[Source: The Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]
Beyond antigenic match: possible agent-host and immuno-epidemiological influences on influenza vaccine effectiveness during the 2015–16 season in Canada
Danuta M Skowronski, Catharine Chambers, Suzana Sabaiduc, Gaston De Serres, Anne-Luise Winter, James A Dickinson, Jonathan B Gubbay, Steven J Drews, Christine Martineau, Hugues Charest, Mel Krajden, Nathalie Bastien, Yan Li Yan Li
The Journal of Infectious Diseases, jix526, https://doi.org/10.1093/infdis/jix526
Published: 04 October 2017 – Received: 07 June 2017
Citation: Danuta M Skowronski, Catharine Chambers, Suzana Sabaiduc, Gaston De Serres, Anne-Luise Winter, James A Dickinson, Jonathan B Gubbay, Steven J Drews, Christine Martineau, Hugues Charest, Mel Krajden, Nathalie Bastien, Yan Li; Beyond antigenic match: possible agent-host and immuno-epidemiological influences on influenza vaccine effectiveness during the 2015–16 season in Canada, The Journal of Infectious Diseases, , jix526, https://doi.org/10.1093/infdis/jix526
© 2017 Oxford University Press
Vaccine effectiveness (VE) estimates are reported from Canada’s Sentinel Practitioner Surveillance Network (SPSN) for the 2015–16 influenza season, characterized by a delayed A(H1N1)pdm09 epidemic and concurrent B(Victoria) activity. Potential influences beyond antigenic match are explored including viral genomic variation, birth cohort effects, prior vaccination and epidemic period.
VE was estimated by test-negative design comparing adjusted-odds ratio for influenza test-positivity among vaccinated vs. unvaccinated participants. Vaccine-virus relatedness was assessed by gene-sequencing and hemagglutination-inhibition assay.
Analyses included 596 influenza A(H1N1)pdm09 and 305 B(Victoria) cases compared to 926 test-negative controls. A(H1N1)pdm09 viruses were considered antigenically-related to vaccine (unchanged since 2009) despite phylogenetic clustering within emerging clade-6B.1. Adjusted-VE for A(H1N1)pdm09 was 43%(95%CI=25–57%), lower in adults born 1957–1976 (25%;95%CI=-16–51%); in those consecutively vaccinated both current and prior season (41%;95%CI=18–57%) vs. current season only (75%;95%CI=45–88%); and among participants presenting in March-April (19%;95%CI=-15–44%) vs. January-February 2016 (62%;95%CI=44–75%). VE for B(Victoria) viruses was 54%(95%CI=32–68%) despite lineage-level mismatch to B(Yamagata) vaccine and without further variation as observed for A(H1N1)pdm09.
Influenza VE findings may require consideration of other agent-host and immuno-epidemiologic influences on vaccine performance beyond antigenic match, including viral genomic variation, birth (immunological) cohort and repeat vaccination effects, and potential within-season waning of vaccine protection.
influenza, influenza vaccine, vaccine effectiveness, influenza A subtype, influenza B lineage, sequencing, hemagglutination inhibition, cohort effects, original antigenic sin, repeat vaccination
Topic: influenza – adult – canada – cohort effect – genes – genome – hemagglutination inhibition tests – influenza virus vaccine – vaccination – vaccines – influenzavirus a
viruses – epidemic – surveillance, medical – influenza a virus, h1n1 subtype – swine influenza – swine-origin influenza virus – host (organism) – mismatch
Issue Section: Major Article
© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact firstname.lastname@example.org
Keywords: Seasonal Influenza; H1N1pdm09; H3N2; B; Vaccines; Canada.