Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: A pooled analysis from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS Network) |
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| Institution: | 1. Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada;2. Centre Hospitalier Universitaire de Québec, Québec, Québec, Canada;3. University of British Columbia, Vancouver, British Columbia, Canada;4. Sanofi Pasteur, Swiftwater, PA, USA;5. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada;7. Mount Sinai Hospital, Toronto, Ontario, Canada;8. GSK, Wavre, Belgium;9. GSK, Mississauga, Ontario, Canada;10. McMaster University, Hamilton, Ontario, Canada;11. North York General Hospital, Toronto, Ontario, Canada;12. St. Boniface Hospital, Winnipeg, Manitoba, Canada;13. The Ottawa Hospital, Ottawa, Ontario, Canada;14. Health Sciences North Research Institute, Sudbury, Ontario, Canada;15. Centre Intégré Universitaire de santé et services sociaux, Quebec, Quebec, Canada;p. Michael Garron Hospital, Toronto, Ontario, Canada;q. William Osler Health System, Brampton, Ontario, Canada;r. GSK, Rockville, MD, USA;s. McGill University, Montreal, Québec, Canada;t. GSK, King of Prussia, PA, USA;u. University of Alberta Hospital, Edmonton, Alberta, Canada;v. The Moncton Hospital, Moncton, New Brunswick, Canada;w. Université de Sherbrooke, Sherbrooke, Québec, Canada;x. Horizon Health, Saint John, New Brunswick, Canada;1. Instituto de Salud Pública de Navarra, IdiSNA–Navarra Institute for Health Research, Pamplona, Spain;2. CIBER Epidemiología y Salud Pública (CIBERESP), Spain;3. Complejo Hospitalario de Navarra, IdiSNA–Navarra Institute for Health Research, Pamplona, Spain;4. Clínica Universidad de Navarra, IdiSNA–Navarra Institute for Health Research, Pamplona, Spain;5. Centro Nacional de Microbiología (WHO National Influenza Centre–Madrid), Instituto de Salud Carlos III, Majadahonda, Spain;1. Department of Virus and Microbiological Special diagnostics, National Influenza Center, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;2. Department of Infectious Diseases and Centre for Global Health, Clinical Institute, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark;3. Department of Infectious Disease Epidemiology & Prevention, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;4. Department of Clinical Microbiology, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark;5. Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 18, 4200 Slagelse, Denmark;6. Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark;7. Department of Clinical Microbiology, Vejle Sygehus, Beriderbakken 4, 7100 Vejle, Denmark;8. Department of Clinical Microbiology, Odense University Hospital, Søndre Blvd. 29, 5000 Odense C, Denmark;9. Department of Clinical Microbiology, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark;1. Department of Epidemiological Surveillance and Intervention, Hellenic Centre for Disease Control and Prevention, Athens, Greece;2. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain;3. Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain;4. National Influenza Reference Laboratory for Southern Greece, Hellenic Pasteur Institute, Athens, Greece;5. National Influenza Reference Laboratory for Northern Greece, Medical School, Aristotle University of Thessaloniki, Greece;1. Immunization Program, Oregon Public Health Division, USA;2. Acute and Communicable Disease Program, Oregon Public Health Division, USA;1. Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan;2. Department of Pediatrics, Keiyu Hospital, Yokohama, Kanagawa, Japan;3. Institute of Clinical Research Department of Infection & Allergy, National Hospital Organization Tochigi Medical Center, Utsunomiya, Tochigi, Japan;4. Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan;5. Department of Pediatrics, National Hospital Organization Saitama National Hospital, Wako, Saitama, Japan;6. Department of Pediatrics, Ota Memorial Hospital, Ota, Gunma, Japan;7. Department of Pediatrics, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan;8. Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, Ashikaga, Tochigi, Japan;9. Division of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan;10. Department of Pediatrics, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochgi, Japan;11. Department of Pediatrics, Nippon Kokan Hospital, Kawasaki, Kanagawa, Japan;12. Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, Japan;13. Department of Pediatrics, Shizuoka City Shimizu Hospital, Shizuoka, Japan;14. Department of Pediatrics, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan;15. Department of Pediatrics, Eiju General Hospital, Tokyo, Japan;1. National Centre of Epidemiology, Institute of Health Carlos III, c/Monforte de Lemos no.5, 28029 Madrid, Spain;2. CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain;3. Institute of Health Carlos III, National Centre for Microbiology, National Influenza Centre, 28220 Majadahonda, Madrid, Spain |
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| Abstract: | BackgroundOngoing assessment of influenza vaccine effectiveness (VE) is critical to inform public health policy. This study aimed to determine the VE of trivalent influenza vaccine (TIV) for preventing influenza-related hospitalizations and other serious outcomes over three consecutive influenza seasons.MethodsThe Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN) conducted active surveillance for influenza in adults ≥16 years (y) of age during the 2011/2012, 2012/2013 and 2013/2014 seasons in hospitals across Canada. A test-negative design was employed: cases were polymerase chain reaction (PCR)-positive for influenza; controls were PCR-negative for influenza and were matched to cases by date, admission site, and age (≥65 y or <65 y). All cases and controls had demographic and clinical characteristics (including influenza immunization status) obtained from the medical record. VE was estimated as 1-OR (odds ratio) in vaccinated vs. unvaccinated patients × 100%. The primary outcome was VE of TIV for preventing laboratory-confirmed influenza-related hospitalization; secondary outcomes included VE of TIV for preventing influenza-related intensive care unit (ICU) admission/mechanical ventilation, and influenza-related death.ResultsOverall, 3394 cases and 4560 controls were enrolled; 2078 (61.2%) cases and 2939 (64.5%) controls were ≥65 y. Overall matched, adjusted VE was 41.7% (95% Confidence Interval (CI): 34.4–48.3%); corresponding VE in adults ≥65 y was 39.3% (95% CI: 29.4–47.8%) and 48.0% (95% CI: 37.5–56.7%) in adults <65 y, respectively. VE for preventing influenza-related ICU admission/mechanical ventilation in all ages was 54.1% (95% CI: 39.8–65.0%); in adults ≥65 y, VE for preventing influenza-related death was 74.5% (95% CI: 44.0–88.4%).ConclusionsWhile effectiveness of TIV to prevent serious outcomes varies year to year, we demonstrate a statistically significant and clinically important TIV VE for preventing hospitalization and other serious outcomes over three seasons. Public health messaging should highlight the overall benefit of influenza vaccines over time while acknowledging year to year variability.ClinicalTrials.gov Identifier: NCT01517191. |
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