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The Impact of Prior Season Vaccination on Subsequent Influenza Vaccine Effectiveness to Prevent Influenza-related Hospitalizations Over 4 Influenza Seasons in Canada.
Clin Infect Dis. 2019 08 30; 69(6):970-979.CI

Abstract

BACKGROUND

Recent studies have demonstrated the possibility of negative associations between prior influenza vaccines and subsequent influenza vaccine effectiveness (VE), depending on season and strain. We investigated this association over 4 consecutive influenza seasons (2011-2012 through 2014-2015) in Canada.

METHODS

Using a matched test-negative design, laboratory-confirmed influenza cases and matched test-negative controls admitted to hospitals were enrolled. Patients were stratified into 4 groups according to influenza vaccine history (not vaccinated current and prior season [referent], vaccinated prior season only, vaccinated current season only, and vaccinated both current and prior season). Conditional logistic regression was used to estimate VE; prior vaccine impact was assessed each season for overall effect and effect stratified by age (<65 years, ≥65 years) and type/subtype (A/H1N1, A/H3N2, influenza B).

RESULTS

Overall, mainly nonsignificant associations were observed. Trends of nonsignificant decreased VE among patients repeatedly vaccinated in both prior and current season relative to the current season only were observed in the A/H3N2-dominant seasons of 2012-2013 and 2014-2015. Conversely, in 2011-2012, during which B viruses circulated, and in 2013-2014, when A/H1N1 circulated, being vaccinated in both seasons tended to result in a high VE in the current season against the dominant circulating subtype.

CONCLUSIONS

Prior vaccine impact on subsequent VE among Canadian inpatients was mainly nonsignificant. Even in circumstances where we observed a trend of negative impact, being repeatedly vaccinated was still more effective than not receiving the current season's vaccine. These findings favor continuation of annual influenza vaccination recommendations, particularly in older adults.

CLINICAL TRIALS REGISTRATION

NCT01517191.

Authors+Show Affiliations

Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.Centre Hospitalier Universitaire de Québec, Québec City, Canada.University of British Columbia, Vancouver, Canada.Business and Decision Life Sciences, Bruxelles, Belgium. Present affiliation: GSK, Wavre, Belgium.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.Mount Sinai Hospital, Toronto, Ontario, Canada.GlaxoSmithKline (GSK), Wavre, Belgium.North York General Hospital, Toronto.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.McMaster University, Hamilton.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.The Ottawa Hospital, Sudbury.Health Sciences North Research Institute, Sudbury.Mount Sinai Hospital, Toronto, Ontario, Canada.Michael Garron Hospital, Toronto.William Osler Health System, Brampton, Ontario.McGill University, Montreal, Québec.GSK, Mississauga, Ontario, Canada.GSK, King of Prussia, Pennsylvania. Present affiliation: Novavax Vaccines, Washington, D.C.The Moncton Hospital, New Brunswick.Centre Hospitalier Universitaire de Québec, Québec City, Canada.Université de Sherbrooke, Québec.Saint John Hospital Regional Hospital, Dalhousie University, New Brunswick, Canada.Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

30508064

Citation

Nichols, M K., et al. "The Impact of Prior Season Vaccination On Subsequent Influenza Vaccine Effectiveness to Prevent Influenza-related Hospitalizations Over 4 Influenza Seasons in Canada." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 69, no. 6, 2019, pp. 970-979.
Nichols MK, Andrew MK, Ye L, et al. The Impact of Prior Season Vaccination on Subsequent Influenza Vaccine Effectiveness to Prevent Influenza-related Hospitalizations Over 4 Influenza Seasons in Canada. Clin Infect Dis. 2019;69(6):970-979.
Nichols, M. K., Andrew, M. K., Ye, L., Hatchette, T. F., Ambrose, A., Boivin, G., Bowie, W., Dos Santos, G., Elsherif, M., Green, K., Haguinet, F., Katz, K., Leblanc, J., Loeb, M., MacKinnon-Cameron, D., McCarthy, A., McElhaney, J. E., McGeer, A., Powis, J., ... McNeil, S. A. (2019). The Impact of Prior Season Vaccination on Subsequent Influenza Vaccine Effectiveness to Prevent Influenza-related Hospitalizations Over 4 Influenza Seasons in Canada. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 69(6), 970-979. https://doi.org/10.1093/cid/ciy1009
Nichols MK, et al. The Impact of Prior Season Vaccination On Subsequent Influenza Vaccine Effectiveness to Prevent Influenza-related Hospitalizations Over 4 Influenza Seasons in Canada. Clin Infect Dis. 2019 08 30;69(6):970-979. PubMed PMID: 30508064.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Impact of Prior Season Vaccination on Subsequent Influenza Vaccine Effectiveness to Prevent Influenza-related Hospitalizations Over 4 Influenza Seasons in Canada. AU - Nichols,M K, AU - Andrew,M K, AU - Ye,L, AU - Hatchette,T F, AU - Ambrose,A, AU - Boivin,G, AU - Bowie,W, AU - Dos Santos,G, AU - Elsherif,M, AU - Green,K, AU - Haguinet,F, AU - Katz,K, AU - Leblanc,J, AU - Loeb,M, AU - MacKinnon-Cameron,D, AU - McCarthy,A, AU - McElhaney,J E, AU - McGeer,A, AU - Powis,J, AU - Richardson,D, AU - Semret,M, AU - Sharma,R, AU - Shinde,V, AU - Smyth,D, AU - Trottier,S, AU - Valiquette,L, AU - Webster,D, AU - McNeil,S A, AU - ,, PY - 2018/04/27/received PY - 2018/11/30/accepted PY - 2018/12/7/pubmed PY - 2020/9/2/medline PY - 2018/12/4/entrez KW - adults KW - hospitalization KW - influenza KW - repeated vaccination KW - vaccine effectiveness SP - 970 EP - 979 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 69 IS - 6 N2 - BACKGROUND: Recent studies have demonstrated the possibility of negative associations between prior influenza vaccines and subsequent influenza vaccine effectiveness (VE), depending on season and strain. We investigated this association over 4 consecutive influenza seasons (2011-2012 through 2014-2015) in Canada. METHODS: Using a matched test-negative design, laboratory-confirmed influenza cases and matched test-negative controls admitted to hospitals were enrolled. Patients were stratified into 4 groups according to influenza vaccine history (not vaccinated current and prior season [referent], vaccinated prior season only, vaccinated current season only, and vaccinated both current and prior season). Conditional logistic regression was used to estimate VE; prior vaccine impact was assessed each season for overall effect and effect stratified by age (<65 years, ≥65 years) and type/subtype (A/H1N1, A/H3N2, influenza B). RESULTS: Overall, mainly nonsignificant associations were observed. Trends of nonsignificant decreased VE among patients repeatedly vaccinated in both prior and current season relative to the current season only were observed in the A/H3N2-dominant seasons of 2012-2013 and 2014-2015. Conversely, in 2011-2012, during which B viruses circulated, and in 2013-2014, when A/H1N1 circulated, being vaccinated in both seasons tended to result in a high VE in the current season against the dominant circulating subtype. CONCLUSIONS: Prior vaccine impact on subsequent VE among Canadian inpatients was mainly nonsignificant. Even in circumstances where we observed a trend of negative impact, being repeatedly vaccinated was still more effective than not receiving the current season's vaccine. These findings favor continuation of annual influenza vaccination recommendations, particularly in older adults. CLINICAL TRIALS REGISTRATION: NCT01517191. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/30508064/The_Impact_of_Prior_Season_Vaccination_on_Subsequent_Influenza_Vaccine_Effectiveness_to_Prevent_Influenza_related_Hospitalizations_Over_4_Influenza_Seasons_in_Canada_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciy1009 DB - PRIME DP - Unbound Medicine ER -