Giuseppe
Emeritus
Component-Specific Effectiveness of Trivalent Influenza Vaccine as Monitored through a Sentinel Surveillance Network in Canada, 2006?2007 - Chicago Journals - The Journal of Infectious Diseases
The Journal of Infectious Diseases 2009;199:000?000
? 2008 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2009/19902-00XX$15.00
DOI: 10.1086/595862
MAJOR ARTICLE
Component-Specific Effectiveness of Trivalent Influenza Vaccine as Monitored through a Sentinel Surveillance Network in Canada, 2006?2007
Danuta M. Skowronski,(1) Gaston De Serres, (2) Jim Dickinson, (3) Martin Petric, (1) Annie Mak, (1) Kevin Fonseca, (4) Trijntje L. Kwindt, (1) Tracy Chan, (1) Nathalie Bastien, (5) Hugues Charest, (2) and Yan Li (5)
(1) British Columbia Centre for Disease Control, Vancouver, British Columbia;
(2) Institut national de sant? publique du Qu?bec, Qu?bec;
(3) University of Calgary and
(4) Alberta Provincial Laboratory, Alberta; and
(5) National Microbiology Laboratory, Public Health Agency of Canada, Manitoba, Canada
Background.
Trivalent inactivated influenza vaccine (TIV) is reformulated annually to contain representative strains of 2 influenza A subtypes (H1N1 and H3N2) and 1 B lineage (Yamagata or Victoria). We describe a sentinel surveillance approach to link influenza variant detection with component-specific vaccine effectiveness (VE) estimation.
Methods.
The 2006?2007 TIV included A/NewCaledonia/20/1999(H1N1)?like, A/Wisconsin/67/2005(H3N2)?like, and B/Malaysia/2506/2004(Victoria)?like components. Included participants were individuals 9 years of age who presented within 1 week after influenzalike illness onset to a sentinel physician between November 2006 and April 2007. Influenza was identified by real-time reverse-transcriptase polymerase chain reaction and/or culture. Isolates were characterized by hemagglutination inhibition assay (HI) and HA1 gene sequence. VE was estimated as .
Results.
A total of 841 participants contributed: 69 (8%) were 65 years of age; 166 (20%) received the 2006?2007 TIV. Influenza was detected in 337 subjects (40%), distributed as follows: A/H3N2, 242 (72%); A/H1N1, 55 (16%); and B, 36 (11%). All but 1 of the A/H1N1 isolates were well matched, half of A/H3N2 isolates were strain mismatched, and all B isolates were lineage-level mismatched to vaccine. Age-adjusted estimated VE for A/H1N1, A/H3N2, and B components was 92% (95% CI, 40%?91%), 41% (95% CI, 6%?63%), and 19% (95% CI, −112% to 69%), respectively, with an overall VE estimate of 47% (95% CI, 18%?65%). Restriction of the analysis to include only working-age adults resulted in lower VE estimates with wide confidence intervals but similar component-specific trends.
Conclusions.
Sentinel surveillance provides a broad platform to link new variant detection and the composite of circulating viruses to annual monitoring of component-specific VE.
Received 17 April 2008; accepted 21 August 2008; electronically published 16 December 2008.
<cite cite="http://www.journals.uchicago.edu/doi/full/10.1086/595862?cookieSet=1">Chicago Journals - The Journal of Infectious Diseases</cite>? 2008 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2009/19902-00XX$15.00
DOI: 10.1086/595862
MAJOR ARTICLE
Component-Specific Effectiveness of Trivalent Influenza Vaccine as Monitored through a Sentinel Surveillance Network in Canada, 2006?2007
Danuta M. Skowronski,(1) Gaston De Serres, (2) Jim Dickinson, (3) Martin Petric, (1) Annie Mak, (1) Kevin Fonseca, (4) Trijntje L. Kwindt, (1) Tracy Chan, (1) Nathalie Bastien, (5) Hugues Charest, (2) and Yan Li (5)
(1) British Columbia Centre for Disease Control, Vancouver, British Columbia;
(2) Institut national de sant? publique du Qu?bec, Qu?bec;
(3) University of Calgary and
(4) Alberta Provincial Laboratory, Alberta; and
(5) National Microbiology Laboratory, Public Health Agency of Canada, Manitoba, Canada
Background.
Trivalent inactivated influenza vaccine (TIV) is reformulated annually to contain representative strains of 2 influenza A subtypes (H1N1 and H3N2) and 1 B lineage (Yamagata or Victoria). We describe a sentinel surveillance approach to link influenza variant detection with component-specific vaccine effectiveness (VE) estimation.
Methods.
The 2006?2007 TIV included A/NewCaledonia/20/1999(H1N1)?like, A/Wisconsin/67/2005(H3N2)?like, and B/Malaysia/2506/2004(Victoria)?like components. Included participants were individuals 9 years of age who presented within 1 week after influenzalike illness onset to a sentinel physician between November 2006 and April 2007. Influenza was identified by real-time reverse-transcriptase polymerase chain reaction and/or culture. Isolates were characterized by hemagglutination inhibition assay (HI) and HA1 gene sequence. VE was estimated as .
Results.
A total of 841 participants contributed: 69 (8%) were 65 years of age; 166 (20%) received the 2006?2007 TIV. Influenza was detected in 337 subjects (40%), distributed as follows: A/H3N2, 242 (72%); A/H1N1, 55 (16%); and B, 36 (11%). All but 1 of the A/H1N1 isolates were well matched, half of A/H3N2 isolates were strain mismatched, and all B isolates were lineage-level mismatched to vaccine. Age-adjusted estimated VE for A/H1N1, A/H3N2, and B components was 92% (95% CI, 40%?91%), 41% (95% CI, 6%?63%), and 19% (95% CI, −112% to 69%), respectively, with an overall VE estimate of 47% (95% CI, 18%?65%). Restriction of the analysis to include only working-age adults resulted in lower VE estimates with wide confidence intervals but similar component-specific trends.
Conclusions.
Sentinel surveillance provides a broad platform to link new variant detection and the composite of circulating viruses to annual monitoring of component-specific VE.
Received 17 April 2008; accepted 21 August 2008; electronically published 16 December 2008.