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Influenza A/subtype and B/lineage effectiveness estimates for the 2011-2012 trivalent vaccine: cross-season and cross-lineage protection with unchanged vaccine.

Abstract

BACKGROUND

We estimate vaccine effectiveness (VE) against both influenza A/subtypes and B/lineages in Canada for the 2011-2012 trivalent inactivated influenza vaccine (TIV) with components entirely unchanged from the 2010-2011 TIV and in the context of phenotypic and genotypic characterization of circulating viruses.

METHODS

In a test-negative case-control study VE was estimated as [1-(adjusted)OddsRatio] × 100 for RT-PCR-confirmed influenza in vaccinated vs nonvaccinated participants. Viruses were characterized by hemagglutination inhibition (HI) and sequencing of antigenic sites of the hemagglutinin (HA) gene.

RESULTS

There were 1507 participants. VE against A(H1N1)pdm09 was 80% (95% confidence interval [CI], 52%-92%): circulating viruses were HI-characterized as vaccine-matched and bore just 2 aminoacid (AA) differences from vaccine. VE against A/H3N2 was 51% (95% CI, 10%-73%): circulating viruses were HI-characterized as vaccine-related but bore ≥11AA differences from vaccine. VE against influenza B was 51% (95% CI, 26%-67%) in total: 71% (95% CI, 40%-86%) for lineage-matched B/Victoria and 27% (95% CI, -21% to 56%) for lineage-mismatched B/Yamagata. For both influenza A and B types, VE was similar among recipients of either 2010-2011 or 2011-2012 TIV alone, higher when vaccinated both seasons.

CONCLUSIONS

Phenotypic and genotypic characterization of circulating and vaccine viruses enhances understanding of TIV performance, shown in 2011-2012 to be substantial against well-conserved A(H1N1)pdm09 and lineage-matched influenza B, suboptimal against genetic-variants of A/H3N2, and further reduced against lineage-mismatched influenza B. With unchanged vaccine components, protection may extend beyond a single season.

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  • Authors

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    Source

    The Journal of infectious diseases 210:1 2014 Jul 01 pg 126-37

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Antigens, Viral
    Canada
    Case-Control Studies
    Child
    Child, Preschool
    Female
    Hemagglutination Inhibition Tests
    Hemagglutinin Glycoproteins, Influenza Virus
    Humans
    Infant
    Influenza A virus
    Influenza B virus
    Influenza Vaccines
    Influenza, Human
    Male
    Middle Aged
    Molecular Sequence Data
    Sequence Analysis, DNA
    Treatment Outcome
    Vaccination
    Young Adult

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    24446529

    Citation

    Skowronski, Danuta M., et al. "Influenza A/subtype and B/lineage Effectiveness Estimates for the 2011-2012 Trivalent Vaccine: Cross-season and Cross-lineage Protection With Unchanged Vaccine." The Journal of Infectious Diseases, vol. 210, no. 1, 2014, pp. 126-37.
    Skowronski DM, Janjua NZ, Sabaiduc S, et al. Influenza A/subtype and B/lineage effectiveness estimates for the 2011-2012 trivalent vaccine: cross-season and cross-lineage protection with unchanged vaccine. J Infect Dis. 2014;210(1):126-37.
    Skowronski, D. M., Janjua, N. Z., Sabaiduc, S., De Serres, G., Winter, A. L., Gubbay, J. B., ... Petric, M. (2014). Influenza A/subtype and B/lineage effectiveness estimates for the 2011-2012 trivalent vaccine: cross-season and cross-lineage protection with unchanged vaccine. The Journal of Infectious Diseases, 210(1), pp. 126-37.
    Skowronski DM, et al. Influenza A/subtype and B/lineage Effectiveness Estimates for the 2011-2012 Trivalent Vaccine: Cross-season and Cross-lineage Protection With Unchanged Vaccine. J Infect Dis. 2014 Jul 1;210(1):126-37. PubMed PMID: 24446529.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Influenza A/subtype and B/lineage effectiveness estimates for the 2011-2012 trivalent vaccine: cross-season and cross-lineage protection with unchanged vaccine. AU - Skowronski,Danuta M, AU - Janjua,Naveed Z, AU - Sabaiduc,Suzana, AU - De Serres,Gaston, AU - Winter,Anne-Luise, AU - Gubbay,Jonathan B, AU - Dickinson,James A, AU - Fonseca,Kevin, AU - Charest,Hugues, AU - Bastien,Nathalie, AU - Li,Yan, AU - Kwindt,Trijntje L, AU - Mahmud,Salaheddin M, AU - Van Caeseele,Paul, AU - Krajden,Mel, AU - Petric,Martin, Y1 - 2014/01/19/ PY - 2014/1/22/entrez PY - 2014/1/22/pubmed PY - 2014/9/16/medline SP - 126 EP - 37 JF - The Journal of infectious diseases JO - J. Infect. Dis. VL - 210 IS - 1 N2 - BACKGROUND: We estimate vaccine effectiveness (VE) against both influenza A/subtypes and B/lineages in Canada for the 2011-2012 trivalent inactivated influenza vaccine (TIV) with components entirely unchanged from the 2010-2011 TIV and in the context of phenotypic and genotypic characterization of circulating viruses. METHODS: In a test-negative case-control study VE was estimated as [1-(adjusted)OddsRatio] × 100 for RT-PCR-confirmed influenza in vaccinated vs nonvaccinated participants. Viruses were characterized by hemagglutination inhibition (HI) and sequencing of antigenic sites of the hemagglutinin (HA) gene. RESULTS: There were 1507 participants. VE against A(H1N1)pdm09 was 80% (95% confidence interval [CI], 52%-92%): circulating viruses were HI-characterized as vaccine-matched and bore just 2 aminoacid (AA) differences from vaccine. VE against A/H3N2 was 51% (95% CI, 10%-73%): circulating viruses were HI-characterized as vaccine-related but bore ≥11AA differences from vaccine. VE against influenza B was 51% (95% CI, 26%-67%) in total: 71% (95% CI, 40%-86%) for lineage-matched B/Victoria and 27% (95% CI, -21% to 56%) for lineage-mismatched B/Yamagata. For both influenza A and B types, VE was similar among recipients of either 2010-2011 or 2011-2012 TIV alone, higher when vaccinated both seasons. CONCLUSIONS: Phenotypic and genotypic characterization of circulating and vaccine viruses enhances understanding of TIV performance, shown in 2011-2012 to be substantial against well-conserved A(H1N1)pdm09 and lineage-matched influenza B, suboptimal against genetic-variants of A/H3N2, and further reduced against lineage-mismatched influenza B. With unchanged vaccine components, protection may extend beyond a single season. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/24446529/Influenza_A/subtype_and_B/lineage_effectiveness_estimates_for_the_2011_2012_trivalent_vaccine:_cross_season_and_cross_lineage_protection_with_unchanged_vaccine_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiu048 DB - PRIME DP - Unbound Medicine ER -