tetano
Editor, Senior Moderator
J Infect Dis. 2017 Oct 4. doi: 10.1093/infdis/jix526. [Epub ahead of print]
[h=1]Beyond antigenic match: possible agent-host and immuno-epidemiological influences on influenza vaccine effectiveness during the 2015-16 season in Canada.[/h] Skowronski DM[SUP]1,[/SUP][SUP]2[/SUP], Chambers C[SUP]1[/SUP], Sabaiduc S[SUP]1[/SUP], De Serres G[SUP]3,[/SUP][SUP]4,[/SUP][SUP]5[/SUP], Winter AL[SUP]6[/SUP], Dickinson JA[SUP]7[/SUP], Gubbay JB[SUP]6,[/SUP][SUP]8[/SUP], Drews SJ[SUP]9,[/SUP][SUP]10[/SUP], Martineau C[SUP]3[/SUP], Charest H[SUP]3[/SUP], Krajden M[SUP]1,[/SUP][SUP]2[/SUP], Bastien N[SUP]11[/SUP], Li Y[SUP]11[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Vaccine effectiveness (VE) estimates are reported from Canada's Sentinel Practitioner Surveillance Network (SPSN) for the 2015-16 influenza season, characterized by a delayed A(H1N1)pdm09 epidemic and concurrent B(Victoria) activity. Potential influences beyond antigenic match are explored including viral genomic variation, birth cohort effects, prior vaccination and epidemic period.
[h=4]Methods:[/h] VE was estimated by test-negative design comparing adjusted-odds ratio for influenza test-positivity among vaccinated vs. unvaccinated participants. Vaccine-virus relatedness was assessed by gene-sequencing and hemagglutination-inhibition assay.
[h=4]Results:[/h] Analyses included 596 influenza A(H1N1)pdm09 and 305 B(Victoria) cases compared to 926 test-negative controls. A(H1N1)pdm09 viruses were considered antigenically-related to vaccine (unchanged since 2009) despite phylogenetic clustering within emerging clade-6B.1. Adjusted-VE for A(H1N1)pdm09 was 43%(95%CI=25-57%), lower in adults born 1957-1976 (25%;95%CI=-16-51%); in those consecutively vaccinated both current and prior season (41%;95%CI=18-57%) vs. current season only (75%;95%CI=45-88%); and among participants presenting in March-April (19%;95%CI=-15-44%) vs. January-February 2016 (62%;95%CI=44-75%). VE for B(Victoria) viruses was 54%(95%CI=32-68%) despite lineage-level mismatch to B(Yamagata) vaccine and without further variation as observed for A(H1N1)pdm09.
[h=4]Conclusions:[/h] Influenza VE findings may require consideration of other agent-host and immuno-epidemiologic influences on vaccine performance beyond antigenic match, including viral genomic variation, birth (immunological) cohort and repeat vaccination effects, and potential within-season waning of vaccine protection.
[h=4]KEYWORDS:[/h] cohort effects; hemagglutination inhibition; influenza; influenza A subtype; influenza B lineage; influenza vaccine; original antigenic sin; repeat vaccination; sequencing; vaccine effectiveness
PMID: 29029166 DOI: 10.1093/infdis/jix526
[h=1]Beyond antigenic match: possible agent-host and immuno-epidemiological influences on influenza vaccine effectiveness during the 2015-16 season in Canada.[/h] Skowronski DM[SUP]1,[/SUP][SUP]2[/SUP], Chambers C[SUP]1[/SUP], Sabaiduc S[SUP]1[/SUP], De Serres G[SUP]3,[/SUP][SUP]4,[/SUP][SUP]5[/SUP], Winter AL[SUP]6[/SUP], Dickinson JA[SUP]7[/SUP], Gubbay JB[SUP]6,[/SUP][SUP]8[/SUP], Drews SJ[SUP]9,[/SUP][SUP]10[/SUP], Martineau C[SUP]3[/SUP], Charest H[SUP]3[/SUP], Krajden M[SUP]1,[/SUP][SUP]2[/SUP], Bastien N[SUP]11[/SUP], Li Y[SUP]11[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Vaccine effectiveness (VE) estimates are reported from Canada's Sentinel Practitioner Surveillance Network (SPSN) for the 2015-16 influenza season, characterized by a delayed A(H1N1)pdm09 epidemic and concurrent B(Victoria) activity. Potential influences beyond antigenic match are explored including viral genomic variation, birth cohort effects, prior vaccination and epidemic period.
[h=4]Methods:[/h] VE was estimated by test-negative design comparing adjusted-odds ratio for influenza test-positivity among vaccinated vs. unvaccinated participants. Vaccine-virus relatedness was assessed by gene-sequencing and hemagglutination-inhibition assay.
[h=4]Results:[/h] Analyses included 596 influenza A(H1N1)pdm09 and 305 B(Victoria) cases compared to 926 test-negative controls. A(H1N1)pdm09 viruses were considered antigenically-related to vaccine (unchanged since 2009) despite phylogenetic clustering within emerging clade-6B.1. Adjusted-VE for A(H1N1)pdm09 was 43%(95%CI=25-57%), lower in adults born 1957-1976 (25%;95%CI=-16-51%); in those consecutively vaccinated both current and prior season (41%;95%CI=18-57%) vs. current season only (75%;95%CI=45-88%); and among participants presenting in March-April (19%;95%CI=-15-44%) vs. January-February 2016 (62%;95%CI=44-75%). VE for B(Victoria) viruses was 54%(95%CI=32-68%) despite lineage-level mismatch to B(Yamagata) vaccine and without further variation as observed for A(H1N1)pdm09.
[h=4]Conclusions:[/h] Influenza VE findings may require consideration of other agent-host and immuno-epidemiologic influences on vaccine performance beyond antigenic match, including viral genomic variation, birth (immunological) cohort and repeat vaccination effects, and potential within-season waning of vaccine protection.
[h=4]KEYWORDS:[/h] cohort effects; hemagglutination inhibition; influenza; influenza A subtype; influenza B lineage; influenza vaccine; original antigenic sin; repeat vaccination; sequencing; vaccine effectiveness
PMID: 29029166 DOI: 10.1093/infdis/jix526