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The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2).
Vaccine. 2015 Jun 04; 33(24):2813-22.V

Abstract

BACKGROUND

In the first five I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe) influenza seasons vaccine effectiveness (VE) results were relatively homogenous among participating study sites. In 2013-2014, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in six European Union (EU) countries to measure 2013-2014 influenza VE against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. Influenza A(H3N2) and A(H1N1)pdm09 viruses co-circulated during the season.

METHODS

Practitioners systematically selected ILI patients to swab within eight days of symptom onset. We compared cases (ILI positive to influenza A(H3N2) or A(H1N1)pdm09) to influenza negative patients. We calculated VE for the two influenza A subtypes and adjusted for potential confounders. We calculated heterogeneity between sites using the I(2) index and Cochrane's Q test. If the I(2) was <50%, we estimated pooled VE as (1 minus the OR)×100 using a one-stage model with study site as a fixed effect. If the I(2) was >49% we used a two-stage random effects model.

RESULTS

We included in the A(H1N1)pdm09 analysis 531 cases and 1712 controls and in the A(H3N2) analysis 623 cases and 1920 controls. For A(H1N1)pdm09, the Q test (p=0.695) and the I(2) index (0%) suggested no heterogeneity of adjusted VE between study sites. Using a one-stage model, the overall pooled adjusted VE against influenza A(H1N1)pdm2009 was 47.5% (95% CI: 16.4-67.0). For A(H3N2), the I(2) was 51.5% (p=0.067). Using a two-stage model for the pooled analysis, the adjusted VE against A(H3N2) was 29.7 (95% CI: -34.4-63.2).

CONCLUSIONS

The results suggest a moderate 2013-2014 influenza VE against A(H1N1)pdm09 and a low VE against A(H3N2). The A(H3N2) estimates were heterogeneous among study sites. Larger sample sizes by study site are needed to prevent statistical heterogeneity, decrease variability and allow for two-stage pooled VE for all subgroup analyses.

Authors+Show Affiliations

Epidemiology Department, EpiConcept, Paris, France. Electronic address: m.valenciano@epiconcept.fr.Epidemiology Department, EpiConcept, Paris, France.Department for Infectious Disease Epidemiology Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany.National Centre of Epidemiology/CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.Department of Public Health, Strategic Planning and Epidemiology, Office of the Chief Medical Officer, Budapest, Hungary.Health Protection Surveillance Centre, Dublin, Ireland.UMF Carol Davila, INCDMI Cantacuzino, Bucharest, Romania.Department of Epidemiology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.National Centre for Microbiology, National Influenza Centre-Institute of Health Carlos III, Madrid, Spain.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

25936723

Citation

Valenciano, Marta, et al. "The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous Moderate Influenza Vaccine Effectiveness Against A(H1N1)pdm09 and Heterogenous Results By Country Against A(H3N2)." Vaccine, vol. 33, no. 24, 2015, pp. 2813-22.
Valenciano M, Kissling E, Reuss A, et al. The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2). Vaccine. 2015;33(24):2813-22.
Valenciano, M., Kissling, E., Reuss, A., Jiménez-Jorge, S., Horváth, J. K., Donnell, J. M., Pitigoi, D., Machado, A., & Pozo, F. (2015). The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2). Vaccine, 33(24), 2813-22. https://doi.org/10.1016/j.vaccine.2015.04.012
Valenciano M, et al. The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous Moderate Influenza Vaccine Effectiveness Against A(H1N1)pdm09 and Heterogenous Results By Country Against A(H3N2). Vaccine. 2015 Jun 4;33(24):2813-22. PubMed PMID: 25936723.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2). AU - Valenciano,Marta, AU - Kissling,Esther, AU - Reuss,Annicka, AU - Jiménez-Jorge,Silvia, AU - Horváth,Judit K, AU - Donnell,Joan M O, AU - Pitigoi,Daniela, AU - Machado,Ausenda, AU - Pozo,Francisco, AU - ,, Y1 - 2015/04/28/ PY - 2014/12/12/received PY - 2015/03/25/revised PY - 2015/04/02/accepted PY - 2015/5/5/entrez PY - 2015/5/6/pubmed PY - 2016/4/20/medline KW - Influenza vaccine KW - Influenza vaccine effectiveness KW - Multicentre study KW - Test-negative design KW - Vaccine effectiveness SP - 2813 EP - 22 JF - Vaccine JO - Vaccine VL - 33 IS - 24 N2 - BACKGROUND: In the first five I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe) influenza seasons vaccine effectiveness (VE) results were relatively homogenous among participating study sites. In 2013-2014, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in six European Union (EU) countries to measure 2013-2014 influenza VE against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. Influenza A(H3N2) and A(H1N1)pdm09 viruses co-circulated during the season. METHODS: Practitioners systematically selected ILI patients to swab within eight days of symptom onset. We compared cases (ILI positive to influenza A(H3N2) or A(H1N1)pdm09) to influenza negative patients. We calculated VE for the two influenza A subtypes and adjusted for potential confounders. We calculated heterogeneity between sites using the I(2) index and Cochrane's Q test. If the I(2) was <50%, we estimated pooled VE as (1 minus the OR)×100 using a one-stage model with study site as a fixed effect. If the I(2) was >49% we used a two-stage random effects model. RESULTS: We included in the A(H1N1)pdm09 analysis 531 cases and 1712 controls and in the A(H3N2) analysis 623 cases and 1920 controls. For A(H1N1)pdm09, the Q test (p=0.695) and the I(2) index (0%) suggested no heterogeneity of adjusted VE between study sites. Using a one-stage model, the overall pooled adjusted VE against influenza A(H1N1)pdm2009 was 47.5% (95% CI: 16.4-67.0). For A(H3N2), the I(2) was 51.5% (p=0.067). Using a two-stage model for the pooled analysis, the adjusted VE against A(H3N2) was 29.7 (95% CI: -34.4-63.2). CONCLUSIONS: The results suggest a moderate 2013-2014 influenza VE against A(H1N1)pdm09 and a low VE against A(H3N2). The A(H3N2) estimates were heterogeneous among study sites. Larger sample sizes by study site are needed to prevent statistical heterogeneity, decrease variability and allow for two-stage pooled VE for all subgroup analyses. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/25936723/The_European_I_MOVE_Multicentre_2013_2014_Case_Control_Study__Homogeneous_moderate_influenza_vaccine_effectiveness_against_A_H1N1_pdm09_and_heterogenous_results_by_country_against_A_H3N2__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)00465-X DB - PRIME DP - Unbound Medicine ER -