tetano
Editor, Senior Moderator
Vaccine
. 2023 Sep 9;S0264-410X(23)01026-5.
doi: 10.1016/j.vaccine.2023.08.070. Online ahead of print. Vaccine Effectiveness of non-adjuvanted and adjuvanted trivalent inactivated influenza vaccines in the prevention of influenza-related hospitalization in older adults: A pooled analysis from the Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)
Henrique Pott[SUP] 1 [/SUP], Melissa K Andrew[SUP] 2 [/SUP], Zachary Shaffelburg[SUP] 2 [/SUP], Michaela K Nichols[SUP] 3 [/SUP], Lingyun Ye[SUP] 4 [/SUP], May ElSherif[SUP] 4 [/SUP], Todd F Hatchette[SUP] 2 [/SUP], Jason LeBlanc[SUP] 5 [/SUP], Ardith Ambrose[SUP] 4 [/SUP], Guy Boivin[SUP] 6 [/SUP], William Bowie[SUP] 7 [/SUP], Jennie Johnstone[SUP] 8 [/SUP], Kevin Katz[SUP] 9 [/SUP], Phillipe Lagacé-Wiens[SUP] 10 [/SUP], Mark Loeb[SUP] 8 [/SUP], Anne McCarthy[SUP] 11 [/SUP], Allison McGeer[SUP] 12 [/SUP], Andre Poirier[SUP] 13 [/SUP], Jeff Powis[SUP] 14 [/SUP], David Richardson[SUP] 15 [/SUP], Makeda Semret[SUP] 16 [/SUP], Stephanie Smith[SUP] 17 [/SUP], Daniel Smyth[SUP] 18 [/SUP], Grant Stiver[SUP] 7 [/SUP], Sylvie Trottier[SUP] 19 [/SUP], Louis Valiquette[SUP] 20 [/SUP], Duncan Webster[SUP] 21 [/SUP], Shelly A McNeil[SUP] 22 [/SUP]; Serious Outcomes Surveillance SOS Network of the Canadian Immunization Research Network CIRN; Toronto Invasive Bacterial Diseases Network TIBDN
Affiliations
Background: Influenza vaccines prevent influenza-related morbidity and mortality; however, suboptimal vaccine effectiveness (VE) of non-adjuvanted trivalent inactivated influenza vaccine (naTIV) or quadrivalent formulations in older adults prompted the use of enhanced products such as adjuvanted TIV (aTIV). Here, the VE of aTIV is compared to naTIV for preventing influenza-associated hospitalization among older adults.
Methods: A test-negative design study was used with pooled data from the 2012 to 2015 influenza seasons. An inverse probability of treatment (IPT)-weighted logistic regression estimated the Odds Ratio (OR) for laboratory-confirmed influenza-associated hospitalization. VE was calculated as (1-OR)*100% with accompanying 95% confidence intervals (CI).
Results: Of 7,101 adults aged ≥ 65, 3,364 received naTIV and 526 received aTIV. The overall VE against influenza hospitalization was 45.9% (95% CI: 40.2%-51.1%) for naTIV and 53.5% (42.8%-62.3%) for aTIV. No statistically significant differences in VE were found between aTIV and naTIV by age group or influenza season, though a trend favoring aTIV over naTIV was noted. Frailty may have impacted VE in aTIV recipients compared to those receiving naTIV, according to an exploratory analysis; VE adjusted by frailty was 59.1% (49.6%-66.8%) for aTIV and 44.8% (39.1%-50.0%) for naTIV. The overall relative VE of aTIV to naTIV against laboratory-confirmed influenza hospital admission was 25% (OR 0.75; 0.61-0.92), demonstrating statistically significant benefit favoring aTIV.
Conclusions: Adjusting for frailty, aTIV showed statistically significantly better protection than naTIV against influenza-associated hospitalizations in older adults. In future studies, it is important to consider frailty as a significant confounder of VE.
Keywords: Adjuvant; Frailty; Influenza; Older adult; Vaccine; Vaccine effectiveness.
. 2023 Sep 9;S0264-410X(23)01026-5.
doi: 10.1016/j.vaccine.2023.08.070. Online ahead of print. Vaccine Effectiveness of non-adjuvanted and adjuvanted trivalent inactivated influenza vaccines in the prevention of influenza-related hospitalization in older adults: A pooled analysis from the Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)
Henrique Pott[SUP] 1 [/SUP], Melissa K Andrew[SUP] 2 [/SUP], Zachary Shaffelburg[SUP] 2 [/SUP], Michaela K Nichols[SUP] 3 [/SUP], Lingyun Ye[SUP] 4 [/SUP], May ElSherif[SUP] 4 [/SUP], Todd F Hatchette[SUP] 2 [/SUP], Jason LeBlanc[SUP] 5 [/SUP], Ardith Ambrose[SUP] 4 [/SUP], Guy Boivin[SUP] 6 [/SUP], William Bowie[SUP] 7 [/SUP], Jennie Johnstone[SUP] 8 [/SUP], Kevin Katz[SUP] 9 [/SUP], Phillipe Lagacé-Wiens[SUP] 10 [/SUP], Mark Loeb[SUP] 8 [/SUP], Anne McCarthy[SUP] 11 [/SUP], Allison McGeer[SUP] 12 [/SUP], Andre Poirier[SUP] 13 [/SUP], Jeff Powis[SUP] 14 [/SUP], David Richardson[SUP] 15 [/SUP], Makeda Semret[SUP] 16 [/SUP], Stephanie Smith[SUP] 17 [/SUP], Daniel Smyth[SUP] 18 [/SUP], Grant Stiver[SUP] 7 [/SUP], Sylvie Trottier[SUP] 19 [/SUP], Louis Valiquette[SUP] 20 [/SUP], Duncan Webster[SUP] 21 [/SUP], Shelly A McNeil[SUP] 22 [/SUP]; Serious Outcomes Surveillance SOS Network of the Canadian Immunization Research Network CIRN; Toronto Invasive Bacterial Diseases Network TIBDN
Affiliations
- PMID: 37696717
- DOI: 10.1016/j.vaccine.2023.08.070
Background: Influenza vaccines prevent influenza-related morbidity and mortality; however, suboptimal vaccine effectiveness (VE) of non-adjuvanted trivalent inactivated influenza vaccine (naTIV) or quadrivalent formulations in older adults prompted the use of enhanced products such as adjuvanted TIV (aTIV). Here, the VE of aTIV is compared to naTIV for preventing influenza-associated hospitalization among older adults.
Methods: A test-negative design study was used with pooled data from the 2012 to 2015 influenza seasons. An inverse probability of treatment (IPT)-weighted logistic regression estimated the Odds Ratio (OR) for laboratory-confirmed influenza-associated hospitalization. VE was calculated as (1-OR)*100% with accompanying 95% confidence intervals (CI).
Results: Of 7,101 adults aged ≥ 65, 3,364 received naTIV and 526 received aTIV. The overall VE against influenza hospitalization was 45.9% (95% CI: 40.2%-51.1%) for naTIV and 53.5% (42.8%-62.3%) for aTIV. No statistically significant differences in VE were found between aTIV and naTIV by age group or influenza season, though a trend favoring aTIV over naTIV was noted. Frailty may have impacted VE in aTIV recipients compared to those receiving naTIV, according to an exploratory analysis; VE adjusted by frailty was 59.1% (49.6%-66.8%) for aTIV and 44.8% (39.1%-50.0%) for naTIV. The overall relative VE of aTIV to naTIV against laboratory-confirmed influenza hospital admission was 25% (OR 0.75; 0.61-0.92), demonstrating statistically significant benefit favoring aTIV.
Conclusions: Adjusting for frailty, aTIV showed statistically significantly better protection than naTIV against influenza-associated hospitalizations in older adults. In future studies, it is important to consider frailty as a significant confounder of VE.
Keywords: Adjuvant; Frailty; Influenza; Older adult; Vaccine; Vaccine effectiveness.