Does consecutive influenza vaccination reduce protection against influenza: A systematic review and meta-analysis

Bartoszko, Jessica J; McNamara, Isabella F.; Aras, Oguz A.Z.; Hylton, Danielle A.; Zhang, Yuan B.; Malhotra, Danya Deepsee; Hyett, Sarah; Morassut, Rita E; Rudziak, Paulina; Loeb, Mark

doi:10.1016/j.vaccine.2018.04.049

Cited by 32 publications

(16 citation statements)

References 65 publications

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“…Our results are consistent with publications using meta-analysis, which suggested no significant reduction in VE when participants received TIV in both current and prior seasons, with the overall VE ranging from 17% to 67%, depending on the subtypes. [33][34][35][36] Furthermore, influenza VE varies by influenza A subtype, with typically higher estimates against A (H1N1) viruses compared with A (H3N2). 3 Since both 2007-08 and 2008-09 influenza seasons in Taiwan were dominated by H1N1 subtype A, the results were not affected by the circulating influenza subtype regardless of matching of the vaccine strains.…”

Section: Discussionmentioning

confidence: 99%

<p>A Population-Based Propensity Score-Matched Study to Assess the Impact of Repeated Vaccination on Vaccine Effectiveness for Influenza-Associated Hospitalization Among the Elderly</p>

Hsu¹,

Lian²,

Chao³

2020

CIA

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Background: Influenza is a major cause of morbidity and mortality in the elderly worldwide. Influenza vaccination can prevent morbidity/mortality from influenza infection. A gap of 1-2 years, before an epidemic strain is recommended by the World Health Organization (WHO) to be the vaccine strain in Southeast Asia, has been reported; this results in a high rate of vaccine mismatch and excess influenza-associated morbidity. The aim of the current study was to evaluate the effect of repeated vaccination on vaccine effectiveness (VE) among the elderly in Taiwan, during years with and without early appearance of antigenically drifted strains. Methods: A historical cohort study was conducted to evaluate the impact of repeated vaccination on the reduction of influenza-associated hospitalization among persons older than 64 years over two influenza seasons: 2007-08, with all circulating virus strains mismatched, and 2008-09, with all virus strains matched with the vaccine strains, considering four exposure effects, namely current vaccine effect, sequential vaccination effect, residual protection effect and no vaccination effect. Propensity score matching on vaccination status was performed to ensure similar baseline characteristics between the groups that received and did not receive vaccination. Results: Only current-year vaccination in combination with prior history of annual revaccination significantly reduced the risk of hospitalization, with adjusted hazard ratios of 0.68 (95% CI: 0.54, 0.85) and 0.74 (95% CI: 0.57, 0.95) during the 2007-08 and 2008-09 influenza seasons, respectively. Further stratification showed that even during the 2007-08 influenza season, when all vaccinations were mismatched with the circulating strains, sequential vaccinations still significantly reduced influenza-associated hospitalization in the female population aged 68-74 and 75-84 years, with adjusted VE of 25.2% (95% CI: −9.6, 49.0%) and 36.9% (95% CI: 17.1, 52.0%), respectively. Conclusion:Our study supports the recommendation of annual revaccination against influenza in the elderly, even though the circulating strain of influenza virus was antigenically mismatched with the vaccine strains.

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Section: Discussionmentioning

confidence: 99%

<p>A Population-Based Propensity Score-Matched Study to Assess the Impact of Repeated Vaccination on Vaccine Effectiveness for Influenza-Associated Hospitalization Among the Elderly</p>

Hsu¹,

Lian²,

Chao³

2020

CIA

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“…Most studies to date incorporated only a single previous season when examining the impact of repeated vaccination [8][9][10][11][12][13]. Meta-analyses of these studies found substantial heterogeneity in repeated vaccination effects [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

The impact of repeated vaccination using 10-year vaccination history on protection against influenza in older adults: a test-negative design study across the 2010/11 to 2015/16 influenza seasons in Ontario, Canada

et al. 2020

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Introduction Annual influenza vaccination is recommended for older adults, but evidence regarding the impact of repeated vaccination has been inconclusive. Aim We investigated vaccine effectiveness (VE) against laboratory-confirmed influenza and the impact of repeated vaccination over 10 previous seasons on current season VE among older adults. Methods We conducted an observational test-negative study in community-dwelling adults aged > 65 years in Ontario, Canada for the 2010/11 to 2015/16 seasons by linking laboratory and health administrative data. We estimated VE using multivariable logistic regression. We assessed the impact of repeated vaccination by stratifying by previous vaccination history. Results We included 58,304 testing episodes for respiratory viruses, with 11,496 (20%) testing positive for influenza and 31,004 (53%) vaccinated. Adjusted VE against laboratory-confirmed influenza for the six seasons combined was 21% (95% confidence interval (CI): 18 to 24%). Patients who were vaccinated in the current season, but had received no vaccinations in the previous 10 seasons, had higher current season VE (34%; 95%CI: 9 to 52%) than patients who had received 1–3 (26%; 95%CI: 13 to 37%), 4–6 (24%; 95%CI: 15 to 33%), 7–8 (13%; 95%CI: 2 to 22%), or 9–10 (7%; 95%CI: −4 to 16%) vaccinations (trend test p = 0.001). All estimates were higher after correcting for misclassification of current season vaccination status. For patients who were not vaccinated in the current season, residual protection rose significantly with increasing numbers of vaccinations received previously. Conclusions Although VE appeared to decrease with increasing numbers of previous vaccinations, current season vaccination likely provides some protection against influenza regardless of the number of vaccinations received over the previous 10 influenza seasons.

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“…These data may explain our higher VE of the 2016-2017 IIV4 against influenza B, as the predominant lineage was absent in the IIV3. Since we lacked data about the time between immunization and disease onset, as well as history of immunization in previous seasons, we were unable to determine the effect of time on influenza VE, and the impact of consecutive immunizations on the protective effectiveness of seasonal vaccines (Bartoszko et al 2018). Moreover, although no participant had influenza before getting vaccinated during the current season, we could not rule out possible bias in our VE estimates as some participants could have had influenza in previous seasons.…”

Section: Discussionmentioning

confidence: 99%

High performance of rapid influenza diagnostic test and variable effectiveness of influenza vaccines in Mexico

Castillejos

Cabello-Gutiérrez

Choreño-Parra

et al. 2019

International Journal of Infectious Diseases

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Objectives: To evaluate the performance of rapid influenza diagnostic tests (RIDT) and influenza vaccines' effectiveness (VE) during an outbreak setting. Methods: We compared the performance of a RIDT with RT-PCR for influenza virus detection in influenzalike illness (ILI) patients enrolled during the 2016/17 season in Mexico City. Using the test-negative design, we estimated influenza VE in all participants and stratified by age, virus subtype, and vaccine type (trivalent vs quadrivalent inactivated vaccines). The protective value of some clinical variables was evaluated by regression analyses. Results: We enrolled 592 patients. RT-PCR detected 93 cases of influenza A(H1N1)pdm09, 55 of AH3N2, 141 of B, and 13 A/B virus infections. RIDT showed 90.7% sensitivity and 95.7% specificity for influenza A virus detection, and 91.5% sensitivity and 95.3% specificity for influenza B virus detection. Overall VE was 33.2% (95% CI: 3.0-54.0; p = 0.02) against any laboratory-confirmed influenza infection. VE estimates against influenza B were higher for the quadrivalent vaccine. Immunization and occupational exposure were protective factors against influenza. Conclusions: The RIDT was useful to detect influenza cases during an outbreak setting. Effectiveness of 2016/17 influenza vaccines administered in Mexico was low but significant. Our data should be considered for future local epidemiological policies.

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Does consecutive influenza vaccination reduce protection against influenza: A systematic review and meta-analysis

Cited by 32 publications

References 65 publications

<p>A Population-Based Propensity Score-Matched Study to Assess the Impact of Repeated Vaccination on Vaccine Effectiveness for Influenza-Associated Hospitalization Among the Elderly</p>

<p>A Population-Based Propensity Score-Matched Study to Assess the Impact of Repeated Vaccination on Vaccine Effectiveness for Influenza-Associated Hospitalization Among the Elderly</p>

The impact of repeated vaccination using 10-year vaccination history on protection against influenza in older adults: a test-negative design study across the 2010/11 to 2015/16 influenza seasons in Ontario, Canada

High performance of rapid influenza diagnostic test and variable effectiveness of influenza vaccines in Mexico

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