Effectiveness of repeated influenza vaccination among the elderly population with high annual vaccine uptake rates during the three consecutive A/H3N2 epidemics |
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| Institution: | 1. Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea;2. Asian Pacific Influenza Institute (APII), Seoul, South Korea;3. Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea;4. Division of Infectious Diseases, Department of Internal Medicine, Catholic University Medical College, St. Vincent’s Hospital, Suwon, South Korea;5. Division of Infectious Diseases, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, South Korea;6. Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea;7. Division of Infectious Diseases, Chungbuk National University College of Medicine, Cheongju, South Korea;8. Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea;9. Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine, Pusan, South Korea;10. Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea;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. Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain;2. CIBER Epidemiología y Salud Pública (CIBERESP), Spain;3. Complejo Hospitalario de Navarra – IdiSNA, Pamplona, Spain;4. 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. Public Health England, London, UK;2. Public Health England, Bristol, UK;1. Department of Family Medicine, Myongji Hospital, Seonam University, College of Medicine, Gyeonggi-do, Republic of Korea;2. Department of Epidemiology and Health Promotion and Institute for Health Promotion, Graduate School of Public Health, Yonsei University, 03722 Seoul, Republic of Korea;3. Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea;4. Department of Family Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea;5. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Medical Center, Seoul, Republic of Korea |
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| Abstract: | BackgroundAnnually, about 80% of the Korean elderly aged ≥65 years receive influenza vaccination. Repeated annual vaccination has been suggested as an important factor of poor influenza vaccine effectiveness (VE), though reported conflicting results.MethodsDuring the consecutive A/H3N2-dominant influenza seasons between 2012 and 2015, we comparatively evaluated the VE (repeated vs. current season only) against laboratory-confirmed influenza, pneumonia and hospitalization in the elderly aged ≥65 years with influenza-like illness (ILI). Clinical and demographic data were collected prospectively, and vaccination status of prior and current seasons was verified using the immunization registry data of Korean Centers for Disease Control and Prevention.ResultsDuring the first A/H3N2-dominant season in 2012–2013, influenza vaccine showed statistically significant effectiveness against influenza A infection only and when vaccinated in the current season only (VE 53%, 95% CI 15–77). In the latter two seasons (2013–2015 years), the adjusted VE for influenza A was indistinguishable between repeated vaccination and vaccination in the current season only.ConclusionDuring consecutive influenza A/H3N2 epidemics, poor influenza vaccine effectiveness may be more pronounced among the elderly population with a high annual vaccine uptake rate. |
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| Keywords: | Influenza Vaccination Effectiveness Antigenic determinants Pneumonia Hospitalization |
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