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Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters in US Adults ≥ 65 Years During the 2017-2018 and 2018-2019 Influenza Seasons.
Clin Infect Dis. 2021 09 07; 73(5):816-823.CI

Abstract

BACKGROUND

The effectiveness of standard, egg-derived quadrivalent influenza vaccines (IIV4) may be reduced in adults ≥65 years of age, largely because of immunosenescence. An MF59-adjuvanted trivalent influenza vaccine (aIIV3) and a high-dose trivalent influenza vaccine (HD-IIV3) offer older adults enhanced protection versus standard vaccines. This study compared the relative effectiveness of aIIV3 with IIV4 and HD-IIV3 in preventing influenza-related medical encounters over 2 US influenza seasons.

METHODS

This retrospective cohort study included US patients ≥65 years vaccinated with aIIV3, IIV4, or HD-IIV3. The outcome of interest was the occurrence of influenza-related medical encounters. Data were derived from a large dataset comprising primary and specialty care electronic medical records linked with pharmacy and medical claims. Adjusted odds ratios (OR) were derived from an inverse probability of treatment-weighted sample adjusted for age, sex, race, ethnicity, geographic region, vaccination week, and health status. Relative vaccine effectiveness (rVE) was determined using the formula (% VE = 1 - ORadjusted) × 100.

RESULTS

In 2017-2018, cohorts included: aIIV3, n = 524 223; IIV4, n = 917 609; and HD-IIV3, n = 3 377 860. After adjustment, 2017-2018 rVE of aIIV3 versus IIV4 was 18.2 (95% confidence interval [CI], 15.8-20.5); aIIV3 vs. HD-IIV3 was 7.7 (95% CI, 2.3-12.8). In 2018-2019, cohorts included: aIIV3, n = 1 031 145; IIV4, n = 915 380; HD-IIV3, n = 3 809 601, with adjusted rVEs of aIIV3 versus IIV4 of 27.8 (95% CI, 25.7-29.9) and vs. HD-IIV3 of 6.9 (95% CI, 3.1-10.6).

CONCLUSION

In the 2017-2018 and 2018-2019 influenza seasons in the United States, aIIV3 demonstrated greater reduction in influenza-related medical encounters than IIV4 and HD-IIV3 in adults ≥65 years.

Authors+Show Affiliations

Seqirus Inc., Kirkland, Quebec, Canada.Veradigm, San Francisco, California, USA.Veradigm, San Francisco, California, USA.Veradigm, San Francisco, California, USA.Seqirus USA Inc., Summit, New Jersey, USA.Seqirus Inc., Kirkland, Quebec, Canada.

Pub Type(s)

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

Language

eng

PubMed ID

33605977

Citation

Boikos, Constantina, et al. "Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters in US Adults ≥ 65 Years During the 2017-2018 and 2018-2019 Influenza Seasons." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 73, no. 5, 2021, pp. 816-823.
Boikos C, Fischer L, O'Brien D, et al. Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters in US Adults ≥ 65 Years During the 2017-2018 and 2018-2019 Influenza Seasons. Clin Infect Dis. 2021;73(5):816-823.
Boikos, C., Fischer, L., O'Brien, D., Vasey, J., Sylvester, G. C., & Mansi, J. A. (2021). Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters in US Adults ≥ 65 Years During the 2017-2018 and 2018-2019 Influenza Seasons. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 73(5), 816-823. https://doi.org/10.1093/cid/ciab152
Boikos C, et al. Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters in US Adults ≥ 65 Years During the 2017-2018 and 2018-2019 Influenza Seasons. Clin Infect Dis. 2021 09 7;73(5):816-823. PubMed PMID: 33605977.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters in US Adults ≥ 65 Years During the 2017-2018 and 2018-2019 Influenza Seasons. AU - Boikos,Constantina, AU - Fischer,Lauren, AU - O'Brien,Dan, AU - Vasey,Joe, AU - Sylvester,Gregg C, AU - Mansi,James A, PY - 2020/10/15/received PY - 2021/2/20/pubmed PY - 2021/9/23/medline PY - 2021/2/19/entrez KW - adjuvanted trivalent inactivated influenza vaccine KW - influenza KW - influenza-related medical encounters KW - older adults KW - relative effectiveness SP - 816 EP - 823 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 73 IS - 5 N2 - BACKGROUND: The effectiveness of standard, egg-derived quadrivalent influenza vaccines (IIV4) may be reduced in adults ≥65 years of age, largely because of immunosenescence. An MF59-adjuvanted trivalent influenza vaccine (aIIV3) and a high-dose trivalent influenza vaccine (HD-IIV3) offer older adults enhanced protection versus standard vaccines. This study compared the relative effectiveness of aIIV3 with IIV4 and HD-IIV3 in preventing influenza-related medical encounters over 2 US influenza seasons. METHODS: This retrospective cohort study included US patients ≥65 years vaccinated with aIIV3, IIV4, or HD-IIV3. The outcome of interest was the occurrence of influenza-related medical encounters. Data were derived from a large dataset comprising primary and specialty care electronic medical records linked with pharmacy and medical claims. Adjusted odds ratios (OR) were derived from an inverse probability of treatment-weighted sample adjusted for age, sex, race, ethnicity, geographic region, vaccination week, and health status. Relative vaccine effectiveness (rVE) was determined using the formula (% VE = 1 - ORadjusted) × 100. RESULTS: In 2017-2018, cohorts included: aIIV3, n = 524 223; IIV4, n = 917 609; and HD-IIV3, n = 3 377 860. After adjustment, 2017-2018 rVE of aIIV3 versus IIV4 was 18.2 (95% confidence interval [CI], 15.8-20.5); aIIV3 vs. HD-IIV3 was 7.7 (95% CI, 2.3-12.8). In 2018-2019, cohorts included: aIIV3, n = 1 031 145; IIV4, n = 915 380; HD-IIV3, n = 3 809 601, with adjusted rVEs of aIIV3 versus IIV4 of 27.8 (95% CI, 25.7-29.9) and vs. HD-IIV3 of 6.9 (95% CI, 3.1-10.6). CONCLUSION: In the 2017-2018 and 2018-2019 influenza seasons in the United States, aIIV3 demonstrated greater reduction in influenza-related medical encounters than IIV4 and HD-IIV3 in adults ≥65 years. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/33605977/Relative_Effectiveness_of_Adjuvanted_Trivalent_Inactivated_Influenza_Vaccine_Versus_Egg_Derived_Quadrivalent_Inactivated_Influenza_Vaccines_and_High_Dose_Trivalent_Influenza_Vaccine_in_Preventing_Influenza_Related_Medical_Encounters_in_US_Adults_≥65_Years_During_the_2017_2018_and_2018_2019_Influenza_Seasons_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciab152 DB - PRIME DP - Unbound Medicine ER -