tetano
Editor, Senior Moderator
J Infect Dis
. 2020 Nov 3;jiaa685.
doi: 10.1093/infdis/jiaa685. Online ahead of print.
Low influenza vaccine effectiveness against A(H3N2) associated hospitalizations in the 2016-2017 and 2017-2018 seasons of the Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN)
Emily T Martin[SUP] 1 [/SUP], Caroline Cheng[SUP] 1 [/SUP], Joshua G Petrie[SUP] 1 [/SUP], Elif Alyanak[SUP] 2 [/SUP], Manjusha Gaglani[SUP] 3 [/SUP], Donald B Middleton[SUP] 4 [/SUP], Shekhar Ghamande[SUP] 3 [/SUP], Fernanda P Silveira[SUP] 4 [/SUP], Kempapura Murthy[SUP] 5 [/SUP], Richard K Zimmerman[SUP] 6 [/SUP], Arnold S Monto[SUP] 1 [/SUP], Christopher Trabue[SUP] 7 [/SUP], H Keipp Talbot[SUP] 8 [/SUP], Jill M Ferdinands[SUP] 2 [/SUP], HAIVEN Study Investigators
Affiliations
Abstract
Introduction: The 2016-2017 and 2017-2018 influenza seasons were notable for high number of hospitalizations for influenza A(H3N2) despite vaccine and circulating strain match.
Methods: We evaluated vaccine effectiveness (VE) against hospitalization in the test-negative HAIVEN study. Nasal-throat swabs were tested by RT-PCR for influenza and VE was determined based on odds of vaccination by generalized estimating equations. Vaccine-specific antibody was measured in a subset of enrollees.
Results: A total of 6,129 adults were enrolled from ten hospitals. Adjusted VE against A(H3N2) was 22.8% (95% C.I. 8.3%, 35.0%), pooled across both years and 49.4% (95% C.I. 34.3%, 61.1%) against B/Yamagata. In 2017-2018, the A(H3N2) VE point estimate for the cell-based vaccine was 43.0% (95% C.I. -36.3%, 76.1%; 56 vaccine recipients) compared to 24.0% (95% C.I. 3.9%, 39.9%) for egg based vaccines. Among 643 with serology data, hemagglutinin antibodies against the egg-based A(H3N2) vaccine strain were increased in influenza-negative individuals.
Conclusions: Low VE for the A/Hong Kong/4801/2014 vaccine virus in both A(H3N2) seasons emphasizes concerns for continued changes in H3N2 antigenic epitopes, including changes that may impact glycosylation and ultimately reduce VE.
Keywords: adults; case-control study; hospitalization; influenza; vaccine; vaccine effectiveness.
. 2020 Nov 3;jiaa685.
doi: 10.1093/infdis/jiaa685. Online ahead of print.
Low influenza vaccine effectiveness against A(H3N2) associated hospitalizations in the 2016-2017 and 2017-2018 seasons of the Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN)
Emily T Martin[SUP] 1 [/SUP], Caroline Cheng[SUP] 1 [/SUP], Joshua G Petrie[SUP] 1 [/SUP], Elif Alyanak[SUP] 2 [/SUP], Manjusha Gaglani[SUP] 3 [/SUP], Donald B Middleton[SUP] 4 [/SUP], Shekhar Ghamande[SUP] 3 [/SUP], Fernanda P Silveira[SUP] 4 [/SUP], Kempapura Murthy[SUP] 5 [/SUP], Richard K Zimmerman[SUP] 6 [/SUP], Arnold S Monto[SUP] 1 [/SUP], Christopher Trabue[SUP] 7 [/SUP], H Keipp Talbot[SUP] 8 [/SUP], Jill M Ferdinands[SUP] 2 [/SUP], HAIVEN Study Investigators
Affiliations
- PMID: 33140094
- DOI: 10.1093/infdis/jiaa685
Abstract
Introduction: The 2016-2017 and 2017-2018 influenza seasons were notable for high number of hospitalizations for influenza A(H3N2) despite vaccine and circulating strain match.
Methods: We evaluated vaccine effectiveness (VE) against hospitalization in the test-negative HAIVEN study. Nasal-throat swabs were tested by RT-PCR for influenza and VE was determined based on odds of vaccination by generalized estimating equations. Vaccine-specific antibody was measured in a subset of enrollees.
Results: A total of 6,129 adults were enrolled from ten hospitals. Adjusted VE against A(H3N2) was 22.8% (95% C.I. 8.3%, 35.0%), pooled across both years and 49.4% (95% C.I. 34.3%, 61.1%) against B/Yamagata. In 2017-2018, the A(H3N2) VE point estimate for the cell-based vaccine was 43.0% (95% C.I. -36.3%, 76.1%; 56 vaccine recipients) compared to 24.0% (95% C.I. 3.9%, 39.9%) for egg based vaccines. Among 643 with serology data, hemagglutinin antibodies against the egg-based A(H3N2) vaccine strain were increased in influenza-negative individuals.
Conclusions: Low VE for the A/Hong Kong/4801/2014 vaccine virus in both A(H3N2) seasons emphasizes concerns for continued changes in H3N2 antigenic epitopes, including changes that may impact glycosylation and ultimately reduce VE.
Keywords: adults; case-control study; hospitalization; influenza; vaccine; vaccine effectiveness.