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Using surveillance data to estimate pandemic vaccine effectiveness against laboratory confirmed influenza A(H1N1)2009 infection: two case-control studies, Spain, season 2009-2010.
BMC Public Health. 2011 Nov 30; 11:899.BP

Abstract

BACKGROUND

Physicians of the Spanish Influenza Sentinel Surveillance System report and systematically swab patients attended to their practices for influenza-like illness (ILI). Within the surveillance system, some Spanish regions also participated in an observational study aiming at estimating influenza vaccine effectiveness (cycEVA study). During the season 2009-2010, we estimated pandemic influenza vaccine effectiveness using both the influenza surveillance data and the cycEVA study.

METHODS

We conducted two case-control studies using the test-negative design, between weeks 48/2009 and 8/2010 of the pandemic season. The surveillance-based study included all swabbed patients in the sentinel surveillance system. The cycEVA study included swabbed patients from seven Spanish regions. Cases were laboratory-confirmed pandemic influenza A(H1N1)2009. Controls were ILI patients testing negative for any type of influenza. Variables collected in both studies included demographic data, vaccination status, laboratory results, chronic conditions, and pregnancy. Additionally, cycEVA questionnaire collected data on previous influenza vaccination, smoking, functional status, hospitalisations, visits to the general practitioners, and obesity. We used logistic regression to calculate adjusted odds ratios (OR), computing pandemic influenza vaccine effectiveness as (1-OR)*100.

RESULTS

We included 331 cases and 995 controls in the surveillance-based study and 85 cases and 351 controls in the cycEVA study. We detected nine (2.7%) and two (2.4%) vaccine failures in the surveillance-based and cycEVA studies, respectively. Adjusting for variables collected in surveillance database and swabbing month, pandemic influenza vaccine effectiveness was 62% (95% confidence interval (CI): -5; 87). The cycEVA vaccine effectiveness was 64% (95%CI: -225; 96) when adjusting for common variables with the surveillance system and 75% (95%CI: -293; 98) adjusting for all variables collected.

CONCLUSION

Point estimates of the pandemic influenza vaccine effectiveness suggested a protective effect of the pandemic vaccine against laboratory-confirmed influenza A(H1N1)2009 in the season 2009-2010. Both studies were limited by the low vaccine coverage and the late start of the vaccination campaign. Routine influenza surveillance provides reliable estimates and could be used for influenza vaccine effectiveness studies in future seasons taken into account the surveillance system limitations.

Authors+Show Affiliations

Institute of Health Carlos III, National Centre of Epidemiology, c/Monforte de Lemos no,5, 28029 Madrid, Spain. csavulescu@isciii.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22129083

Citation

Savulescu, Camelia, et al. "Using Surveillance Data to Estimate Pandemic Vaccine Effectiveness Against Laboratory Confirmed Influenza A(H1N1)2009 Infection: Two Case-control Studies, Spain, Season 2009-2010." BMC Public Health, vol. 11, 2011, p. 899.
Savulescu C, Jiménez-Jorge S, de Mateo S, et al. Using surveillance data to estimate pandemic vaccine effectiveness against laboratory confirmed influenza A(H1N1)2009 infection: two case-control studies, Spain, season 2009-2010. BMC Public Health. 2011;11:899.
Savulescu, C., Jiménez-Jorge, S., de Mateo, S., Pozo, F., Casas, I., Breña, P. P., Galmés, A., Vanrell, J. M., Rodriguez, C., Vega, T., Martinez, A., Torner, N., Ramos, J. M., Serrano, M. C., Castilla, J., Cenoz, M. G., Altzibar, J. M., Arteagoitia, J. M., Quiñones, C., ... Larrauri, A. (2011). Using surveillance data to estimate pandemic vaccine effectiveness against laboratory confirmed influenza A(H1N1)2009 infection: two case-control studies, Spain, season 2009-2010. BMC Public Health, 11, 899. https://doi.org/10.1186/1471-2458-11-899
Savulescu C, et al. Using Surveillance Data to Estimate Pandemic Vaccine Effectiveness Against Laboratory Confirmed Influenza A(H1N1)2009 Infection: Two Case-control Studies, Spain, Season 2009-2010. BMC Public Health. 2011 Nov 30;11:899. PubMed PMID: 22129083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Using surveillance data to estimate pandemic vaccine effectiveness against laboratory confirmed influenza A(H1N1)2009 infection: two case-control studies, Spain, season 2009-2010. AU - Savulescu,Camelia, AU - Jiménez-Jorge,Silvia, AU - de Mateo,Salvador, AU - Pozo,Francisco, AU - Casas,Inmaculada, AU - Breña,Pilar Pérez, AU - Galmés,Antonia, AU - Vanrell,Juana M, AU - Rodriguez,Carolina, AU - Vega,Tomas, AU - Martinez,Ana, AU - Torner,Nuria, AU - Ramos,Julián M, AU - Serrano,Maria C, AU - Castilla,Jesús, AU - Cenoz,Manuel García, AU - Altzibar,Jone M, AU - Arteagoitia,Jose M, AU - Quiñones,Carmen, AU - Perucha,Milagros, AU - Larrauri,Amparo, Y1 - 2011/11/30/ PY - 2011/06/16/received PY - 2011/11/30/accepted PY - 2011/12/2/entrez PY - 2011/12/2/pubmed PY - 2012/6/1/medline SP - 899 EP - 899 JF - BMC public health JO - BMC Public Health VL - 11 N2 - BACKGROUND: Physicians of the Spanish Influenza Sentinel Surveillance System report and systematically swab patients attended to their practices for influenza-like illness (ILI). Within the surveillance system, some Spanish regions also participated in an observational study aiming at estimating influenza vaccine effectiveness (cycEVA study). During the season 2009-2010, we estimated pandemic influenza vaccine effectiveness using both the influenza surveillance data and the cycEVA study. METHODS: We conducted two case-control studies using the test-negative design, between weeks 48/2009 and 8/2010 of the pandemic season. The surveillance-based study included all swabbed patients in the sentinel surveillance system. The cycEVA study included swabbed patients from seven Spanish regions. Cases were laboratory-confirmed pandemic influenza A(H1N1)2009. Controls were ILI patients testing negative for any type of influenza. Variables collected in both studies included demographic data, vaccination status, laboratory results, chronic conditions, and pregnancy. Additionally, cycEVA questionnaire collected data on previous influenza vaccination, smoking, functional status, hospitalisations, visits to the general practitioners, and obesity. We used logistic regression to calculate adjusted odds ratios (OR), computing pandemic influenza vaccine effectiveness as (1-OR)*100. RESULTS: We included 331 cases and 995 controls in the surveillance-based study and 85 cases and 351 controls in the cycEVA study. We detected nine (2.7%) and two (2.4%) vaccine failures in the surveillance-based and cycEVA studies, respectively. Adjusting for variables collected in surveillance database and swabbing month, pandemic influenza vaccine effectiveness was 62% (95% confidence interval (CI): -5; 87). The cycEVA vaccine effectiveness was 64% (95%CI: -225; 96) when adjusting for common variables with the surveillance system and 75% (95%CI: -293; 98) adjusting for all variables collected. CONCLUSION: Point estimates of the pandemic influenza vaccine effectiveness suggested a protective effect of the pandemic vaccine against laboratory-confirmed influenza A(H1N1)2009 in the season 2009-2010. Both studies were limited by the low vaccine coverage and the late start of the vaccination campaign. Routine influenza surveillance provides reliable estimates and could be used for influenza vaccine effectiveness studies in future seasons taken into account the surveillance system limitations. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/22129083/Using_surveillance_data_to_estimate_pandemic_vaccine_effectiveness_against_laboratory_confirmed_influenza_A_H1N1_2009_infection:_two_case_control_studies_Spain_season_2009_2010_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-899 DB - PRIME DP - Unbound Medicine ER -