Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type During 2013–2014 in the United States

Gaglani, Manjusha; Pruszynski, Jessica; Murthy, Kempapura; Clipper, Lydia; Robertson, Anne; Reis, Michael; Chung, Jessie R.; Piedra, Pedro A.; Avadhanula, Vasanthi; Nowalk, Mary Patricia; Zimmerman, Richard K.; Jackson, Michael L.; Jackson, Lisa A.; Petrie, Joshua G.; Ohmit, Suzanne E.; Monto, Arnold S.; McLean, Huong Q.; Belongia, Edward A.; Fry, Alicia M.; Flannery, Brendan

doi:10.1093/infdis/jiv577

Cited by 175 publications

(156 citation statements)

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“…Eighteen studies met the eligibility criteria [4,13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Of these, one study was restricted to hospitalized patients and was therefore excluded from the meta-analysis [31].…”

Section: Resultsmentioning

confidence: 99%

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Belongia

Skowronski

McLean

et al. 2017

Expert Review of Vaccines

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Introduction: Studies in the 1970s and 1980s signaled concern that repeated influenza vaccination could affect vaccine protection. The antigenic distance hypothesis provided a theoretical framework to explain variability in repeat vaccination effects based on antigenic similarity between successive vaccine components and the epidemic strain. Areas covered: A meta-analysis of vaccine effectiveness studies from 2010-11 through 2014-15 shows substantial heterogeneity in repeat vaccination effects within and between seasons and subtypes. When negative effects were observed, they were most pronounced for H3N2, especially in 2014-15 when vaccine components were unchanged and antigenically distinct from the epidemic strain. Studies of repeated vaccination across multiple seasons suggest that vaccine effectiveness may be influenced by more than one prior season. In immunogenicity studies, repeated vaccination blunts the hemagglutinin antibody response, particularly for H3N2. Expert commentary: Substantial heterogeneity in repeated vaccination effects is not surprising given the variation in study populations and seasons, and the variable effects of antigenic distance and immunological landscape in different age groups and populations. Caution is required in the interpretation of pooled results across multiple seasons, since this can mask important variation in repeat vaccination effects between seasons. Multi-season clinical studies are needed to understand repeat vaccination effects and guide recommendations. ARTICLE HISTORY

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Section: Resultsmentioning

confidence: 99%

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Belongia

Skowronski

McLean

et al. 2017

Expert Review of Vaccines

Self Cite

239

185

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“…This distribution represents a statistically significant change from the 2013-2014 season in the US Flu VE Network in which 78% received standard-dose IIV3, 0.3% received high-dose IIV3, 14% received IIV4, and 8% received LAIV4 (P < .001) [3]. Figure 2 shows the differences in the type of influenza vaccine given across 3 age groups-2-17 years, 18-64 years, and ≥65 years-in the 2013-2014 and 2014-2015 influenza seasons.…”

Section: Distribution Of Influenza Vaccine Typementioning

confidence: 87%

“…For the past 4 years, the US Flu VE Network has provided effectiveness estimates for seasonal influenza vaccine [3,4,8,9,11,14,15] for the purposes of monitoring and guiding influenza vaccine policy. These 4 influenza seasons have differed from each other in terms of timing and severity of the epidemic, from the relatively mild 2011-2012 season, with peak incidence in March, to moderately severe seasons from 2012-2013 through 2014-2015, with peak incidence in late December to early January [6].…”

Section: Discussionmentioning

confidence: 99%

“…These 4 influenza seasons have differed from each other in terms of timing and severity of the epidemic, from the relatively mild 2011-2012 season, with peak incidence in March, to moderately severe seasons from 2012-2013 through 2014-2015, with peak incidence in late December to early January [6]. The predominant influenza A virus and VE have also varied by season, from 39% against A/H3N2 during 2011-2012 [8,9] to 51% against A/H1N1 in 2013-2014 [3]. VE estimates for influenza B viruses have simultaneously varied from 51% to 66% [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…All participants with EIR-documented 2014-2015 influenza vaccination ≥14 days prior to illness onset were considered vaccinated. Participants in Michigan, Pennsylvania, and Texas were additionally considered vaccinated if they were able to report a plausible place and time of vaccine receipt from an off-site provider without vaccination records ( plausible self-report), and participants in Washington who reported any off-site vaccination ≥14 days before illness onset were considered vaccinated [3]. Those vaccinated 0-13 days prior to illness onset were excluded.…”

Section: Vaccination Statusmentioning

confidence: 99%

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2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

et al. 2016

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Background. Circulating A/H3N2 influenza viruses drifted significantly after strain selection for the 2014-2015 vaccines. Also in 2014-2015, the Advisory Committee on Immunization Practices recommended preferential use of live attenuated influenza vaccine (LAIV) over inactivated influenza vaccine (IIV) among children aged 2-8 years.Methods. Vaccine effectiveness (VE) across age groups and vaccine types was examined among outpatients with acute respiratory illness at 5 US sites using a test-negative design, that compared the odds of vaccination among reverse transcription polymerase chain reaction-confirmed influenza positives and negatives.Results. Of 9311 enrollees with complete data, 7078 (76%) were influenza negative, 1840 (19.8%) were positive for influenza A (A/H3N2, n = 1817), and 395 (4.2%) were positive for influenza B (B/Yamagata, n = 340). The overall adjusted VE was 19% (95% confidence interval [CI], 10% to 27%) and was statistically significant in all age strata except those aged 18-64 years. The adjusted VE of 6% (95%CI, −5% to 17%) against A/H3N2-associated illness was not statistically significant, unlike VE for influenza B/Yamagata, which was 55% (95%CI, 43% to 65%). Among those aged 2-8 years, VE against A/H3N2 was 15% (95%CI, −16% to 38%) for IIV and −3% (CI, −50% to 29%) for LAIV; VE against B/Yamagata was 40% (95%CI, −20% to 70%) for IIV and 74% (95%CI, 25% to 91%) for LAIV.Conclusions. The 2014-2015 influenza vaccines offered little protection against the predominant influenza A/H3N2 virus but were effective against influenza B. Preferential use of LAIV among young children was not supported.

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Association of Prior Vaccination With Influenza Vaccine Effectiveness in Children Receiving Live Attenuated or Inactivated Vaccine

et al. 2018

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IMPORTANCE Some studies have reported negative effects of prior-season influenza vaccination.Prior-season influenza vaccination effects on vaccine effectiveness (VE) in children are not well understood.OBJECTIVE To assess the association of prior-season influenza vaccination with subsequent VE in children aged 2 to 17 years. DESIGN, SETTING, AND PARTICIPANTS This multiseason, test-negative case-control study wasconducted in outpatient clinics at 4 US sites among children aged 2 to 17 years with a medically attended febrile acute respiratory illness. Participants were recruited during the 2013-2014, 2014-2015, and 2015-2016 seasons when influenza circulated locally. Cases were children with influenza confirmed by reverse-transcription polymerase chain reaction. Test-negative control individuals were children with negative test results for influenza. EXPOSURES Vaccination history, including influenza vaccine type received in the enrollment season (live attenuated influenza vaccine [LAIV], inactivated influenza vaccine [IIV], or no vaccine) and season before enrollment (LAIV, IIV, or no vaccine), determined from medical records and immunization registries. MAIN OUTCOMES AND MEASURES LAIV and IIV effectiveness by influenza type and subtype (influenza A[H1N1]pdm09, influenza A[H3N2], or influenza B), estimated as 100 × (1 − odds ratio) in a logistic regression model with adjustment for potential confounders. Prior season vaccination associations were assessed with an interaction term. RESULTSOf 3369 children (1749 [52%] male; median age, 6.6 years [range, 2-17 years]) included in the analysis, 772 (23%) had a positive test result for influenza and 1674 (50%) were vaccinated in the enrollment season. Among LAIV recipients, VE against influenza A(H3N2) was higher among children vaccinated in both the enrollment and 1 prior season (50.3% [95% CI, 17.0% to 70.2%]) than among those without 1 prior season vaccination (−82.4% [95% CI, −267.5% to 9.5%], interaction P < .001). The effectiveness of LAIV against influenza A(H1N1)pdm09 was not associated with prior season vaccination among those with prior season vaccination (47.5% [95% CI, 11.4% to 68.9%]) and among those without prior season vaccination (7.8% [95% CI, −101.9% to 57.9%]) (interaction P = .37). Prior season vaccination was not associated with effectiveness of IIV against influenza A(H3N2) (38.7% [95% CI, 6.8% to 59.6%] among those with prior-season vaccination and 23.2% [95% CI, −38.3% to 57.4%] among those without prior-season vaccination, interaction P = .16) or with effectiveness of IIV against influenza A[H1N1]pdm09 (72.4% [95% CI, 56.0% to 82.7%] among(continued) Key Points Question Is prior-season vaccination associated with vaccine effectiveness by type in children aged 2 to 17 years? Findings In this multiseason, testnegative case-control study, live attenuated influenza vaccine effectiveness was higher in children vaccinated in both the enrollment and prior season compared with those vaccinated only in the enrollment season. Prior-season vaccination was...

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Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type During 2013–2014 in the United States

Abstract: During 2013-2014, IIV was significantly effective against A(H1N1)pdm09. Lack of LAIV4 effectiveness in children highlights the importance of continued annual monitoring of effectiveness of influenza vaccines in the United States.

Cited by 175 publications

References 40 publications

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

Repeated annual influenza vaccination and vaccine effectiveness: review of evidence

2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

Association of Prior Vaccination With Influenza Vaccine Effectiveness in Children Receiving Live Attenuated or Inactivated Vaccine

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