Effectiveness of Influenza Vaccines in the HIVE Household Cohort Over 8 Years: Is There Evidence of Indirect Protection?
| Autor: | Amy P Callear, Joshua G. Petrie, Ryan E. Malosh, Emily T. Martin, Richard Evans, Caroline Cheng, Mark S. Thompson, Rachel Truscon, Arnold S. Monto, Emileigh Johnson, Latifa Bazzi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
0301 basic medicine Microbiology (medical) Influenza vaccine 030106 microbiology Rate ratio Virus 03 medical and health sciences symbols.namesake Influenza A Virus H1N1 Subtype 0302 clinical medicine Influenza Human cohort study Humans Medicine 030212 general & internal medicine Poisson regression Child vaccine effectiveness business.industry Influenza A Virus H3N2 Subtype Incidence (epidemiology) Confounding Vaccination indirect protection Major Articles and Commentaries AcademicSubjects/MED00290 Infectious Diseases Influenza Vaccines Child Preschool Vaccination coverage Cohort symbols Seasons influenza business Demography Cohort study |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciab395 |
| Popis: | Background The evidence that influenza vaccination programs regularly provide protection to unvaccinated individuals (ie, indirect effects) of a community is lacking. We sought to determine the direct, indirect, and total effects of influenza vaccine in the Household Influenza Vaccine Evaluation (HIVE) cohort. Methods Using longitudinal data from the HIVE cohort from 2010–11 through 2017–18, we estimated direct, indirect, and total influenza vaccine effectiveness (VE) and the incidence rate ratio of influenza virus infection using adjusted mixed-effect Poisson regression models. Total effectiveness was determined through comparison of vaccinated members of full or partially vaccinated households to unvaccinated individuals in completely unvaccinated households. Results The pooled, direct VE against any influenza was 30.2% (14.0–43.4). Direct VE was higher for influenza A/H1N1 43.9% (3.9 to 63.5) and B 46.7% (17.2 to 57.5) than A/H3N2 31.7% (10.5 to 47.8) and was higher for young children 42.4% (10.1 to 63.0) than adults 18.6% (−6.3 to 37.7). Influenza incidence was highest in completely unvaccinated households (10.6 per 100 person-seasons) and lower at all other levels of household vaccination coverage. We found little evidence of indirect VE after adjusting for potential confounders. Total VE was 56.4% (30.1–72.9) in low coverage, 43.2% (19.5–59.9) in moderate coverage, and 33.0% (12.1 to 49.0) in fully vaccinated households. Conclusions Influenza vaccines may have a benefit above and beyond the direct effect but that effect in this study was small. Although there may be exceptions, the goal of global vaccine recommendations should remain focused on provision of documented, direct protection to those vaccinated. We estimate direct, indirect, and total influenza vaccine effectiveness in a household cohort study over 8 seasons. In this population we found consistent, moderate direct protection of mild influenza illness by vaccination but we found little evidence of indirect protection. |
| Databáze: | OpenAIRE |
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