% confidence interval [CI] 13%-46%) in preventing admission to hospital for nonsevere influenza, 74% (95% CI 42%-88%) in preventing admissions to ICU and 70% (95% CI 34%-87%) in preventing death. Vaccination in the current season only had no significant effect on cases of severe influenza. Among inpatients with influenza, vaccination in the current and any previous season reduced the risk of severe outcomes (adjusted odds ratio 0.45, 95% CI 0.26-0.76). INTERPRETATION Among older adults, repeated vaccination for influenza was twice as effective in preventing severe influenza compared with nonsevere influenza in patients who were admitted to hospital, which is attributable to the combination of the number of admissions to hospital for influenza that were prevented and reduced disease severity. These results reinforce recommendations for annual vaccination for influenza in older adults.
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Affiliation(s)
- Itziar Casado
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Ángela Domínguez
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Diana Toledo
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Judith Chamorro
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Jenaro Astray
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Mikel Egurrola
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - María Amelia Fernández-Sierra
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Vicente Martín
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - María Morales-Suárez-Varela
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Pere Godoy
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra - IdiSNA (Casado, Castilla), Pamplona, Spain; Departament de Medicina (Domínguez, Toledo), Universitat de Barcelona, Barcelona, Spain; Complejo Hospitalario de Navarra (Chamorro), Pamplona, Spain; Subdirección General de Epidemiología (Astray), Madrid, Spain; Hospital de Galdakao-Usansolo (Egurrola), Vizcaya, Spain; Complejo Hospitalario Universitario de Granada (Fernández-Sierra), Granada, Spain; Instituto de Biomedicina, Universidad de León (Martín), León, Spain; Departament de Medicina Preventiva (Morales-Suárez-Varela), Universitat de Valencia, Valencia, Spain; Agència de Salut Pública de Catalunya (Godoy), Institut de Recerca Biomèdica de Lleida, Lleida, Spain; CIBER Epidemiología y Salud Pública - CIBERESP (Casado, Domínguez, Toledo, Martín, Morales-Suárez-Varela, Godoy, Castilla), Madrid, Spain.
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31
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Juanbeltz R, Pérez-García A, Aguinaga A, Martínez-Baz I, Casado I, Burgui C, Goñi-Esarte S, Repáraz J, Zozaya JM, San Miguel R, Ezpeleta C, Castilla J. Progress in the elimination of hepatitis C virus infection: A population-based cohort study in Spain. PLoS One 2018; 13:e0208554. [PMID: 30513107 PMCID: PMC6279228 DOI: 10.1371/journal.pone.0208554] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/18/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The World Health Organization set targets to eliminate hepatitis C virus (HCV) infection through detection and treatment of all cases by 2030. This study aimed to describe the progress and difficulties in the elimination of HCV infection in Navarra, Spain. METHODS Using electronic healthcare databases, we performed a population-based prospective cohort study to describe changes in the prevalence of diagnosed active HCV infection at the beginning of 2015 and the end of 2017, the rate of new diagnoses and the rate of post-treatment viral clearance (PTVC) during this period. RESULTS At the beginning of 2015 there were 1503 patients diagnosed with positive HCV-RNA, 2.4 per 1000 inhabitants, and at the end of 2017 the prevalence had decreased by 47%. In the study period, 333 (18 per 100,000 person-years) new positive HCV-RNA cases were detected, but only 76 (23%; 4.2 per 100,000 person-years) did not have anti-HCV antibodies previously detected. Prevalent cases and new diagnoses of active infection were more frequent in men, people born in 1950-1979, HIV-infected patients and in those with lower income levels. Among patients with HCV-RNA, 984 achieved PTVC (22.7 per 100 person-years). PTVC was less frequent in patients born before 1940, in immigrants and in patients with lower income levels. CONCLUSIONS The prevalence of diagnosed active HCV infection has dropped by almost half over three years, because the number of patients with PTVC was much higher than the number of new diagnoses. Interventions specifically targeted at population groups with less favourable trends may be necessary.
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Affiliation(s)
- Regina Juanbeltz
- Instituto de Salud Pública de Navarra—IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
| | - Alejandra Pérez-García
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
- Department of Clinical Microbiology, Complejo Hospitalario de Navarra—IdiSNA, Pamplona, Spain
| | - Aitziber Aguinaga
- Department of Clinical Microbiology, Complejo Hospitalario de Navarra—IdiSNA, Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra—IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra—IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
| | - Cristina Burgui
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
- Department of Pharmacy, Complejo Hospitalario de Navarra—IdiSNA, Pamplona, Spain
| | - Silvia Goñi-Esarte
- Department of Gastroenterology and Hepatology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Jesús Repáraz
- Department of Internal Medicine, Complejo Hospitalario de Navarra—IdiSNA, Pamplona, Spain
| | - José Manuel Zozaya
- Department of Gastroenterology and Hepatology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Ramón San Miguel
- Department of Pharmacy, Complejo Hospitalario de Navarra—IdiSNA, Pamplona, Spain
| | - Carmen Ezpeleta
- Department of Clinical Microbiology, Complejo Hospitalario de Navarra—IdiSNA, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra—IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
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32
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Rondy M, Gherasim A, Casado I, Launay O, Rizzo C, Pitigoi D, Mickiene A, Marbus SD, Machado A, Syrjänen RK, Pem-Novose I, Horváth JK, Larrauri A, Castilla J, Vanhems P, Alfonsi V, Ivanciuc AE, Kuliese M, van Gageldonk-Lafeber R, Gomez V, Ikonen N, Lovric Z, Ferenczi A, Moren A. Low 2016/17 season vaccine effectiveness against hospitalised influenza A(H3N2) among elderly: awareness warranted for 2017/18 season. ACTA ACUST UNITED AC 2018; 22. [PMID: 29043961 PMCID: PMC5710120 DOI: 10.2807/1560-7917.es.2017.22.41.17-00645] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In a multicentre European hospital study we measured influenza vaccine effectiveness (IVE) against A(H3N2) in 2016/17. Adjusted IVE was 17% (95% confidence interval (CI): 1 to 31) overall; 25% (95% CI: 2 to 43) among 65–79-year-olds and 13% (95% CI: −15 to 30) among those ≥ 80 years. As the A(H3N2) vaccine component has not changed for 2017/18, physicians and public health experts should be aware that IVE could be low where A(H3N2) viruses predominate.
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Affiliation(s)
| | - Alin Gherasim
- CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain.,National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | - Odile Launay
- Université Paris Descartes, Sorbonne Paris Cité, APHP, CIC Cochin-Pasteur, Paris, France.,Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), CIC 1417, Paris, France
| | | | - Daniela Pitigoi
- University of Medicine and Pharmacy Carol Davila, National Institute for Research Cantacuzino, Bucharest, Romania
| | - Aukse Mickiene
- Department of Infectious diseases of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Sierk D Marbus
- Centre for Epidemiology and surveillance of infectious diseases, Centre for Infectious disease control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ausenda Machado
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ritva K Syrjänen
- Impact Assessment Unit, National Institute for Health and Welfare, Tampere, Finland
| | - Iva Pem-Novose
- Epidemiology Service, Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain.,National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | - Philippe Vanhems
- Emerging Pathogens Laboratory - Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, Centre National de la Recherche Scientifique (CNRS), UMR5308, Ecole Nationale Supérieure (ENS) de Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Infection Control and Epidemiology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), CIC 1417, Paris, France
| | | | - Alina E Ivanciuc
- National Institute for Research Cantacuzino, Bucharest, Romania, Faculty of Biology, Bucharest University
| | - Monika Kuliese
- Department of Infectious diseases of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rianne van Gageldonk-Lafeber
- Centre for Epidemiology and surveillance of infectious diseases, Centre for Infectious disease control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Veronica Gomez
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Niina Ikonen
- Unit of Expert Microbiology, National Institute for Health and Welfare, Helsinki, Finland
| | - Zvjezdana Lovric
- Epidemiology Service, Croatian Institute of Public Health, Zagreb, Croatia
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- The members of the I-Move+ hospital working group are listed at the end of the article
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Rondy M, Larrauri A, Casado I, Alfonsi V, Pitigoi D, Launay O, Syrjänen RK, Gefenaite G, Machado A, Vučina VV, Horváth JK, Paradowska-Stankiewicz I, Marbus SD, Gherasim A, Díaz-González JA, Rizzo C, Ivanciuc AE, Galtier F, Ikonen N, Mickiene A, Gomez V, Kurečić Filipović S, Ferenczi A, Korcinska MR, van Gageldonk-Lafeber R, Valenciano M. 2015/16 seasonal vaccine effectiveness against hospitalisation with influenza A(H1N1)pdm09 and B among elderly people in Europe: results from the I-MOVE+ project. ACTA ACUST UNITED AC 2018; 22:30580. [PMID: 28797322 PMCID: PMC5553054 DOI: 10.2807/1560-7917.es.2017.22.30.30580] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/08/2017] [Indexed: 11/20/2022]
Abstract
We conducted a multicentre test-negative case-control study in 27 hospitals of 11 European countries to measure 2015/16 influenza vaccine effectiveness (IVE) against hospitalised influenza A(H1N1)pdm09 and B among people aged ≥ 65 years. Patients swabbed within 7 days after onset of symptoms compatible with severe acute respiratory infection were included. Information on demographics, vaccination and underlying conditions was collected. Using logistic regression, we measured IVE adjusted for potential confounders. We included 355 influenza A(H1N1)pdm09 cases, 110 influenza B cases, and 1,274 controls. Adjusted IVE against influenza A(H1N1)pdm09 was 42% (95% confidence interval (CI): 22 to 57). It was 59% (95% CI: 23 to 78), 48% (95% CI: 5 to 71), 43% (95% CI: 8 to 65) and 39% (95% CI: 7 to 60) in patients with diabetes mellitus, cancer, lung and heart disease, respectively. Adjusted IVE against influenza B was 52% (95% CI: 24 to 70). It was 62% (95% CI: 5 to 85), 60% (95% CI: 18 to 80) and 36% (95% CI: -23 to 67) in patients with diabetes mellitus, lung and heart disease, respectively. 2015/16 IVE estimates against hospitalised influenza in elderly people was moderate against influenza A(H1N1)pdm09 and B, including among those with diabetes mellitus, cancer, lung or heart diseases.
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Affiliation(s)
| | - Amparo Larrauri
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | - Itziar Casado
- CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain.,Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain
| | | | | | - Odile Launay
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, APHP, CIC Cochin-Pasteur, Paris, France
| | - Ritva K Syrjänen
- Impact Assessment Unit, National Institute for Health and Welfare, Tampere, Finland
| | - Giedre Gefenaite
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ausenda Machado
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Sierk D Marbus
- Centre for Epidemiology and surveillance of infectious diseases, Centre for infectious disease control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Alin Gherasim
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain
| | | | | | | | - Florence Galtier
- Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.,CIC de Montpellier, Hôpital Saint-Eloi, CHU de Montpellier, Montpellier, France
| | - Niina Ikonen
- Viral Infections Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Aukse Mickiene
- Department of Infectious diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Veronica Gomez
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | - Monika R Korcinska
- National institute of Public Health - National Institute of Hygiene, Department of Epidemiology, Warsaw, Poland
| | - Rianne van Gageldonk-Lafeber
- Centre for Epidemiology and surveillance of infectious diseases, Centre for infectious disease control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | -
- The I-MOVE+ hospital working group is listed at the end of the article
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Casado I, Martínez-Baz I, Floristán Y, Chamorro J, Ezpeleta C, Castilla J. Cause of death in hospitalized patients with laboratory-confirmed influenza. An Sist Sanit Navar 2017; 38:263-8. [PMID: 26486532 DOI: 10.23938/assn.0075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND We analyzed the underlying cause of death recorded in hospitalized patients with laboratory-confirmed influenza. METHODS The present study included all patients with a laboratory-confirmed diagnosis of influenza during the influenza seasons 2009-2010 to 2013-2014 who were attended to in hospital and died. Their underlying cause of death according to the International Classification of Diseases 10th Revision was obtained from the Navarre Mortality Registry. RESULTS Among 49 patients studied, the underlying causes of death were 35% influenza, 4% pneumonia, 14% other respiratory diseases, 10% circulatory disease and 37% other causes. CONCLUSIONS Non-cardiorespiratory causes accounted for a third of deaths in patients with confirmed influenza, thus all-cause mortality should be considered in estimating the full burden of influenza mortality.
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Affiliation(s)
| | | | | | | | | | - J Castilla
- Instituto de Salud Pública de Navarra, Pamplona, 31003, Spain.
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35
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Martínez-Baz I, Casado I, Navascués A, Díaz-González J, Aguinaga A, Barrado L, Delfrade J, Ezpeleta C, Castilla J. Effect of Repeated Vaccination With the Same Vaccine Component Against 2009 Pandemic Influenza A(H1N1) Virus. J Infect Dis 2017; 215:847-855. [PMID: 28453845 DOI: 10.1093/infdis/jix055] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 11/10/2016] [Accepted: 01/24/2017] [Indexed: 11/14/2022] Open
Abstract
Background The 2009 pandemic influenza A(H1N1) (A[H1N1]pdm09) vaccine component has remained unchanged from 2009. We estimate the effectiveness of current and prior inactivated influenza A(H1N1)pdm09 vaccination from influenza seasons 2010-2011 to 2015-2016. Methods Patients attended with influenza-like illness were tested for influenza. Four periods with continued A(H1N1)pdm09 circulation were included in a test-negative design. Results We enrolled 1278 cases and 2343 controls. As compared to individuals never vaccinated against influenza A(H1N1)pdm09, the highest effectiveness (66%; 95% confidence interval, 49%-78%) was observed in those vaccinated in the current season who had received 1-2 prior doses. The effectiveness was not statistically lower in individuals vaccinated in the current season only (52%) or in those without current vaccination and >2 prior doses (47%). However, the protection was lower in individuals vaccinated in the current season after >2 prior doses (38%; P = .009) or those currently unvaccinated with 1-2 prior doses (10%; P < .001). Current-season vaccination improved the effect in individuals with 1-2 prior doses and did not modify significantly the risk of influenza in individuals with >2 prior doses. Conclusion Current vaccination or several prior doses were needed for high protection. Despite the decreasing effect of repeated vaccination, current-season vaccination was not inferior to no current-season vaccination.
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Affiliation(s)
- Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana Navascués
- Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Jorge Díaz-González
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | | | | | - Josu Delfrade
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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36
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Castilla J, Navascués A, Casado I, Díaz-González J, Pérez-García A, Fernandino L, Martínez-Baz I, Aguinaga A, Pozo F, Ezpeleta C, Primary Health Care Sentinel Network And The Network For Influenza Surveillance In Hospitals Of Navarre. Combined effectiveness of prior and current season influenza vaccination in northern Spain: 2016/17 mid-season analysis. ACTA ACUST UNITED AC 2017; 22. [PMID: 28230523 PMCID: PMC5322189 DOI: 10.2807/1560-7917.es.2017.22.7.30465] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/16/2017] [Indexed: 12/15/2022]
Abstract
The 2016/17 mid-season vaccine effectiveness estimate against influenza A(H3N2) was 15% (95% confidence interval: −11 to 35) in Navarre. Comparing to individuals unvaccinated in the current and four prior seasons, effectiveness was 24% for current and 3–4 prior doses, 61% for current and 1–2 prior doses, 42% for only current vaccination, and 58% for 3–4 prior doses. This suggests moderate effectiveness for different combinations of vaccination in the current and prior seasons.
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Affiliation(s)
- Jesús Castilla
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ana Navascués
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Jorge Díaz-González
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Alejandra Pérez-García
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Leticia Fernandino
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Aitziber Aguinaga
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Francisco Pozo
- Centro Nacional de Microbiología (WHO National Influenza Centre - Madrid), Instituto de Salud Carlos III, Majadahonda, Spain
| | - Carmen Ezpeleta
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
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Mahé I, Chidiac J, Bertoletti L, Font C, Trujillo-Santos J, Peris M, Pérez Ductor C, Nieto S, Grandone E, Monreal M, Arcelus J, Ballaz A, Barba R, Barrón M, Barrón-Andrés B, Bascuñana J, Blanco-Molina A, Bueso T, Casado I, Culla A, de Miguel J, del Toro J, Díaz-Peromingo J, Falgá C, Fernández-Capitán C, Font C, Font L, Gallego P, García-Bragado F, García-Brotons P, Gómez V, González J, Grau E, Grimón A, Guirado L, Gutiérrez J, Hernández G, Hernández-Blasco L, Isern V, Jara-Palomares L, Jaras M, Jiménez D, Lacruz B, Lecumberri R, Lobo J, López-Jiménez L, López-Reyes R, López-Sáez J, Lorente M, Lorenzo A, Madridano O, Marchena P, Martín-Antorán J, Martín-Martos F, Monreal M, Morales M, Nauffal D, Nieto J, Nieto S, Núñez M, Otalora S, Otero R, Pagán B, Pedrajas J, Pérez C, Pérez G, Peris M, Porras J, Ramírez L, Reig O, Riera A, Rivas A, Rodríguez-Dávila M, Rosa V, Ruiz-Artacho P, Ruiz-Giménez N, Ruiz-Martínez C, Sampériz A, Sala C, Sanz O, Soler S, Sopeña B, Suarez I, Suriñach J, Tiberio G, Tolosa C, Trujillo-Santos J, Uresandi F, Valle R, Vela J, Villalta J, Malfante P, Verhamme P, Wells P, Hirmerova J, Malý R, Tomko T, Salgado E, Bertoletti L, Bura-Riviere A, Farge-Bancel D, Hij A, Mahé I, Merah A, Papadakis M, Braester A, Brenner B, Tzoran I, Apollonio A, Barillari G, Candeloro G, Ciammaichella M, Di Micco P, Ferrazzi P, Grandone E, Lessiani G, Lodigiani C, Mastroiacovo D, Pace F, Pinelli M, Prandoni P, Rota L, Tiraferri E, Tufano A, Visonà A, Belovs A, Skride A, Moreira M, Ribeiro J, Sousa M, Bosevski M, Zdraveska M, Alatri A, Bounameaux H, Calanca L, Mazzolai L, Serrano J, Decousus H, Reis A. The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site. Am J Med 2017; 130:337-347. [PMID: 27884650 DOI: 10.1016/j.amjmed.2016.10.017] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [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] [Received: 01/26/2016] [Revised: 09/21/2016] [Accepted: 10/24/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. AIM AND METHODS We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). RESULTS As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). CONCLUSIONS Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.
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Affiliation(s)
- Isabelle Mahé
- Department of Internal Medicine, Hôpital Louis Mourier, Investigation Network on Venous Thrombo-embolism (INNOVTE), Colombes (APHP), University Paris 7, EA REMES 7334 France.
| | - Jean Chidiac
- Department of Internal Medicine, Hôpital Louis Mourier, Investigation Network on Venous Thrombo-embolism (INNOVTE), Colombes (APHP), University Paris 7, EA REMES 7334 France
| | - Laurent Bertoletti
- Department of Vascular and Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, French Clinical Research Infrastructure Network (F-CRIN), INNOVTE
| | - Carme Font
- Department of Medical Oncology, IDIBAPS/Translational Genomics and Targeted Therapeutics in Solid Tumors, Hospital Clinic de Barcelona, Spain
| | - Javier Trujillo-Santos
- Department of Internal Medicine, Complejo Hospitalario Universitario de Cartagena, Murcia, Spain
| | - Marisa Peris
- Department of Internal Medicine, Hospital Provincial Castellon; CEU Cardenal Herrero University, Spain
| | - Cristina Pérez Ductor
- Department of Emergency Medicine, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Santiago Nieto
- Department of Haematology, Hospital de la Vega Lorenzo Guirao, Murcia, Spain
| | - Elvira Grandone
- Atherosclerosis and Thrombosis Unit, Casa Sollievo Della Sofferenza, Foggia, Italy
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Católica de Murcia, Spain
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Castilla J, Navascués A, Fernández-Alonso M, Reina G, Albéniz E, Pozo F, Álvarez N, Martínez-Baz I, Guevara M, García-Cenoz M, Irisarri F, Casado I, Ezpeleta C. Effects of previous episodes of influenza and vaccination in preventing laboratory-confirmed influenza in Navarre, Spain, 2013/14 season. ACTA ACUST UNITED AC 2017; 20:30243. [PMID: 27277013 DOI: 10.2807/1560-7917.es.2016.21.22.30243] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 07/27/2015] [Accepted: 02/25/2016] [Indexed: 11/20/2022]
Abstract
We estimated whether previous episodes of influenza and trivalent influenza vaccination prevented laboratory-confirmed influenza in Navarre, Spain, in season 2013/14. Patients with medically-attended influenza-like illness (MA-ILI) in hospitals (n = 645) and primary healthcare (n = 525) were included. We compared 589 influenza cases and 581 negative controls. MA-ILI related to a specific virus subtype in the previous five seasons was defined as a laboratory-confirmed influenza infection with the same virus subtype or MA-ILI during weeks when more than 25% of swabs were positive for this subtype. Persons with previous MA-ILI had 30% (95% confidence interval (CI): -7 to 54) lower risk of MA-ILI, and those with previous MA-ILI related to A(H1N1)pdm09 or A(H3N2) virus, had a, respectively, 63% (95% CI: 16-84) and 65% (95% CI: 13-86) lower risk of new laboratory-confirmed influenza by the same subtype. Overall adjusted vaccine effectiveness in preventing laboratory-confirmed influenza was 31% (95% CI: 5-50): 45% (95% CI: 12-65) for A(H1N1)pdm09 and 20% (95% CI: -16 to 44) for A(H3N2). While a previous influenza episode induced high protection only against the same virus subtype, influenza vaccination provided low to moderate protection against all circulating subtypes. Influenza vaccine remains the main preventive option for high-risk populations.
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Affiliation(s)
- Jesús Castilla
- Instituto de Salud Pública de Navarra, IdiSNA - Navarra Institute for Health Research, Pamplona, Spain
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Aguinaga A, Díaz-González J, Pérez-García A, Barrado L, Martínez-Baz I, Casado I, Juanbeltz R, Ezpeleta C, Castilla J. The prevalence of diagnosed and undiagnosed hepatitis C virus infection in Navarra, Spain, 2014-2016. Enferm Infecc Microbiol Clin 2017; 36:325-331. [PMID: 28110858 DOI: 10.1016/j.eimc.2016.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 11/30/2016] [Accepted: 12/04/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the prevalence of hepatitis C virus (HCV) infection in Navarra, Spain, as well as to distinguish between diagnosed and undiagnosed infections. METHODS A study was conducted on patients scheduled for surgery unrelated to HCV infection. They were all tested for HCV antibodies, under a routine scheme, from January 2014 to September 2016. Patients with a positive result by enzyme immunoassay were confirmed using immunoblot and/or HCV-RNA. Previous laboratory results were also taken into account. The prevalence was adjusted to the sex and age structure of the Navarra population. RESULTS The study included a total of 7,378 patients with a median age 46 years, of whom 50% women. HCV antibodies were detected in 69 patients, which is a prevalence in the population of 0.83% (95% confidence interval: 0.64-1.05), and was higher in men (1.11%) than in women (0.56%; P=.0102). Among the HCV positive patients, 67 (97%) had had another previous positive result. Population prevalence of previous positive HCV was 0.80%, and was 0.03% for a new diagnosis. Of the HCV positive patients, 78% had detectable HCV-RNA. It was estimated that 0.65% of the population had had detectable HCV-RNA, and 0.51% continued to have it when recruited into the study. CONCLUSION Previous estimates of prevalence of HCV infection should be revised downwards. Only a small proportion of HCV positive patients remain undiagnosed, and only a small part have active infection.
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Affiliation(s)
- Aitziber Aguinaga
- Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España
| | - Jorge Díaz-González
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España
| | - Alejandra Pérez-García
- Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pamplona, España
| | - Laura Barrado
- Hospital García Orcoyen, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Estella, Navarra, España
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pamplona, España
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pamplona, España
| | - Regina Juanbeltz
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pamplona, España
| | - Carmen Ezpeleta
- Servicio de Microbiología Clínica, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Pamplona, España.
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Martínez-Baz I, Navascués A, Pozo F, Chamorro J, Albeniz E, Casado I, Reina G, Cenoz MG, Ezpeleta C, Castilla J. Influenza vaccine effectiveness in preventing inpatient and outpatient cases in a season dominated by vaccine-matched influenza B virus. Hum Vaccin Immunother 2016; 11:1626-33. [PMID: 25996366 DOI: 10.1080/21645515.2015.1038002] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Studies that have evaluated the influenza vaccine effectiveness (VE) to prevent laboratory-confirmed influenza B cases are uncommon, and few have analyzed the effect in preventing hospitalized cases. We have evaluated the influenza VE in preventing outpatient and hospitalized cases with laboratory-confirmed influenza in the 2012-2013 season, which was dominated by a vaccine-matched influenza B virus. In the population covered by the Navarra Health Service, all hospitalized patients with influenza-like illness (ILI) and all ILI patients attended by a sentinel network of general practitioners were swabbed for influenza testing, and all were included in a test-negative case-control analysis. VE was calculated as (1-odds ratio) × 100. Among 744 patients tested, 382 (51%) were positive for influenza virus: 70% for influenza B, 24% for A(H1N1)pdm09, and 5% for A(H3N2). The overall estimate of VE in preventing laboratory-confirmed influenza was 63% (95% confidence interval (CI): 34 to 79), 55% (1 to 80) in outpatients and 74% (33 to 90) in hospitalized patients. The VE was 70% (41 to 85) against influenza B and 43% (-45 to 78) against influenza A. The VE against virus B was 87% (52 to 96) in hospitalized patients and 56% in outpatients (-5 to 81). Adjusted comparison of vaccination status between inpatient and outpatient cases with influenza B did not show statistically significant differences (odds ratio: 1.13; p = 0.878). These results suggest a high protective effect of the vaccine in the 2012-2013 season, with no differences found for the effect between outpatient and hospitalized cases.
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Alonso de Leciñana M, Egido J, Casado I, Ribó M, Dávalos A, Masjuan J, Caniego J, Martínez-Vila E, Díez Tejedor E. Réplica a la carta «Algunas consideraciones sobre el infarto cerebral desde otra óptica». Neurologia 2016; 31:136. [DOI: 10.1016/j.nrl.2014.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 06/21/2014] [Indexed: 11/25/2022] Open
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Alonso de Leciñana M, Egido J, Casado I, Ribó M, Dávalos A, Masjuan J, Caniego J, Martínez-Vila E, Díez Tejedor E. Reply to letter “Remarks on cerebral infarct from another point of view”. Neurología (English Edition) 2016. [DOI: 10.1016/j.nrleng.2014.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Castilla J, Navascués A, Fernández-Alonso M, Reina G, Pozo F, Casado I, Guevara M, Martínez-Baz I, Barricarte A, Ezpeleta C. Effectiveness of subunit influenza vaccination in the 2014-2015 season and residual effect of split vaccination in previous seasons. Vaccine 2016; 34:1350-7. [PMID: 26854911 DOI: 10.1016/j.vaccine.2016.01.054] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 01/08/2016] [Accepted: 01/26/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND In Navarra, Spain, subunit vaccine was first used in the 2014-2015 season, whereas trivalent split-virion influenza vaccines had been used in previous seasons. We estimate the effectiveness of the subunit vaccine in the current season and split vaccine in the two previous seasons against laboratory-confirmed influenza in the 2014-2015 season. METHODS Patients with influenza-like illness hospitalized or attended by sentinel general practitioners were swabbed for influenza testing. The previous and current vaccine status of laboratory-confirmed cases was compared to test-negative controls. RESULTS Among 1213 patients tested, 619 (51%) were confirmed for influenza virus: 52% influenza A(H3N2), 46% influenza B, and 2% A(H1N1)pdm09. The overall effectiveness for subunit vaccination in the current season was 19% (95% confidence interval [CI]: -13 to 42), 2% (95%CI: -47 to 35) against influenza A(H3N2) and 32% (95%CI: -4 to 56) against influenza B. The effectiveness against any influenza was 67% (95%CI: 17-87) for 2012-2013 and 2013-2014 vaccination only, 42% (95%CI: -31 to 74) for 2014-2015 vaccination only, and 38% (95%CI: 8-58) for vaccination in the 2012-2013, 2013-2014 and 2014-2015 seasons. The same estimates against influenza A(H3N2) were 47% (95%CI: -60 to 82), -54% (95%CI: -274 to 37) and 28% (95%CI: -17 to 56), and against influenza B were 82% (95%CI: 19-96), 93% (95%CI: 45-99) and 43% (95%CI: 5-66), respectively. CONCLUSION These results suggest a considerable residual protection of split vaccination in previous seasons, low overall effectiveness of current season subunit vaccination, and possible interference between current subunit and previous split vaccines.
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Affiliation(s)
- Jesús Castilla
- Instituto de Salud Pública de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Ana Navascués
- Complejo Hospitalario de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain
| | - Mirian Fernández-Alonso
- Clínica Universidad de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain
| | - Gabriel Reina
- Clínica Universidad de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco Pozo
- Centro Nacional de Microbiología (WHO National Influenza Centre-Madrid), Instituto de Salud Carlos III, Majadahonda, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Aurelio Barricarte
- Instituto de Salud Pública de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carmen Ezpeleta
- Complejo Hospitalario de Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain
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Casado I, Domínguez A, Toledo D, Chamorro J, Force L, Soldevila N, Astray J, Egurrola M, Godoy P, Mayoral JM, Tamames S, Sanz F, Castilla J, The Project PI12/02079 Working Grou. Effect of influenza vaccination on the prognosis of hospitalized influenza patients. Expert Rev Vaccines 2016; 15:425-32. [DOI: 10.1586/14760584.2016.1134328] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Itziar Casado
- Instituto de Salud Pública de Navarra, IdiSNA – Navarra Institute for Health Research, Pamplona, Spain
| | - Angela Domínguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
| | - Diana Toledo
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
| | - Judith Chamorro
- Servicio de Medicina Preventiva, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Lluis Force
- Unidad de Enfermedades Infecciosas, Hospital de Mataró, Mataró, Spain
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
| | - Jenaro Astray
- Dirección de Salud Pública, Consejería de Sanidad, Madrid, Spain
| | - Mikel Egurrola
- Servicio de Neumología, Hospital de Galdakao, Usansolo, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, Lleida, Spain
| | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Valladolid, Spain
| | - Francisco Sanz
- Servicio de Neumología, Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra, IdiSNA – Navarra Institute for Health Research, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Ugarte MD, Adin A, Goicoa T, Casado I, Ardanaz E, Larrañaga N. Temporal evolution of brain cancer incidence in the municipalities of Navarre and the Basque Country, Spain. BMC Public Health 2015; 15:1018. [PMID: 26438178 PMCID: PMC4594739 DOI: 10.1186/s12889-015-2354-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 07/20/2015] [Accepted: 09/23/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Brain cancer incidence rates in Spain are below the European's average. However, there are two regions in the north of the country, Navarre and the Basque Country, ranked among the European regions with the highest incidence rates for both males and females. Our objective here was two-fold. Firstly, to describe the temporal evolution of the geographical pattern of brain cancer incidence in Navarre and the Basque Country, and secondly, to look for specific high risk areas (municipalities) within these two regions in the study period (1986-2008). METHODS A mixed Poisson model with two levels of spatial effects is used. The model also included two levels of spatial effects (municipalities and local health areas). Model fitting was carried out using penalized quasi-likelihood. High risk regions were detected using upper one-sided confidence intervals. RESULTS Results revealed a group of high risk areas surrounding Pamplona, the capital city of Navarre, and a few municipalities with significant high risks in the northern part of the region, specifically in the border between Navarre and the Basque Country (Gipuzkoa). The global temporal trend was found to be increasing. Differences were also observed among specific risk evolutions in certain municipalities. CONCLUSIONS Brain cancer incidence in Navarre and the Basque Country (Spain) is still increasing with time. The number of high risk areas within those two regions is also increasing. Our study highlights the need of continuous surveillance of this cancer in the areas of high risk. However, due to the low percentage of cases explained by the known risk factors, primary prevention should be applied as a general recommendation in these populations.
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Affiliation(s)
- María Dolores Ugarte
- Department of Statistics and O.R., Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
- Institute for Advanced Materials (INAMAT), Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
| | - Aritz Adin
- Department of Statistics and O.R., Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
- Institute for Advanced Materials (INAMAT), Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
| | - Tomás Goicoa
- Department of Statistics and O.R., Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
- Institute for Advanced Materials (INAMAT), Public University of Navarre, Campus de Arrosadía, Pamplona, 31006, Spain.
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.
| | - Itziar Casado
- Navarre Public Health Institute, Calle Leyre 15, Pamplona, 31006, Spain.
| | - Eva Ardanaz
- Navarre Public Health Institute, Calle Leyre 15, Pamplona, 31006, Spain.
- CIBER of Epidemiology an Public Health CIBERESP, Madrid, Spain.
| | - Nerea Larrañaga
- CIBER of Epidemiology an Public Health CIBERESP, Madrid, Spain.
- Public Health Division of Gipuzkoa, BIODonostia Research Institute, Government of the Basque Country, Nafarroa hiribidea 4, Donostia-San Sebastián, 20013, Spain.
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Casado I, Martínez-Baz I, Floristán Y, Chamorro J, Ezpeleta C, Castilla J. Cause of death in hospitalized patients with laboratory-confirmed influenza. An Sist Sanit Navar 2015. [DOI: 10.4321/s1137-66272015000200010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Trujillo-Santos J, Lozano F, Lorente MA, Adarraga D, Hirmerova J, Del Toro J, Mazzolai L, Barillari G, Barrón M, Monreal M, Alcalde M, Andújar V, Arcelus J, Barba R, Barrón M, Barrón-Andrés B, Bascuñana J, Blanco-Molina A, Bueso T, Casado I, Climent A, Conget F, del Molino F, del Toro J, Falgá C, Fernández-Capitán C, Font L, Gallego P, García-Bragado F, Gómez V, González J, González-Bachs E, Grau E, Guijarro R, Guil M, Gutiérrez J, Jara-Palomares L, Jaras M, Jiménez D, Jiménez R, Lecumberri R, Lobo J, López-Jiménez L, López-Montes L, López-Reyes R, López-Sáez J, Lorente M, Lorenzo A, Luque J, Madridano O, Marchena P, Martín-Antorán J, Mellado M, Monreal M, Morales M, Nauffal D, Nieto J, Núñez M, Ogea J, Otero R, Pagán B, Pedrajas J, Pérez-Rus G, Peris M, Porras J, Pons I, Riera-Mestre A, Rivas A, Rodríguez-Dávila M, Román P, Rosa V, Ruiz-Giménez N, Ruiz J, Sabio P, Samperiz A, Sánchez R, Soler S, Suriñach J, Tiberio G, Trujillo-Santos J, Uresandi F, Valero B, Valle R, Vela J, Villalobos A, Malfante P, Verhamme P, Peerlinck K, Wells P, Malý R, Hirmerova J, Kaletova M, Tomko T, Bertoletti L, Bura-Riviere A, Farès M, Grange C, Mahe I, Merah A, Quere I, Schellong S, Papadakis M, Braester A, Brenner B, Tzoran I, Zeltser D, Apollonio A, Barillari G, Ciammaichella M, Di Micco P, Duce R, Guida A, Maida R, Pace F, Pasca S, Piovella C, Pesavento R, Poggio R, Prandoni P, Rota L, Tiraferri E, Tonello D, Tufano A, Visonà A, Zalunardo B, Almeida S, Leal-Seabra F, Sousa M, Bosevski M, Alatri A, Bounameaux H, Calanca L, Mazzolai L, Serrano J. A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the lower limbs. Am J Med 2015; 128:90.e9-15. [PMID: 25242230 DOI: 10.1016/j.amjmed.2014.08.023] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 08/18/2014] [Accepted: 08/19/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy. METHODS We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home. RESULTS As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001). CONCLUSIONS Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated.
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Affiliation(s)
- Javier Trujillo-Santos
- Department of Internal Medicine, Complejo Hospitalario Universitario de Cartagena, Murcia, Spain
| | - Francisco Lozano
- Department of Angiology and Vascular Surgery, Complejo Asistencial de Salamanca, Salamanca, Spain
| | - Manuel Alejandro Lorente
- Department of Internal Medicine, Hospital de la Agencia Valenciana de Salud Vega Baja, Alicante, Spain
| | - Dolores Adarraga
- Department of Internal Medicine, Hospital de Montilla, Córdoba, Spain
| | - Jana Hirmerova
- Department of Internal Medicine, University Hospital Plzen, Plzen, Czech Republic
| | - Jorge Del Toro
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Lucia Mazzolai
- Department of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Giovanni Barillari
- Department of Internal Medicine, Ospedale S. Maria della Misericordia, Udine, Italy
| | - Manuel Barrón
- Department of Pneumonology, Hospital San Pedro, Logroño, La Rioja, Spain
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
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Vivancos J, Gilo F, Frutos R, Maestre J, García-Pastor A, Quintana F, Roda J, Ximénez-Carrillo A, Díez Tejedor E, Fuentes B, Alonso de Leciñana M, Álvarez-Sabin J, Arenillas J, Calleja S, Casado I, Castellanos M, Castillo J, Dávalos A, Díaz-Otero F, Egido J, Fernández J, Freijo M, Gállego J, Gil-Núñez A, Irimia P, Lago A, Masjuan J, Martí-Fábregas J, Martínez-Sánchez P, Martínez-Vila E, Molina C, Morales A, Nombela F, Purroy F, Ribó M, Rodríguez-Yañez M, Roquer J, Rubio F, Segura T, Serena J, Simal P, Tejada J. Clinical management guidelines for subarachnoid haemorrhage. Diagnosis and treatment. Neurología (English Edition) 2014. [DOI: 10.1016/j.nrleng.2012.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Fuentes B, Gállego J, Gil-Nuñez A, Morales A, Purroy F, Roquer J, Segura T, Tejada J, Lago A, Díez-Tejedor E, Alonso de Leciñana M, Álvarez-Sabin J, Arenillas J, Calleja S, Casado I, Castellanos M, Castillo J, Dávalos A, Díaz-Otero F, Egido J, López-Fernández J, Freijo M, García Pastor A, Gilo F, Irimia P, Maestre J, Masjuan J, Martí-Fábregas J, Martínez-Sánchez P, Martínez-Vila E, Molina C, Nombela F, Ribó M, Rodríguez-Yañez M, Rubio F, Serena J, Simal P, Vivancos J. Guía para el tratamiento preventivo del ictus isquémico y AIT (II). Recomendaciones según subtipo etiológico. Neurologia 2014; 29:168-83. [DOI: 10.1016/j.nrl.2011.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 06/29/2011] [Indexed: 11/28/2022] Open
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Alonso de Leciñana M, Egido J, Casado I, Ribó M, Dávalos A, Masjuan J, Caniego J, Martínez Vila E, Díez Tejedor E, Fuentes (Secretaría) B, Álvarez-Sabin J, Arenillas J, Calleja S, Castellanos M, Castillo J, Díaz-Otero F, López-Fernández J, Freijo M, Gállego J, García-Pastor A, Gil-Núñez A, Gilo F, Irimia P, Lago A, Maestre J, Martí-Fábregas J, Martínez-Sánchez P, Molina C, Morales A, Nombela F, Purroy F, Rodríguez-Yañez M, Roquer J, Rubio F, Segura T, Serena J, Simal P, Tejada J, Vivancos J. Guidelines for the treatment of acute ischaemic stroke. Neurología (English Edition) 2014. [DOI: 10.1016/j.nrleng.2011.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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