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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.
J Infect Dis. 2016 May 15; 213(10):1546-56.JI

Abstract

BACKGROUND

The predominant strain during the 2013-2014 influenza season was 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09). This vaccine-component has remained unchanged from 2009.

METHODS

The US Flu Vaccine Effectiveness Network enrolled subjects aged ≥6 months with medically attended acute respiratory illness (MAARI), including cough, with illness onset ≤7 days before enrollment. Influenza was confirmed by reverse-transcription polymerase chain reaction (RT-PCR). We determined the effectiveness of trivalent or quadrivalent inactivated influenza vaccine (IIV) among subjects ages ≥6 months and the effectiveness of quadrivalent live attenuated influenza vaccine (LAIV4) among children aged 2-17 years, using a test-negative design. The effect of prior receipt of any A(H1N1)pdm09-containing vaccine since 2009 on the effectiveness of current-season vaccine was assessed.

RESULTS

We enrolled 5999 subjects; 5637 (94%) were analyzed; 18% had RT-PCR-confirmed A(H1N1)pdm09-related MAARI. Overall, the effectiveness of vaccine against A(H1N1)pdm09-related MAARI was 54% (95% confidence interval [CI], 46%-61%). Among fully vaccinated children aged 2-17 years, the effectiveness of LAIV4 was 17% (95% CI, -39% to 51%) and the effectiveness of IIV was 60% (95% CI, 36%-74%). Subjects aged ≥9 years showed significant residual protection of any prior A(H1N1)pdm09-containing vaccine dose(s) received since 2009, as did children <9 years old considered fully vaccinated by prior season.

CONCLUSIONS

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.

Authors+Show Affiliations

Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple.Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple.Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple.Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple.Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple.Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple.Centers for Disease Control and Prevention, Atlanta, Georgia.Baylor College of Medicine, Houston, Texas.Baylor College of Medicine, Houston, Texas.University of Pittsburgh, Pennsylvania.University of Pittsburgh, Pennsylvania.Group Health Research Institute, Seattle, Washington.Group Health Research Institute, Seattle, Washington.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.Marshfield Clinic Research Foundation, Wisconsin.Marshfield Clinic Research Foundation, Wisconsin.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

26743842

Citation

Gaglani, Manjusha, et al. "Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed By Vaccine Type During 2013-2014 in the United States." The Journal of Infectious Diseases, vol. 213, no. 10, 2016, pp. 1546-56.
Gaglani M, Pruszynski J, Murthy K, et al. Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type During 2013-2014 in the United States. J Infect Dis. 2016;213(10):1546-56.
Gaglani, M., Pruszynski, J., Murthy, K., Clipper, L., Robertson, A., Reis, M., Chung, J. R., Piedra, P. A., Avadhanula, V., Nowalk, M. P., Zimmerman, R. K., Jackson, M. L., Jackson, L. A., Petrie, J. G., Ohmit, S. E., Monto, A. S., McLean, H. Q., Belongia, E. A., Fry, A. M., & Flannery, B. (2016). Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type During 2013-2014 in the United States. The Journal of Infectious Diseases, 213(10), 1546-56. https://doi.org/10.1093/infdis/jiv577
Gaglani M, et al. Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed By Vaccine Type During 2013-2014 in the United States. J Infect Dis. 2016 May 15;213(10):1546-56. PubMed PMID: 26743842.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type During 2013-2014 in the United States. AU - Gaglani,Manjusha, AU - Pruszynski,Jessica, AU - Murthy,Kempapura, AU - Clipper,Lydia, AU - Robertson,Anne, AU - Reis,Michael, AU - Chung,Jessie R, AU - Piedra,Pedro A, AU - Avadhanula,Vasanthi, AU - Nowalk,Mary Patricia, AU - Zimmerman,Richard K, AU - Jackson,Michael L, AU - Jackson,Lisa A, AU - Petrie,Joshua G, AU - Ohmit,Suzanne E, AU - Monto,Arnold S, AU - McLean,Huong Q, AU - Belongia,Edward A, AU - Fry,Alicia M, AU - Flannery,Brendan, Y1 - 2016/01/06/ PY - 2015/09/04/received PY - 2015/10/13/accepted PY - 2016/1/9/entrez PY - 2016/1/9/pubmed PY - 2016/9/28/medline KW - influenza KW - influenza vaccine KW - influenza vaccine effectiveness KW - vaccine effectiveness SP - 1546 EP - 56 JF - The Journal of infectious diseases JO - J Infect Dis VL - 213 IS - 10 N2 - BACKGROUND: The predominant strain during the 2013-2014 influenza season was 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09). This vaccine-component has remained unchanged from 2009. METHODS: The US Flu Vaccine Effectiveness Network enrolled subjects aged ≥6 months with medically attended acute respiratory illness (MAARI), including cough, with illness onset ≤7 days before enrollment. Influenza was confirmed by reverse-transcription polymerase chain reaction (RT-PCR). We determined the effectiveness of trivalent or quadrivalent inactivated influenza vaccine (IIV) among subjects ages ≥6 months and the effectiveness of quadrivalent live attenuated influenza vaccine (LAIV4) among children aged 2-17 years, using a test-negative design. The effect of prior receipt of any A(H1N1)pdm09-containing vaccine since 2009 on the effectiveness of current-season vaccine was assessed. RESULTS: We enrolled 5999 subjects; 5637 (94%) were analyzed; 18% had RT-PCR-confirmed A(H1N1)pdm09-related MAARI. Overall, the effectiveness of vaccine against A(H1N1)pdm09-related MAARI was 54% (95% confidence interval [CI], 46%-61%). Among fully vaccinated children aged 2-17 years, the effectiveness of LAIV4 was 17% (95% CI, -39% to 51%) and the effectiveness of IIV was 60% (95% CI, 36%-74%). Subjects aged ≥9 years showed significant residual protection of any prior A(H1N1)pdm09-containing vaccine dose(s) received since 2009, as did children <9 years old considered fully vaccinated by prior season. CONCLUSIONS: 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. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/26743842/Influenza_Vaccine_Effectiveness_Against_2009_Pandemic_Influenza_A_H1N1__Virus_Differed_by_Vaccine_Type_During_2013_2014_in_the_United_States_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiv577 DB - PRIME DP - Unbound Medicine ER -