End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18

Richard Pebody, Abdelmajid Djennad, Joanna Ellis, Nick Andrews, Diogo F P Marques, Simon Cottrell, Arlene J Reynolds, Rory Gunson, Monica Galiano, Katja Hoschler, Angie Lackenby, Chris Robertson, Mark O'Doherty, Mary Sinnathamby, Nikolaos Panagiotopoulos, Ivelina Yonova, Rebecca Webb, Catherine Moore, Matthew Donati, Muhammad Sartaj & 4 others Samantha J Shepherd, Jim McMenamin, Simon de Lusignan, Maria Zambon

Research output: Contribution to journalArticle

Abstract

Background: In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV). Aim: To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue. Methods: This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples. Results: Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15% (95% confidence interval (CI): −6.3 to 32) against all influenza; −16.4% (95% CI: −59.3 to 14.9) against A(H3N2); 24.7% (95% CI: 1.1 to 42.7) against B and 66.3% (95% CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9% (95% CI: −32.6 to 59.7) against all influenza; −75.5% (95% CI: −289.6 to 21) against A(H3N2); 60.8% (95% CI: 8.2 to 83.3) against B and 90.3% (95% CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9% (95% CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds. Conclusions: Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.

LanguageEnglish
Article number1800488
Number of pages17
JournalEurosurveillance
Volume24
Issue number31
DOIs
Publication statusPublished - 1 Aug 2019

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Influenza Vaccines
Confidence Intervals
Vaccines
Human Influenza
Inactivated Vaccines
Seroepidemiologic Studies
Ovum
H3N2 Subtype Influenza A Virus
Viruses
Cercopithecine Herpesvirus 1
United Kingdom
Viral Structures
Attenuated Vaccines
Antibodies
Influenza A virus
Orthomyxoviridae
England
Eggs
Observational Studies
Primary Health Care

Keywords

  • influenza vaccine
  • vaccine effectiveness
  • United Kingdom

Cite this

Pebody, R., Djennad, A., Ellis, J., Andrews, N., Marques, D. F. P., Cottrell, S., ... Zambon, M. (2019). End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18. Eurosurveillance, 24(31), [1800488]. https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488
Pebody, Richard ; Djennad, Abdelmajid ; Ellis, Joanna ; Andrews, Nick ; Marques, Diogo F P ; Cottrell, Simon ; Reynolds, Arlene J ; Gunson, Rory ; Galiano, Monica ; Hoschler, Katja ; Lackenby, Angie ; Robertson, Chris ; O'Doherty, Mark ; Sinnathamby, Mary ; Panagiotopoulos, Nikolaos ; Yonova, Ivelina ; Webb, Rebecca ; Moore, Catherine ; Donati, Matthew ; Sartaj, Muhammad ; Shepherd, Samantha J ; McMenamin, Jim ; de Lusignan, Simon ; Zambon, Maria. / End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18. In: Eurosurveillance. 2019 ; Vol. 24, No. 31.
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abstract = "Background: In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV). Aim: To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue. Methods: This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples. Results: Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15{\%} (95{\%} confidence interval (CI): −6.3 to 32) against all influenza; −16.4{\%} (95{\%} CI: −59.3 to 14.9) against A(H3N2); 24.7{\%} (95{\%} CI: 1.1 to 42.7) against B and 66.3{\%} (95{\%} CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9{\%} (95{\%} CI: −32.6 to 59.7) against all influenza; −75.5{\%} (95{\%} CI: −289.6 to 21) against A(H3N2); 60.8{\%} (95{\%} CI: 8.2 to 83.3) against B and 90.3{\%} (95{\%} CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9{\%} (95{\%} CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds. Conclusions: Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.",
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Pebody, R, Djennad, A, Ellis, J, Andrews, N, Marques, DFP, Cottrell, S, Reynolds, AJ, Gunson, R, Galiano, M, Hoschler, K, Lackenby, A, Robertson, C, O'Doherty, M, Sinnathamby, M, Panagiotopoulos, N, Yonova, I, Webb, R, Moore, C, Donati, M, Sartaj, M, Shepherd, SJ, McMenamin, J, de Lusignan, S & Zambon, M 2019, 'End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18' Eurosurveillance, vol. 24, no. 31, 1800488. https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488

End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18. / Pebody, Richard; Djennad, Abdelmajid; Ellis, Joanna; Andrews, Nick; Marques, Diogo F P; Cottrell, Simon; Reynolds, Arlene J; Gunson, Rory; Galiano, Monica; Hoschler, Katja; Lackenby, Angie; Robertson, Chris; O'Doherty, Mark; Sinnathamby, Mary; Panagiotopoulos, Nikolaos; Yonova, Ivelina; Webb, Rebecca; Moore, Catherine; Donati, Matthew; Sartaj, Muhammad; Shepherd, Samantha J; McMenamin, Jim; de Lusignan, Simon; Zambon, Maria.

In: Eurosurveillance, Vol. 24, No. 31, 1800488, 01.08.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18

AU - Pebody, Richard

AU - Djennad, Abdelmajid

AU - Ellis, Joanna

AU - Andrews, Nick

AU - Marques, Diogo F P

AU - Cottrell, Simon

AU - Reynolds, Arlene J

AU - Gunson, Rory

AU - Galiano, Monica

AU - Hoschler, Katja

AU - Lackenby, Angie

AU - Robertson, Chris

AU - O'Doherty, Mark

AU - Sinnathamby, Mary

AU - Panagiotopoulos, Nikolaos

AU - Yonova, Ivelina

AU - Webb, Rebecca

AU - Moore, Catherine

AU - Donati, Matthew

AU - Sartaj, Muhammad

AU - Shepherd, Samantha J

AU - McMenamin, Jim

AU - de Lusignan, Simon

AU - Zambon, Maria

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Background: In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV). Aim: To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue. Methods: This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples. Results: Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15% (95% confidence interval (CI): −6.3 to 32) against all influenza; −16.4% (95% CI: −59.3 to 14.9) against A(H3N2); 24.7% (95% CI: 1.1 to 42.7) against B and 66.3% (95% CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9% (95% CI: −32.6 to 59.7) against all influenza; −75.5% (95% CI: −289.6 to 21) against A(H3N2); 60.8% (95% CI: 8.2 to 83.3) against B and 90.3% (95% CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9% (95% CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds. Conclusions: Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.

AB - Background: In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV). Aim: To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue. Methods: This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples. Results: Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15% (95% confidence interval (CI): −6.3 to 32) against all influenza; −16.4% (95% CI: −59.3 to 14.9) against A(H3N2); 24.7% (95% CI: 1.1 to 42.7) against B and 66.3% (95% CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9% (95% CI: −32.6 to 59.7) against all influenza; −75.5% (95% CI: −289.6 to 21) against A(H3N2); 60.8% (95% CI: 8.2 to 83.3) against B and 90.3% (95% CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9% (95% CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds. Conclusions: Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.

KW - influenza vaccine

KW - vaccine effectiveness

KW - United Kingdom

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U2 - 10.2807/1560-7917.ES.2019.24.31.1800488

DO - 10.2807/1560-7917.ES.2019.24.31.1800488

M3 - Article

VL - 24

JO - Eurosurveillance

T2 - Eurosurveillance

JF - Eurosurveillance

SN - 1560-7917

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