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Vaccine . The effect of seasonal influenza vaccine on medically-attended influenza and non-influenza respiratory viruses infections at primary care

tetano

Editor, Senior Moderator
Vaccine


. 2021 May 17;S0264-410X(21)00541-7.
doi: 10.1016/j.vaccine.2021.04.059. Online ahead of print.
The effect of seasonal influenza vaccine on medically-attended influenza and non-influenza respiratory viruses infections at primary care level, Hong Kong SAR, 2017/18 to 2019/20


Yung-Wai Chan[SUP] 1 [/SUP], Miu-Ling Wong[SUP] 2 [/SUP], Fong-Yuen Kwok[SUP] 2 [/SUP], Albert Ka-Wing Au[SUP] 2 [/SUP], Emily Chi-Mei Leung[SUP] 2 [/SUP], Shuk-Kwan Chuang[SUP] 2 [/SUP]



Affiliations

Abstract

Effectiveness of seasonal influenza vaccine (SIV) varies with the degree of matching with the vaccine and circulating viruses. We continued our SIV effectiveness against medically-attended influenza-like illness (ILI) under the Department of Health Hong Kong's sentinel private medical practitioners (PMP) network, using the test-negative case-control design, for the 2018/19 and 2019/20 season. In addition, we studied the potential interference between SIV and ILI caused by non-influenza respiratory viruses (NIRV) based on data collated from 2017/18 to 2019/20 seasons. 3404 patients were analysed. Across the 2017/18 to 2019/20 seasons, the vaccine effectiveness (VE) of SIV was 44% (95% CI 30-56%) against pan-negative controls, 57% (95%CI: 42-68%) against NIRV controls and 50% (95%CI 38-59%) against both. SIV was moderately effective against medically-attended ILI caused by influenza A/B in both 2018/19 and 2019/20 winter seasons (53.2% (95%CI 36.7-65.5%) and 41.8% (95%CI 6.3-64.1%), respectively). The VE against the main circulating subtype, influenza A(H1), was higher for the 2018/19 season (57.2% (95%CI 39.8-69.9%), compared to 34.6% (95%CI -9.6-61.4%) in the 2019/20 season). When compared to pan negative controls, those with single NIRV infections were similarly likely to have received SIV (OR 1.05 (95%CI 0.72-1.54) within the influenza season; OR 0.97 (95%CI 0.73-1.29) when including non-influenza seasons). Analyses by type of virus showed no increased risk of SIV identified among those with single infections of EV/RV, HMPV and parainfluenza but a 2-fold increased risk was shown for those with single infections of adenovirus and parainfluenza virus (adenovirus: OR 2.54 (95%CI 1.24-5.14) within influenza season and OR 1.78 (95%CI 1.01-3.09) for the whole period; parainfluenza virus: OR 2.01 (95%CI 1.22-3.29) within influenza season and OR 1.89 (95%CI 1.29-2.76) for the whole period). SIV programme and surveillance of influenza and NIRV, including SARS-CoV-2, should continue during the COVID-19 pandemic.

Keywords: Influenza; Influenza vaccine; Respiratory viruses; Vaccine effectiveness.
 
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