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Influenza vaccination is not associated with detection of noninfluenza respiratory viruses in seasonal studies of influenza vaccine effectiveness.
Clin Infect Dis 2013; 57(6):789-93CI

Abstract

BACKGROUND

 The test-negative control study design is the basis for observational studies of influenza vaccine effectiveness (VE). Recent studies have suggested that influenza vaccination increases the risk of noninfluenza respiratory virus infection. Such an effect could create bias in VE studies using influenza-negative controls. We investigated the association between influenza infection, vaccination, and detection of other respiratory viruses among children <5 years old and adults ≥50 years old with acute respiratory illness who participated in seasonal studies of influenza vaccine effectiveness.

METHODS

 Nasal/nasopharyngeal samples collected from 2004–2005 through 2009–2010 were tested for 19 respiratory virus targets using a multiplex reverse-transcription polymerase chain reaction (RT-PCR) platform. Vaccination status was determined using a validated registry. Adjusted odds ratios for influenza and vaccination status were calculated using three different control groups: influenza-negative, other respiratory virus positive, and pan-negative.

RESULTS

 Influenza was detected in 12% of 2010 children and 20% of 1738 adults. Noninfluenza respiratory viruses were detected in 70% of children and 38% of adults without influenza. The proportion vaccinated did not vary between virus-positive controls and pan-negative controls in children (P = .62) or adults (P = .33). Influenza infection was associated with reduced odds of vaccination, but adjusted odds ratios differed by no more than 0.02 when the analysis used influenza-negative or virus-positive controls.

CONCLUSIONS

 Influenza vaccination was not associated with detection of noninfluenza respiratory viruses. Use of influenza-negative controls did not generate a biased estimate of vaccine effectiveness due to an effect of vaccination on other respiratory virus infections.

Authors+Show Affiliations

Marshfield Clinic Research Foundation, Marshfield, WI 54449, USA.No 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

23748138

Citation

Sundaram, Maria E., et al. "Influenza Vaccination Is Not Associated With Detection of Noninfluenza Respiratory Viruses in Seasonal Studies of Influenza Vaccine Effectiveness." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 57, no. 6, 2013, pp. 789-93.
Sundaram ME, McClure DL, VanWormer JJ, et al. Influenza vaccination is not associated with detection of noninfluenza respiratory viruses in seasonal studies of influenza vaccine effectiveness. Clin Infect Dis. 2013;57(6):789-93.
Sundaram, M. E., McClure, D. L., VanWormer, J. J., Friedrich, T. C., Meece, J. K., & Belongia, E. A. (2013). Influenza vaccination is not associated with detection of noninfluenza respiratory viruses in seasonal studies of influenza vaccine effectiveness. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 57(6), pp. 789-93.
Sundaram ME, et al. Influenza Vaccination Is Not Associated With Detection of Noninfluenza Respiratory Viruses in Seasonal Studies of Influenza Vaccine Effectiveness. Clin Infect Dis. 2013;57(6):789-93. PubMed PMID: 23748138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza vaccination is not associated with detection of noninfluenza respiratory viruses in seasonal studies of influenza vaccine effectiveness. AU - Sundaram,Maria E, AU - McClure,David L, AU - VanWormer,Jeffrey J, AU - Friedrich,Thomas C, AU - Meece,Jennifer K, AU - Belongia,Edward A, PY - 2013/6/11/entrez PY - 2013/6/12/pubmed PY - 2014/5/13/medline SP - 789 EP - 93 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 57 IS - 6 N2 - BACKGROUND:  The test-negative control study design is the basis for observational studies of influenza vaccine effectiveness (VE). Recent studies have suggested that influenza vaccination increases the risk of noninfluenza respiratory virus infection. Such an effect could create bias in VE studies using influenza-negative controls. We investigated the association between influenza infection, vaccination, and detection of other respiratory viruses among children <5 years old and adults ≥50 years old with acute respiratory illness who participated in seasonal studies of influenza vaccine effectiveness. METHODS:  Nasal/nasopharyngeal samples collected from 2004–2005 through 2009–2010 were tested for 19 respiratory virus targets using a multiplex reverse-transcription polymerase chain reaction (RT-PCR) platform. Vaccination status was determined using a validated registry. Adjusted odds ratios for influenza and vaccination status were calculated using three different control groups: influenza-negative, other respiratory virus positive, and pan-negative. RESULTS:  Influenza was detected in 12% of 2010 children and 20% of 1738 adults. Noninfluenza respiratory viruses were detected in 70% of children and 38% of adults without influenza. The proportion vaccinated did not vary between virus-positive controls and pan-negative controls in children (P = .62) or adults (P = .33). Influenza infection was associated with reduced odds of vaccination, but adjusted odds ratios differed by no more than 0.02 when the analysis used influenza-negative or virus-positive controls. CONCLUSIONS:  Influenza vaccination was not associated with detection of noninfluenza respiratory viruses. Use of influenza-negative controls did not generate a biased estimate of vaccine effectiveness due to an effect of vaccination on other respiratory virus infections. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/23748138/Influenza_vaccination_is_not_associated_with_detection_of_noninfluenza_respiratory_viruses_in_seasonal_studies_of_influenza_vaccine_effectiveness_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cit379 DB - PRIME DP - Unbound Medicine ER -