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; Samantha J Shepherd; Jim McMenamin; Simon de Lusignan; Maria Zambon

doi: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

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 SartajSamantha J Shepherd, Jim McMenamin, Simon de Lusignan, Maria Zambon

^*Corresponding author for this work

Mathematics And Statistics

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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.

Original language	English
Article number	1800488
Number of pages	17
Journal	Eurosurveillance
Volume	24
Issue number	31
DOIs	https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488
Publication status	Published - 1 Aug 2019

Funding

SL has received university funding for studies of post vaccination adverse events of interest from GSK, and for attitudes to vaccination from Seqirus; and has been a member of Seqirus and Sanofi advisory boards. MD received lecturing fee from Sanofi Pasteur MSD; SpeeDx provided partial financial support for an educational meeting and UK Clinical Virology Network (UK CVN) which he chairs is a registered charity which includes a number of commercial partners. CM has received funding as an advisory board member of Seqirus. No other co-authors had conflicts to declare.

Keywords

influenza vaccine
vaccine effectiveness
United Kingdom

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Pebody, R., Djennad, A., Ellis, J., Andrews, N., Marques, D. F. P., Cottrell, S., Reynolds, A. J., 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., ... Zambon, M. (2019). End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18. Eurosurveillance, 24(31), Article 1800488. https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488

@article{9596758c827b4ebea9be62c4ec4a3c67,

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

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.",

keywords = "influenza vaccine, vaccine effectiveness, United Kingdom",

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

year = "2019",

month = aug,

day = "1",

doi = "10.2807/1560-7917.ES.2019.24.31.1800488",

language = "English",

volume = "24",

journal = "Eurosurveillance",

issn = "1025-496X",

number = "31",

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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

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

UR - https://www.scopus.com/pages/publications/85070807896

U2 - 10.2807/1560-7917.ES.2019.24.31.1800488

DO - 10.2807/1560-7917.ES.2019.24.31.1800488

M3 - Article

C2 - 31387673

AN - SCOPUS:85070807896

SN - 1025-496X

VL - 24

JO - Eurosurveillance

JF - Eurosurveillance

IS - 31

M1 - 1800488

ER -

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

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