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Transpl Int . A Retrospective Test-Negative Case-Control Study to Evaluate Influenza Vaccine Effectiveness in Preventing Influenza Among Immunocomp

tetano

Editor, Senior Moderator
Transpl Int


. 2025 May 16:38:14187.
doi: 10.3389/ti.2025.14187. eCollection 2025. A Retrospective Test-Negative Case-Control Study to Evaluate Influenza Vaccine Effectiveness in Preventing Influenza Among Immunocompromised Adults With a Solid Organ Transplant

Manon L M Prins[SUP] 1 2 [/SUP], Ernst D van Dokkum[SUP] 3 4 [/SUP], Aiko P J de Vries[SUP] 5 [/SUP], Maarten E Tushuizen[SUP] 6 [/SUP], Danny van der Helm[SUP] 5 [/SUP], Edwin M Spithoven[SUP] 7 [/SUP], Irene M van der Meer[SUP] 8 [/SUP], J H Marc Groeneveld[SUP] 9 [/SUP], Leo G Visser[SUP] 1 [/SUP], Saskia le Cessie[SUP] 10 [/SUP], Albert M Vollaard[SUP] 11 [/SUP], Geert H Groeneveld[SUP] 1 2 [/SUP]



Affiliations
Abstract

Vaccination may prevent influenza in solid organ transplant (SOT) recipients. This study evaluates the influenza vaccine effectiveness (VE) in this high-risk population in the Netherlands. We also compared disease progression and 30-day mortality between vaccinated and unvaccinated influenza patients. In this multicenter, test-negative case-control study, SOT recipients with respiratory symptoms were included when tested for viral respiratory infections during the respiratory seasons between 1 January 2013 and 1 July 2024. Cases had a positive influenza PCR, while controls tested negative. Influenza vaccination in cases (74/174) and controls (291/602) were compared after adjusting for potential confounders. VE was calculated as (1-adjusted odds ratio) x 100. The overall VE was 6.9% (95% CI -40.9 to 38.4), with considerable variation across seasons. For those aged ≥65 years, VE was higher (32.4%, 95% CI -56.5-70.8) compared to those aged 18-64 years (4.8%, 95% CI -56.5 to 42.1). The adjusted VE against influenza A [7.5% (-46.0 to 41.3)] was higher than against influenza B (-3.8% (-146.7 to 56.3)). No differences in influenza-related complications were observed between the vaccinated and unvaccinated cases. The observed seasonal influenza vaccine effectiveness in adult SOT recipients is limited; further investigation for improvement is warranted.

Keywords: Netherlands; influenza; influenza vaccination; influenza vaccine effectiveness; solid organ transplant patients.

 
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