Effectiveness of seasonal influenza vaccine in Australia, 2015: An epidemiological,antigenic and phylogenetic assessment |
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| Institution: | 1. Victorian Infectious Diseases Reference Laboratory, The Doherty Institute, Melbourne, Victoria, Australia;2. National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia;3. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia;4. PathWest Laboratory Medicine WA, Perth, Western Australia, Australia;5. School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia;6. Discipline of General Practice, University of Adelaide, Adelaide, South Australia, Australia;7. World Health Organization Collaborating Centre for Reference and Research on Influenza, The Doherty Institute, Melbourne, Victoria, Australia;8. Communicable Disease Control Directorate, Western Australia Department of Health, Perth, Western Australia, Australia;9. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA;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. Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China;2. Beijing Center for Disease Prevention and Control, Beijing, China;3. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region;4. Foundation for the Promotion of Health and Biomedical Research in the Valencia Region FISABIO – Public Health, Valencia, 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. Istituto Superiore di Sanità, Rome, Italy;2. Dipartimento Scienze biomediche ed oncologia umana, Università degli Studi di Bari Aldo Moro, Bari, Italy;3. Dipartimento di Scienze biomediche per la salute, Università degli Studi di Milano, Milan, Italy;4. Governo della Prevenzione e tutela sanitaria, Regione Lombardia, Milan, Italy;5. SeREMI ASL AL, Servizio Riferimento Regionale, Epidemiologia Malattie Infettive, Alessandria, Italy;6. Ospedale “Amedeo di Savoia”- Torino, Italy;7. Servizio Sanità pubblica, D. G. Sanità e Politiche sociali, Regione Emilia-Romagna, Bologna, Italy;8. Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Università degli Studi di Parma, Italy;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;1. National Centre of Epidemiology, Institute of Health Carlos III, Spain;2. National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Spain;3. CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Spain;4. Subdirección de Salud Pública y Adicciones de Bizkaia, Pais Vasco, Spain;5. Instituto de Salud Pública, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain;6. Dirección General de Salud Pública, Consejería de Sanidad de Castilla y León, Valladolid, Spain;7. Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública y Consumo de La Rioja, La Rioja, Spain;8. Servicio de Epidemiología, Dirección General de Salut Pública, Mallorca, Baleares, Spain;9. Servicio de Epidemiología. DGSC, Consejería de Bienestar Social y Sanidad, Ciudad Autónoma de Melilla, Spain |
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| Abstract: | BackgroundA record number of laboratory-confirmed influenza cases were notified in Australia in 2015, during which type A(H3) and type B Victoria and Yamagata lineages co-circulated. We estimated effectiveness of the 2015 inactivated seasonal influenza vaccine against specific virus lineages and clades.MethodsThree sentinel general practitioner networks conduct surveillance for laboratory-confirmed influenza amongst patients presenting with influenza-like illness in Australia. Data from the networks were pooled to estimate vaccine effectiveness (VE) for seasonal trivalent influenza vaccine in Australia in 2015 using the case test-negative study design.ResultsThere were 2443 eligible patients included in the study, of which 857 (35%) were influenza-positive. Thirty-three and 19% of controls and cases respectively were reported as vaccinated. Adjusted VE against all influenza was 54% (95% CI: 42, 63). Antigenic characterisation data suggested good match between vaccine and circulating strains of A(H3); however VE for A(H3) was low at 44% (95% CI: 21, 60). Phylogenetic analysis indicated most circulating viruses were from clade 3C.2a, rather than the clade included in the vaccine (3C.3a). VE point estimates were higher against B/Yamagata lineage influenza (71%; 95% CI: 57, 80) than B/Victoria (42%, 95% CI: 13, 61), and in younger people.ConclusionsOverall seasonal vaccine was protective against influenza infection in Australia in 2015. Higher VE against the B/Yamagata lineage included in the trivalent vaccine suggests that more widespread use of quadrivalent vaccine could have improved overall effectiveness of influenza vaccine. Genetic characterisation suggested lower VE against A(H3) influenza was due to clade mismatch of vaccine and circulating viruses. |
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| Keywords: | Influenza Influenza-like illness Vaccines and immunisation Surveillance Vaccine effectiveness |
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