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- Title
Low Influenza Vaccine Effectiveness Against A(H3N2)-Associated Hospitalizations in 2016-2017 and 2017-2018 of the Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN).
- Authors
Martin, Emily T; Cheng, Caroline; Petrie, Joshua G; Alyanak, Elif; Gaglani, Manjusha; Middleton, Donald B; Ghamande, Shekhar; Silveira, Fernanda P; Murthy, Kempapura; Zimmerman, Richard K; Monto, Arnold S; Trabue, Christopher; Talbot, H Keipp; Ferdinands, Jill M; Investigators, HAIVEN Study; HAIVEN Study Investigators
- Abstract
<bold>Background: </bold>The 2016-2017 and 2017-2018 influenza seasons were notable for the high number of hospitalizations for influenza A(H3N2) despite vaccine and circulating strain match.<bold>Methods: </bold>We evaluated vaccine effectiveness (VE) against hospitalization in the test-negative HAIVEN study. Nasal-throat swabs were tested by quantitative reverse transcription polymerase chain reaction (RT-PCR) for influenza and VE was determined based on odds of vaccination by generalized estimating equations. Vaccine-specific antibody was measured in a subset of enrollees.<bold>Results: </bold>A total of 6129 adults were enrolled from 10 hospitals. Adjusted VE against A(H3N2) was 22.8% (95% confidence interval [CI], 8.3% to 35.0%), pooled across both years and 49.4% (95% CI, 34.3% to 61.1%) against B/Yamagata. In 2017-2018, the A(H3N2) VE point estimate for the cell-based vaccine was 43.0% (95% CI, -36.3% to 76.1%; 56 vaccine recipients) compared to 24.0% (95% CI, 3.9% to 39.9%) for egg-based vaccines. Among 643 with serology data, hemagglutinin antibodies against the egg-based A(H3N2) vaccine strain were increased in influenza-negative individuals.<bold>Conclusions: </bold>Low VE for the A/Hong Kong/4801/2014 vaccine virus in both A(H3N2) seasons emphasizes concerns for continued changes in H3N2 antigenic epitopes, including changes that may impact glycosylation and ultimately reduce VE.
- Subjects
HONG Kong (China); FLU vaccine efficacy; REVERSE transcriptase polymerase chain reaction; VACCINE effectiveness; GENERALIZED estimating equations; HOSPITAL care
- Publication
Journal of Infectious Diseases, 2021, Vol 223, Issue 12, p2062
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiaa685