tetano
Editor, Senior Moderator
J Infect Dis. 2018 Dec 18. doi: 10.1093/infdis/jiy716. [Epub ahead of print]
[h=1]Relative effectiveness of cell-cultured and egg-based influenza vaccines among the U.S. elderly, 2017-18.[/h] Izurieta HS[SUP]1,[/SUP][SUP]2[/SUP], Chillarige Y[SUP]3[/SUP], Kelman J[SUP]4[/SUP], Wei Y[SUP]3[/SUP], Lu Y[SUP]1[/SUP], Xu W[SUP]3[/SUP], Lu M[SUP]3[/SUP], Pratt D[SUP]1[/SUP], Chu S[SUP]4[/SUP], Wernecke M[SUP]3[/SUP], MaCurdy T[SUP]3[/SUP], Forshee R[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] The low influenza vaccine effectiveness (VE) observed during the A(H3N2)-dominated 2017-18 season may be due to vaccine virus adaptation to growth in eggs. We compared effectiveness of cell-cultured and egg-based vaccines among Medicare beneficiaries.
[h=4]Methods:[/h] Retrospective cohort study on beneficiaries ages ≥65 years who received an influenza vaccine (cell-cultured, egg-based quadrivalent; egg-based high-dose, adjuvanted, or standard-dose trivalent) during the 2017-18 season. We used Poisson regression to evaluate relative VE (RVE) in preventing influenza hospital encounters.
[h=4]Results:[/h] Of >13 million beneficiaries, RVE for cell-cultured vaccines relative to egg-based quadrivalent vaccines was 10% (95% CI: 7% to 13%). In a mid-season interim analysis, this estimate was 16.5% (95% CI: 10.3% to 22.2%). In a five-way comparison, cell-cultured (RVE 11%, 95% CI: 8% to 14%) and egg-based high-dose (RVE 8%, 95% CI: 7% to 10%) vaccines were more effective than egg-based quadrivalent vaccines.
[h=4]Conclusions :[/h] he modest VE difference between cell-cultured and egg-based vaccines only partially explains the low overall VE reported by CDC, suggesting egg adaptation was not the main contributor to the low VE found among individuals ages ≥65 years. The mid-season interim analysis we performed demonstrates that our methods can be used to evaluate VE actively during the flu season.
PMID: 30561688 DOI: 10.1093/infdis/jiy716
[h=1]Relative effectiveness of cell-cultured and egg-based influenza vaccines among the U.S. elderly, 2017-18.[/h] Izurieta HS[SUP]1,[/SUP][SUP]2[/SUP], Chillarige Y[SUP]3[/SUP], Kelman J[SUP]4[/SUP], Wei Y[SUP]3[/SUP], Lu Y[SUP]1[/SUP], Xu W[SUP]3[/SUP], Lu M[SUP]3[/SUP], Pratt D[SUP]1[/SUP], Chu S[SUP]4[/SUP], Wernecke M[SUP]3[/SUP], MaCurdy T[SUP]3[/SUP], Forshee R[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] The low influenza vaccine effectiveness (VE) observed during the A(H3N2)-dominated 2017-18 season may be due to vaccine virus adaptation to growth in eggs. We compared effectiveness of cell-cultured and egg-based vaccines among Medicare beneficiaries.
[h=4]Methods:[/h] Retrospective cohort study on beneficiaries ages ≥65 years who received an influenza vaccine (cell-cultured, egg-based quadrivalent; egg-based high-dose, adjuvanted, or standard-dose trivalent) during the 2017-18 season. We used Poisson regression to evaluate relative VE (RVE) in preventing influenza hospital encounters.
[h=4]Results:[/h] Of >13 million beneficiaries, RVE for cell-cultured vaccines relative to egg-based quadrivalent vaccines was 10% (95% CI: 7% to 13%). In a mid-season interim analysis, this estimate was 16.5% (95% CI: 10.3% to 22.2%). In a five-way comparison, cell-cultured (RVE 11%, 95% CI: 8% to 14%) and egg-based high-dose (RVE 8%, 95% CI: 7% to 10%) vaccines were more effective than egg-based quadrivalent vaccines.
[h=4]Conclusions :[/h] he modest VE difference between cell-cultured and egg-based vaccines only partially explains the low overall VE reported by CDC, suggesting egg adaptation was not the main contributor to the low VE found among individuals ages ≥65 years. The mid-season interim analysis we performed demonstrates that our methods can be used to evaluate VE actively during the flu season.
PMID: 30561688 DOI: 10.1093/infdis/jiy716