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Int J Infect Dis . Taiwan's Response to Influenza: A Seroepidemiological Evaluation of Policies and Implications for Pandemic Preparedness

tetano

Editor, Senior Moderator
Int J Infect Dis


. 2022 Feb 27;S1201-9712(22)00116-3.
doi: 10.1016/j.ijid.2022.02.038. Online ahead of print.
Taiwan's Response to Influenza: A Seroepidemiological Evaluation of Policies and Implications for Pandemic Preparedness


Pui-I Ho[SUP] 1 [/SUP], Wei Liu[SUP] 1 [/SUP], Tiger Zheng-Rong Li[SUP] 1 [/SUP], Ta-Chien Chan[SUP] 2 [/SUP], Chia-Chi Ku[SUP] 3 [/SUP], Yu-Hui Lien[SUP] 1 [/SUP], Ya-Hui Daphne Shen[SUP] 4 [/SUP], Juine-Ruey Chen[SUP] 5 [/SUP], Muh-Yong Yen[SUP] 6 [/SUP], Yu-Kang Tu[SUP] 1 [/SUP], Wan-Yu Lin[SUP] 1 [/SUP], Richard Compans[SUP] 7 [/SUP], Ping-Ing Lee[SUP] 8 [/SUP], Chwan-Chuen King[SUP] 9 [/SUP]



Affiliations

Abstract

Objectives: To evaluate class suspension and mass vaccination implemented among Taipei schoolchildren during the 2009 influenza pandemic and investigate factors affecting antibody responses.
Methods: We conducted two cohort studies on: (1) 972 schoolchildren from November 2009 - March 2010 to evaluate pandemic policies and (2) 935 schoolchildren from November 2011 - March 2012 to verify factors in antibody waning. Anti-influenza H1N1pdm09 hemagglutination inhibition antibodies (HI-Ab) were measured from serum samples collected before vaccination, and at 1- and 4-months post-vaccination. Factors affecting HI-Ab responses were investigated through logistic regression and generalized estimating equation.
Results: Seroprevalence of H1N1pdm09 before vaccination was significantly higher among schoolchildren who experienced class suspensions than those didn't (59.6% v.s. 47.5%, p<0.05). Participants in after-school activities (adjusted odds ratios [aOR]=2.47, p=0.047) and ≥ 3 hours/week of exercise (aOR=2.86, p=0.019) were significantly correlated with H1N1pdm09 infection. Two doses of the H1N1pdm09 vaccine demonstrated significantly better antibody persistence than one dose [HI-Ab-GMT: 132.5 vs 88.6, p=0.047]. Vaccine effectiveness after controlling pre-existing immunity was 86% [32-97%]. Exercise ≥ 3 hours/week and pre-existing immunity were significantly associated with antibody waning/maintenance.
Conclusions: This study is the first to show exercise and pre-existing immunity may affect antibody waning. Further investigation is needed to identify immune correlates of protection.

Keywords: Taiwan; emerging infectious diseases; pandemic influenza; public health policy; seroepidemiology; vaccination.
 
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