Vaccine Effectiveness Against Influenza A(H3N2)-Associated Hospitalized Illness: United States, 2022

被引:13
|
作者
Tenforde, Mark W. [1 ]
Patel, Manish M. [1 ]
Lewis, Nathaniel M. [1 ]
Adams, Katherine [1 ]
Gaglani, Manjusha [2 ]
Steingrub, Jay S. [3 ]
Shapiro, Nathan, I [4 ]
Duggal, Abhijit [5 ]
Prekker, Matthew E. [6 ,7 ]
Peltan, Ithan D. [8 ,9 ]
Hager, David N. [10 ]
Gong, Michelle N. [11 ]
Exline, Matthew C. [12 ]
Ginde, Adit A. [13 ]
Mohr, Nicholas M. [14 ]
Mallow, Christopher [15 ]
Martin, Emily T. [16 ]
Talbot, H. Keipp [17 ,18 ]
Gibbs, Kevin W. [19 ]
Kwon, Jennie H. [20 ]
Chappell, James D. [21 ]
Halasa, Natasha [21 ]
Lauring, Adam S. [22 ,23 ]
Lindsell, Christopher J. [24 ]
Swan, Sydney A. [24 ]
Hart, Kimberly W. [24 ]
Womack, Kelsey N. [25 ]
Baughman, Adrienne [26 ]
Grijalva, Carlos G. [18 ]
Self, Wesley H. [25 ,26 ]
机构
[1] Ctr Dis Control & Prevent, Influenza Div, 1600 Clifton Rd NE,H24-7, Atlanta, GA 30329 USA
[2] Texas A&M Univ, Coll Med, Baylor Scott & White Hlth, Temple, TX 76508 USA
[3] Baystate Med Ctr, Dept Med, Springfield, MA 01199 USA
[4] Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA 02215 USA
[5] Cleveland Clin, Dept Med, Cleveland, OH 44106 USA
[6] Hennepin Cty Med Ctr, Dept Emergency Med, Minneapolis, MN 55415 USA
[7] Hennepin Cty Med Ctr, Dept Med, Minneapolis, MN 55415 USA
[8] Intermt Med Ctr, Dept Med, Murray, UT USA
[9] Univ Utah, Salt Lake City, UT USA
[10] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
[11] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA
[12] Ohio State Univ, Dept Med, Columbus, OH 43210 USA
[13] Univ Colorado, Sch Med, Dept Emergency Med, Aurora, CO USA
[14] Univ Iowa, Dept Emergency Med, Iowa City, IA 52242 USA
[15] Univ Miami, Dept Med, Miami, FL USA
[16] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA
[17] Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN USA
[18] Vanderbilt Univ, Med Ctr, Dept Hlth Policy, Nashville, TN USA
[19] Wake Forest Sch Med, Dept Med, Winston Salem, NC 27101 USA
[20] Washington Univ, Dept Med, St Louis, MO 63110 USA
[21] Vanderbilt Univ, Med Ctr, Dept Pediat, Nashville, TN 37232 USA
[22] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA
[23] Univ Michigan, Dept Microbiol & Immunol, Ann Arbor, MI 48109 USA
[24] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USA
[25] Vanderbilt Univ, Med Ctr, Vanderbilt Inst Clin & Translat Res, Nashville, TN USA
[26] Vanderbilt Univ, Med Ctr, Dept Emergency Med, Nashville, TN USA
关键词
influenza; vaccine effectiveness; antigenic drift; SARS-CoV-2; OLDER;
D O I
10.1093/cid/ciac869
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
During the 2021-2022 US influenza season, circulating A(H3N2) viruses were antigenically different than the vaccine. Vaccine effectiveness against hospitalized illness was 26% (95% CI: -14-52%) for adults 18-64-years and -3% (95% CI: -54-31) for adults >= 65-years. Background The COVID-19 pandemic was associated with historically low influenza circulation during the 2020-2021 season, followed by an increase in influenza circulation during the 2021-2022 US season. The 2a.2 subgroup of the influenza A(H3N2) 3C.2a1b subclade that predominated was antigenically different from the vaccine strain. Methods To understand the effectiveness of the 2021-2022 vaccine against hospitalized influenza illness, a multistate sentinel surveillance network enrolled adults aged >= 18 years hospitalized with acute respiratory illness and tested for influenza by a molecular assay. Using the test-negative design, vaccine effectiveness (VE) was measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative controls, adjusting for confounders. A separate analysis was performed to illustrate bias introduced by including SARS-CoV-2-positive controls. Results A total of 2334 patients, including 295 influenza cases (47% vaccinated), 1175 influenza- and SARS-CoV-2-negative controls (53% vaccinated), and 864 influenza-negative and SARS-CoV-2-positive controls (49% vaccinated), were analyzed. Influenza VE was 26% (95% CI: -14% to 52%) among adults aged 18-64 years, -3% (-54% to 31%) among adults aged >= 65 years, and 50% (15-71%) among adults aged 18-64 years without immunocompromising conditions. Estimated VE decreased with inclusion of SARS-CoV-2-positive controls. Conclusions During a season where influenza A(H3N2) was antigenically different from the vaccine virus, vaccination was associated with a reduced risk of influenza hospitalization in younger immunocompetent adults. However, vaccination did not provide protection in adults >= 65 years of age. Improvements in vaccines, antivirals, and prevention strategies are warranted.
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收藏
页码:1030 / 1037
页数:8
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