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Influenza vaccine effectiveness in preventing influenza-associated intensive care admissions and attenuating severe disease among adults in New Zealand 2012-2015.
Vaccine. 2018 09 18; 36(39):5916-5925.V

Abstract

BACKGROUND

Little is known about inactivated influenza vaccine effectiveness (IVE) in preventing very severe disease, including influenza-associated intensive care unit (ICU) admissions.

METHODS

The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) project enrolled adults (aged ≥ 18 years) with acute respiratory illness (ARI) in general ward (GW) hospital settings (n = 3034) and ICUs (n = 101) during 2012-2015. IVE was assessed using a test-negative design comparing the odds of influenza vaccination among influenza positives vs. negatives (confirmed by real-time reverse transcription polymerase chain reaction). All models were adjusted for season, weeks from season peak, and a vaccination propensity score.

RESULTS

Influenza virus infection was confirmed in 28% of GW hospital and 41% of ICU patients; influenza vaccination was documented for 56% and 41%, respectively. Across seasons, IVE was 37% (95% confidence intervals [CI] = 23-48%) among GW patients and 82% (95% CI = 45-94%) among ICU patients. IVE point estimates were > 70% against ICU influenza and consistently higher than IVE against GW influenza when stratified by season, by virus (sub)types, and for adults with or without chronic medical conditions and for both adults aged <65 and ≥65 years old. Among hospitalized influenza positives, influenza vaccination was associated with a 59% reduction in the odds of ICU admission (aOR = 0.41, 95% CI = 0.18-0.96) and with shorter ICU lengths of stay (LOS), but not with radiograph-confirmed pneumonia or GW hospital LOS.

CONCLUSION

Inactivated influenza vaccines prevented influenza-associated ICU admissions, may have higher effectiveness in ICU than GW hospital settings, and appeared to reduce the risk of severe disease among those who are infected despite vaccination.

Authors+Show Affiliations

Centers for Disease Control and Prevention (CDC), Atlanta, USA. Electronic address: isq8@cdc.gov.University of Otago, School of Medicine in Wellington, New Zealand. Electronic address: nevil.pierse@otago.ac.nz.Institute of Environmental Science and Research, Wellington, New Zealand.Institute of Environmental Science and Research, Wellington, New Zealand.Centers for Disease Control and Prevention (CDC), Atlanta, USA; Battelle, Atlanta, USA.University of Otago, School of Medicine in Wellington, New Zealand.University of Otago, School of Medicine in Wellington, New Zealand.University of Auckland, Auckland, New Zealand.Auckland District Health Board, Auckland, New Zealand.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

30077480

Citation

Thompson, Mark G., et al. "Influenza Vaccine Effectiveness in Preventing Influenza-associated Intensive Care Admissions and Attenuating Severe Disease Among Adults in New Zealand 2012-2015." Vaccine, vol. 36, no. 39, 2018, pp. 5916-5925.
Thompson MG, Pierse N, Sue Huang Q, et al. Influenza vaccine effectiveness in preventing influenza-associated intensive care admissions and attenuating severe disease among adults in New Zealand 2012-2015. Vaccine. 2018;36(39):5916-5925.
Thompson, M. G., Pierse, N., Sue Huang, Q., Prasad, N., Duque, J., Claire Newbern, E., Baker, M. G., Turner, N., & McArthur, C. (2018). Influenza vaccine effectiveness in preventing influenza-associated intensive care admissions and attenuating severe disease among adults in New Zealand 2012-2015. Vaccine, 36(39), 5916-5925. https://doi.org/10.1016/j.vaccine.2018.07.028
Thompson MG, et al. Influenza Vaccine Effectiveness in Preventing Influenza-associated Intensive Care Admissions and Attenuating Severe Disease Among Adults in New Zealand 2012-2015. Vaccine. 2018 09 18;36(39):5916-5925. PubMed PMID: 30077480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza vaccine effectiveness in preventing influenza-associated intensive care admissions and attenuating severe disease among adults in New Zealand 2012-2015. AU - Thompson,Mark G, AU - Pierse,Nevil, AU - Sue Huang,Q, AU - Prasad,Namrata, AU - Duque,Jazmin, AU - Claire Newbern,E, AU - Baker,Michael G, AU - Turner,Nikki, AU - McArthur,Colin, AU - ,, Y1 - 2018/08/01/ PY - 2018/03/20/received PY - 2018/06/08/revised PY - 2018/07/15/accepted PY - 2018/8/6/pubmed PY - 2019/2/15/medline PY - 2018/8/6/entrez KW - Hospital KW - Influenza vaccine KW - Intensive care unit KW - Test negative design KW - Vaccine effectiveness SP - 5916 EP - 5925 JF - Vaccine JO - Vaccine VL - 36 IS - 39 N2 - BACKGROUND: Little is known about inactivated influenza vaccine effectiveness (IVE) in preventing very severe disease, including influenza-associated intensive care unit (ICU) admissions. METHODS: The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) project enrolled adults (aged ≥ 18 years) with acute respiratory illness (ARI) in general ward (GW) hospital settings (n = 3034) and ICUs (n = 101) during 2012-2015. IVE was assessed using a test-negative design comparing the odds of influenza vaccination among influenza positives vs. negatives (confirmed by real-time reverse transcription polymerase chain reaction). All models were adjusted for season, weeks from season peak, and a vaccination propensity score. RESULTS: Influenza virus infection was confirmed in 28% of GW hospital and 41% of ICU patients; influenza vaccination was documented for 56% and 41%, respectively. Across seasons, IVE was 37% (95% confidence intervals [CI] = 23-48%) among GW patients and 82% (95% CI = 45-94%) among ICU patients. IVE point estimates were > 70% against ICU influenza and consistently higher than IVE against GW influenza when stratified by season, by virus (sub)types, and for adults with or without chronic medical conditions and for both adults aged <65 and ≥65 years old. Among hospitalized influenza positives, influenza vaccination was associated with a 59% reduction in the odds of ICU admission (aOR = 0.41, 95% CI = 0.18-0.96) and with shorter ICU lengths of stay (LOS), but not with radiograph-confirmed pneumonia or GW hospital LOS. CONCLUSION: Inactivated influenza vaccines prevented influenza-associated ICU admissions, may have higher effectiveness in ICU than GW hospital settings, and appeared to reduce the risk of severe disease among those who are infected despite vaccination. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/30077480/Influenza_vaccine_effectiveness_in_preventing_influenza_associated_intensive_care_admissions_and_attenuating_severe_disease_among_adults_in_New_Zealand_2012_2015_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(18)30997-6 DB - PRIME DP - Unbound Medicine ER -