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Clin Infect Dis . Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, and Death: United States, 2022-2023

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2023 Dec 5:ciad677.
doi: 10.1093/cid/ciad677. Online ahead of print. Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, and Death: United States, 2022-2023

Nathaniel M Lewis[SUP] 1 [/SUP], Yuwei Zhu[SUP] 2 [/SUP], Ithan D Peltan[SUP] 3 [/SUP], Manjusha Gaglani[SUP] 4 [/SUP], Tresa McNeal[SUP] 5 [/SUP], Shekhar Ghamande[SUP] 6 [/SUP], Jay S Steingrub[SUP] 7 [/SUP], Nathan I Shapiro[SUP] 8 [/SUP], Abhijit Duggal[SUP] 9 [/SUP], William S Bender[SUP] 10 [/SUP], Leyla Taghizadeh[SUP] 11 [/SUP], Samuel M Brown[SUP] 3 [/SUP], David N Hager[SUP] 12 [/SUP], Michelle N Gong[SUP] 13 [/SUP], Amira Mohamed[SUP] 14 [/SUP], Matthew C Exline[SUP] 14 [/SUP], Akram Khan[SUP] 15 [/SUP], Jennifer G Wilson[SUP] 16 [/SUP], Nida Qadir[SUP] 17 [/SUP], Steven Y Chang[SUP] 17 [/SUP], Adit A Ginde[SUP] 18 [/SUP], Nicholas M Mohr[SUP] 19 [/SUP], Christopher Mallow[SUP] 20 [/SUP], Adam S Lauring[SUP] 21 [/SUP], Nicholas J Johnson[SUP] 22 [/SUP], Kevin W Gibbs[SUP] 23 [/SUP], Jennie H Kwon[SUP] 24 [/SUP], Cristie Columbus[SUP] 25 [/SUP], Robert L Gottlieb[SUP] 26 [/SUP], Catherine Raver[SUP] 25 [/SUP], Ivana A Vaughn[SUP] 27 [/SUP], Mayur Ramesh[SUP] 28 [/SUP], Cassandra Johnson[SUP] 2 [/SUP], Lois Lamerato[SUP] 27 [/SUP], Basmah Safdar[SUP] 29 [/SUP], Jonathan D Casey[SUP] 30 [/SUP], Todd W Rice[SUP] 30 [/SUP], Natasha Halasa[SUP] 31 [/SUP], James D Chappell[SUP] 31 [/SUP], Carlos G Grijalva[SUP] 32 [/SUP], H Keipp Talbot[SUP] 33 [/SUP], Adrienne Baughman[SUP] 34 [/SUP], Kelsey N Womack[SUP] 35 [/SUP], Sydney A Swan[SUP] 2 [/SUP], Elizabeth Harker[SUP] 1 [/SUP], Ashley Price[SUP] 1 [/SUP], Jennifer DeCuir[SUP] 1 [/SUP], Diya Surie[SUP] 1 [/SUP], Sascha Ellington[SUP] 1 [/SUP], Wesley H Self[SUP] 36 [/SUP]; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network



Collaborators, Affiliations
Abstract

Background: Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain.
Methods: To understand effectiveness of the 2022-2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative control-patients.
Results: A total of 3707 patients, including 714 influenza cases (33% vaccinated) and 2993 influenza- and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative controls (49% vaccinated) were analyzed. VE against influenza-associated hospitalization was 37% (95% confidence interval [CI]: 27%-46%) and varied by age (18-64 years: 47% [30%-60%]; ≥65 years: 28% [10%-43%]), and virus (A[H3N2]: 29% [6%-46%], A[H1N1]: 47% [23%-64%]). VE against more severe influenza-associated outcomes included: 41% (29%-50%) against influenza with hypoxemia treated with supplemental oxygen; 65% (56%-72%) against influenza with respiratory, cardiovascular, or renal failure treated with organ support; and 66% (40%-81%) against influenza with respiratory failure treated with invasive mechanical ventilation.
Conclusions: During an early 2022-2023 influenza season with a well-matched influenza vaccine, vaccination was associated with reduced risk of influenza-associated hospitalization and organ failure.

Keywords: acute respiratory illness; attenuation; influenza; organ failure; vaccine effectiveness.

 
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