Effectiveness of influenza vaccine against influenza A in Europe in seasons of different A(H1N1)pdm09 and the same A(H3N2) vaccine components (2016–17 and 2017–18)

Kissling, Esther; Pozo, Francisco; Buda, Silke; Vilcu, Ana‐Maria; Rizzo, Caterina; Gherasim, Alin; Horváth, J; Brytting, Mia; Domegan, Lisa; Meijer, Adam; Paradowska-Stankiewicz, Iwona; Machado, Ausenda; Vučina, Vesna Višekruna; Lazăr, Mihaela; Johansen, Kari; Dürrwald, Ralf; Werf, Sylvie van der; Bella, Antonino; Larrauri, Amparo; Ferenczi, Annamária; Zakikhany, Katherina; O’Donnell, Joan; Dijkstra, Frederika; Bogusz, J; Guiomar, Raquel; Filipović, Sanja; Pițigoi, Daniela; Penttinen, Pasi; Valenciano, Marta

doi:10.1016/j.jvacx.2019.100042

Cited by 24 publications

(44 citation statements)

References 29 publications

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“…The lack of VE against influenza A(H3N2) among 15-64-year-olds has not been seen before in I-MOVE studies [26][27][28][29]. The VE against influenza A(H3N2) in this age group in 2016/17 and 2017/18, when the A/Hong Kong/4801/2014 (H3N2)-like vaccine virus component was used (a 3C.2a clade virus) and predominantly 3C.2a (sub)clades circulated, was 34% and 33%, respectively [5]. The 2018/19 VE was higher in flanking age groups.…”

Section: Discussionmentioning

confidence: 75%

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Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15–64-year-olds in Europe: exploration by birth cohort

Kissling¹,

Pozo

Buda

et al. 2019

Eurosurveillance

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Introduction: Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE). Aim: The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort. Methods: We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0-14, 15-64, ≥ 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32-54-year-olds (1964-86) sharing potential childhood imprinting to serine at haemagglutinin position 159. Results: Influenza A(H3N2) VE among all ages was −1% (95% confidence interval (CI): −24 to 18) and 46% (95% CI: 8-68), −26% (95% CI: −66 to 4) and 20% (95% CI: −20 to 46) among 0-14, 15-64 and ≥ 65-year-olds, respectively. Among 15-64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: −34 to 50) and −74% (95% CI: −259 to 16), respectively. VE was −18% (95% CI: −140 to 41), −53% (95% CI: −131 to −2) and −12% (95% CI: −74 to 28) among 15-31-year-olds (1987-2003), 32-54-yearolds (1964-86) and 55-64-year-olds (1954-63), respectively. Discussion: The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964-86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15-64-year-olds and the public health impact of the I-REV hypothesis warrant further study.

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Section: Discussionmentioning

confidence: 75%

“…Since 2008/09, the Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE) primary care multicentre case control study (MCCS) has provided vaccine effectiveness (VE) estimates by influenza virus (sub) type, age group and target population. Since 2015/16, I-MOVE has also estimated VE by virus genetic clade [4,5].…”

Section: Introductionmentioning

confidence: 99%

Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15–64-year-olds in Europe: exploration by birth cohort

Kissling¹,

Pozo

Buda

et al. 2019

Eurosurveillance

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“…Immunological measures such as broadly neutralizing antibodies [ 13 ] and interferon gamma (IFNγ) producing T-cells [ 14 , 15 , 16 , 17 , 18 ] are cross-reactive within the subtypes of influenza A, which may provide protection in the years when there is a vaccine strain mismatch to circulating strain of influenza virus. This has been a common occurrence with A/H3N2 strains [ 19 , 20 ]. Our previous studies have shown that a high ratio of IFNγ to interleukin-10 (IL-10) production in response to ex vivo influenza A/H3N2 challenge of PBMCs is a correlate of protection in older adults [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Antibody and Cell-Mediated Immune Responses Are Correlates of Protection against Influenza Infection in Vaccinated Older Adults

et al. 2021

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Despite efforts to design better vaccines for older adults, the risk for serious complications of influenza remains disproportionately high. Identifying correlates of vaccine effectiveness and understanding the heterogeneity of health outcomes in older adults are key to the vaccine development pipeline. We sought correlates of protection against laboratory-confirmed influenza illness (LCII) in a 4-year randomized trial of standard versus high-dose influenza vaccination of adults 65 years and older. To this end, we quantified serum hemagglutination-inhibition (HAI) titers and interferon-gamma (IFNγ) and interleukin-10 (IL-10) secretion by virus-challenged peripheral blood mononuclear cells. Of the 608 participants included, 26 developed either A/H3N2-(n = 17) or B-LCII (n = 9) at 10–20 weeks post-vaccination. Antibody titres for A/H3N2 at 4-weeks post-vaccination were significantly associated with protection against LCII, where every 1-standard deviation increase reduced the odds of A/H3N2-LCII by 53%. Although B-titres did not correlate with protection against B-LCII, the fold-increase in IFNγ:IL-10 ratios from pre- to 4-weeks post-vaccination was significantly associated with protection against B-LCII, where every 1-standard deviation increase reduced the odds by 71%. Our results suggest that both antibody and cell-mediated immune measures are valuable and potentially complementary correlates of protection against LCII in vaccinated older adults, although this may depend on the viral type causing infection.

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“…The vaccine was well-matched with the circulating strains and the antibody responses observed in this study corresponded well with the overall vaccine effectiveness in the larger cohort study which enrolled more than 1,700 participants and estimated the effectiveness of IIV3 against laboratory-confirmed, influenza-associated acute respiratory illness among pregnant women at 65% (95% CI 38%-81%) [33]. Unlike some previous studies from other countries that have reported a low vaccine effectiveness against influenza A(H3N2) which have been attributed to either the egg-adaptive mutations in the A(H3N2) vaccine strain [34,35] or poor immunogenicity in general [36], results of this study and the VE cohort study found IIV3 to be immunogenic and effective against A(H3N2) among pregnant women [33]. These data provide important empirical support to the policy of recommending seasonal influenza vaccination to pregnant women, particularly in countries like Thailand where the vaccine coverage among this group is perennially low.…”

Section: Plos Onementioning

confidence: 99%

Antibody responses induced by trivalent inactivated influenza vaccine among pregnant and non-pregnant women in Thailand: A matched cohort study

et al. 2021

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Background We compared influenza antibody titers among vaccinated and unvaccinated pregnant and non-pregnant women. Methods During 1st June– 30th September 2018, four groups of cohort participants—vaccinated pregnant, unvaccinated pregnant, vaccinated non-pregnant, and unvaccinated non-pregnant women were selected by matching age, gestational age, and the week of vaccination. Serum antibody titers against each strain of 2018 Southern Hemisphere inactivated trivalent influenza vaccine (IIV3) were assessed by hemagglutination inhibition (HI) assay on Day 0 (pre-vaccination) and Day 28 (one month post-vaccination) serum samples. Geometric mean titer (GMT), GMT ratio (GMR), seroconversion (defined as ≥4 fold increase in HI titer), and seroprotection (i.e. HI titer ≥1:40) were compared across the study groups using multilevel regression analyses, controlling for previous year vaccination from medical records and baseline antibody levels. Results A total of 132 participants were enrolled in the study (33 in each of the four study groups). The baseline GMTs for influenza A(H1N1), A(H3N2), and B vaccine strains were not significantly different among all four groups (all p-values >0.05). After one month, both vaccinated groups had significantly higher GMT, GMR, seroconversion, and seroprotection than their unvaccinated controls (all p-values <0.05). The seroconversion rate was over 60% for any strain among the vaccinated groups, with the highest (88.8%) observed against A(H1N1) in the vaccinated pregnant group. Similarly, at least 75% of the vaccinated participants developed seroprotective antibody levels against all three strains; the highest seroprotection was found against A(H3N2) at 92.6% among vaccinated non-pregnant participants. Antibody responses (post-vaccination GMT, GMR, seroconversion, and seroprotection) were not significantly different between pregnant and non-pregnant women for all three strains of IIV3 (all p>0.05). Conclusions The 2018 seasonal IIV3 was immunogenic against all three vaccine strains and pregnancy did not seem to alter the immune response to IIV3. These findings support the current influenza vaccination recommendations for pregnant women.

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Effectiveness of influenza vaccine against influenza A in Europe in seasons of different A(H1N1)pdm09 and the same A(H3N2) vaccine components (2016–17 and 2017–18)

Abstract: HighlightsInfluenza A(H3N2) circulated in Europe in 2016–17 and 2017–18 and A(H1N1)pdm09 in 2017–18.Changed A(H1N1)pdm09 vaccine component VE was 58% against A(H1N1)pdm09 in 2017–18.A(H3N2) VE was 13% and 28% among all ages in 2016–17 and 2017–18, respectively.

Cited by 24 publications

References 29 publications

Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15–64-year-olds in Europe: exploration by birth cohort

Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15–64-year-olds in Europe: exploration by birth cohort

Antibody and Cell-Mediated Immune Responses Are Correlates of Protection against Influenza Infection in Vaccinated Older Adults

Antibody responses induced by trivalent inactivated influenza vaccine among pregnant and non-pregnant women in Thailand: A matched cohort study

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