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Effectiveness of Trivalent and Quadrivalent Inactivated Vaccines against Influenza B in the United States, 2011-2012 to 2016-2017

tetano

Editor, Senior Moderator
Clin Infect Dis. 2020 Feb 1. pii: ciaa102. doi: 10.1093/cid/ciaa102. [Epub ahead of print] [h=1]Effectiveness of Trivalent and Quadrivalent Inactivated Vaccines against Influenza B in the United States, 2011-2012 to 2016-2017.[/h]
Gaglani M[SUP]1[/SUP], Vasudevan A[SUP]1[/SUP], Raiyani C[SUP]1[/SUP], Murthy K[SUP]1[/SUP], Chen W[SUP]1[/SUP], Reis M[SUP]1[/SUP], Belongia EA[SUP]2[/SUP], McLean HQ[SUP]2[/SUP], Jackson ML[SUP]3[/SUP], Jackson LA[SUP]3[/SUP], Zimmerman RK[SUP]4[/SUP], Nowalk MP[SUP]4[/SUP], Monto AS[SUP]5[/SUP], Martin ET[SUP]5[/SUP], Chung JR[SUP]6[/SUP], Spencer S[SUP]6[/SUP], Fry AM[SUP]6[/SUP], Flannery B[SUP]6[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Since 2013, quadrivalent influenza vaccines containing two B viruses gradually replaced trivalent vaccines in the United States. We compared vaccine effectiveness of quadrivalent to trivalent inactivated vaccines (IIV4 to IIV3) against illness due to influenza B during the transition when IIV4 use increased rapidly.
[h=4]METHODS:[/h] The US Influenza Vaccine Effectiveness (Flu VE) Network analyzed 25,019 of 42,600 outpatients aged ≥6 months enrolled within 7 days of illness-onset during six seasons from 2011-2012. Upper respiratory specimens were tested for influenza virus type and B-lineage. Using logistic regression, we estimated IIV4 or IIV3 effectiveness by comparing the odds of influenza B infection overall, and by B lineage among vaccinated versus unvaccinated participants. Over four seasons from 2013-2014, we compared relative odds of influenza B infection among IIV4 versus IIV3 recipients.
[h=4]RESULTS:[/h] Trivalent vaccines included the predominantly circulating B lineage in four of six seasons. During four influenza seasons when both IIV4 and IIV3 were widely used, overall effectiveness against any influenza B was 53% (95% confidence interval [CI], 45 to 59) for IIV4 versus 45% (95% CI, 34 to 54) for IIV3. IIV4 was more effective than IIV3 against the B lineage not included in IIV3, but comparative effectiveness against illness related to any influenza B favored neither vaccine valency.
[h=4]CONCLUSIONS:[/h] Uptake of quadrivalent inactivated influenza vaccines was not associated with increased protection against any influenza B illness, despite higher effectiveness of quadrivalent vaccines against the added B virus lineage. Public health impact and cost-benefit analyses are needed globally.
? The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.


[h=4]KEYWORDS:[/h] Inactivated influenza vaccine; Influenza B lineage; Quadrivalent; Trivalent; effectiveness

PMID: 32006430 DOI: 10.1093/cid/ciaa102
 
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