End of season influenza vaccine effectiveness in primary care in adults and children in the United Kingdom in 2018/19

Richard G. Pebody; Heather Whitaker; Joanna Ellis; Nick Andrews; Diogo F.P. Marques; Simon Cottrell; Arlene J. Reynolds; Rory Gunson; Catherine Thompson; Monica Galiano; Angie Lackenby; Chris Robertson; Mark G. O'Doherty; Katie Owens; Ivelina Yonova; Samantha J. Shepherd; Catherine Moore; Jillian Johnston; Matthew Donati; Jim McMenamin; Simon de Lusignan; Maria Zambon

doi:10.1016/j.vaccine.2019.10.071

End of season influenza vaccine effectiveness in primary care in adults and children in the United Kingdom in 2018/19

Richard G. Pebody^*, Heather Whitaker, Joanna Ellis, Nick Andrews, Diogo F.P. Marques, Simon Cottrell, Arlene J. Reynolds, Rory Gunson, Catherine Thompson, Monica Galiano, Angie Lackenby, Chris Robertson, Mark G. O'Doherty, Katie Owens, Ivelina Yonova, Samantha J. Shepherd, Catherine Moore, Jillian Johnston, Matthew Donati, Jim McMenaminSimon de Lusignan, Maria Zambon

^*Corresponding author for this work

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Abstract

2018/19 was the first season of introduction of a newly licensed adjuvanted influenza vaccine (aTIV) for adults aged 65 years and over and the sixth season in the roll-out of a childhood influenza vaccination programme with a quadrivalent live attenuated influenza vaccine (LAIV). The season saw mainly A(H1N1)pdm09 and latterly A(H3N2) circulation. End-of-season adjusted vaccine effectiveness (aVE) estimates against laboratory confirmed influenza infection in primary care were calculated using the test negative case control method adjusting for key confounders. End-of-season aVE was 44.3% (95% CI: 26.8, 57.7) against all laboratory-confirmed influenza; 45.7% (95% CI: 26.0, 60.1) against influenza A(H1N1)pdm09 and 35.1% (95% CI: −3.7,59.3) against A(H3N2). Overall aVE was 49.9% (95%CI: −13.7, 77.9) for all those ≥ 65 years of age and 62.0% (95% CI: 3.4, 85.0) for those who received aTIV. Overall aVE for 2–17 year olds receiving LAIV was 48.6% (95% CI: −4.4, 74.7). The paper provides evidence of overall significant influenza VE in 2018/19, most notably against influenza A(H1N1)pdm09, however, as seen in 2017/18, there was reduced, non-significant VE against A(H3N2). aTIV provided significant protection for those 65 years of age and over.

Original language	English
Number of pages	9
Journal	Vaccine
Early online date	1 Nov 2019
DOIs	https://doi.org/10.1016/j.vaccine.2019.10.071
Publication status	E-pub ahead of print - 1 Nov 2019

Funding

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: SdeL 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

effectiveness
influenza
primary care
vaccine

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10.1016/j.vaccine.2019.10.071

Pebody-etal-Vaccine-2019-End-of-season-influenza-vaccine-effectiveness-in-primary-careAccepted author manuscript, 844 KBLicence: CC BY-NC-ND 4.0

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Pebody, R. G., Whitaker, H., Ellis, J., Andrews, N., Marques, D. F. P., Cottrell, S., Reynolds, A. J., Gunson, R., Thompson, C., Galiano, M., Lackenby, A., Robertson, C., O'Doherty, M. G., Owens, K., Yonova, I., Shepherd, S. J., Moore, C., Johnston, J., Donati, M., ... Zambon, M. (2019). End of season influenza vaccine effectiveness in primary care in adults and children in the United Kingdom in 2018/19. Vaccine. Advance online publication. https://doi.org/10.1016/j.vaccine.2019.10.071

@article{61286183682d4ff196c44b7f76ffca1e,

title = "End of season influenza vaccine effectiveness in primary care in adults and children in the United Kingdom in 2018/19",

abstract = "2018/19 was the first season of introduction of a newly licensed adjuvanted influenza vaccine (aTIV) for adults aged 65 years and over and the sixth season in the roll-out of a childhood influenza vaccination programme with a quadrivalent live attenuated influenza vaccine (LAIV). The season saw mainly A(H1N1)pdm09 and latterly A(H3N2) circulation. End-of-season adjusted vaccine effectiveness (aVE) estimates against laboratory confirmed influenza infection in primary care were calculated using the test negative case control method adjusting for key confounders. End-of-season aVE was 44.3\% (95\% CI: 26.8, 57.7) against all laboratory-confirmed influenza; 45.7\% (95\% CI: 26.0, 60.1) against influenza A(H1N1)pdm09 and 35.1\% (95\% CI: −3.7,59.3) against A(H3N2). Overall aVE was 49.9\% (95\%CI: −13.7, 77.9) for all those ≥ 65 years of age and 62.0\% (95\% CI: 3.4, 85.0) for those who received aTIV. Overall aVE for 2–17 year olds receiving LAIV was 48.6\% (95\% CI: −4.4, 74.7). The paper provides evidence of overall significant influenza VE in 2018/19, most notably against influenza A(H1N1)pdm09, however, as seen in 2017/18, there was reduced, non-significant VE against A(H3N2). aTIV provided significant protection for those 65 years of age and over.",

keywords = "effectiveness, influenza, primary care, vaccine",

author = "Pebody, \{Richard G.\} and Heather Whitaker and Joanna Ellis and Nick Andrews and Marques, \{Diogo F.P.\} and Simon Cottrell and Reynolds, \{Arlene J.\} and Rory Gunson and Catherine Thompson and Monica Galiano and Angie Lackenby and Chris Robertson and O'Doherty, \{Mark G.\} and Katie Owens and Ivelina Yonova and Shepherd, \{Samantha J.\} and Catherine Moore and Jillian Johnston and Matthew Donati and Jim McMenamin and Lusignan, \{Simon de\} and Maria Zambon",

year = "2019",

month = nov,

day = "1",

doi = "10.1016/j.vaccine.2019.10.071",

language = "English",

journal = "Vaccine",

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Pebody, RG, Whitaker, H, Ellis, J, Andrews, N, Marques, DFP, Cottrell, S, Reynolds, AJ, Gunson, R, Thompson, C, Galiano, M, Lackenby, A, Robertson, C, O'Doherty, MG, Owens, K, Yonova, I, Shepherd, SJ, Moore, C, Johnston, J, Donati, M, McMenamin, J, Lusignan, SD & Zambon, M 2019, 'End of season influenza vaccine effectiveness in primary care in adults and children in the United Kingdom in 2018/19', Vaccine. https://doi.org/10.1016/j.vaccine.2019.10.071

TY - JOUR

T1 - End of season influenza vaccine effectiveness in primary care in adults and children in the United Kingdom in 2018/19

AU - Pebody, Richard G.

AU - Whitaker, Heather

AU - Ellis, Joanna

AU - Andrews, Nick

AU - Marques, Diogo F.P.

AU - Cottrell, Simon

AU - Reynolds, Arlene J.

AU - Gunson, Rory

AU - Thompson, Catherine

AU - Galiano, Monica

AU - Lackenby, Angie

AU - Robertson, Chris

AU - O'Doherty, Mark G.

AU - Owens, Katie

AU - Yonova, Ivelina

AU - Shepherd, Samantha J.

AU - Moore, Catherine

AU - Johnston, Jillian

AU - Donati, Matthew

AU - McMenamin, Jim

AU - Lusignan, Simon de

AU - Zambon, Maria

PY - 2019/11/1

Y1 - 2019/11/1

N2 - 2018/19 was the first season of introduction of a newly licensed adjuvanted influenza vaccine (aTIV) for adults aged 65 years and over and the sixth season in the roll-out of a childhood influenza vaccination programme with a quadrivalent live attenuated influenza vaccine (LAIV). The season saw mainly A(H1N1)pdm09 and latterly A(H3N2) circulation. End-of-season adjusted vaccine effectiveness (aVE) estimates against laboratory confirmed influenza infection in primary care were calculated using the test negative case control method adjusting for key confounders. End-of-season aVE was 44.3% (95% CI: 26.8, 57.7) against all laboratory-confirmed influenza; 45.7% (95% CI: 26.0, 60.1) against influenza A(H1N1)pdm09 and 35.1% (95% CI: −3.7,59.3) against A(H3N2). Overall aVE was 49.9% (95%CI: −13.7, 77.9) for all those ≥ 65 years of age and 62.0% (95% CI: 3.4, 85.0) for those who received aTIV. Overall aVE for 2–17 year olds receiving LAIV was 48.6% (95% CI: −4.4, 74.7). The paper provides evidence of overall significant influenza VE in 2018/19, most notably against influenza A(H1N1)pdm09, however, as seen in 2017/18, there was reduced, non-significant VE against A(H3N2). aTIV provided significant protection for those 65 years of age and over.

AB - 2018/19 was the first season of introduction of a newly licensed adjuvanted influenza vaccine (aTIV) for adults aged 65 years and over and the sixth season in the roll-out of a childhood influenza vaccination programme with a quadrivalent live attenuated influenza vaccine (LAIV). The season saw mainly A(H1N1)pdm09 and latterly A(H3N2) circulation. End-of-season adjusted vaccine effectiveness (aVE) estimates against laboratory confirmed influenza infection in primary care were calculated using the test negative case control method adjusting for key confounders. End-of-season aVE was 44.3% (95% CI: 26.8, 57.7) against all laboratory-confirmed influenza; 45.7% (95% CI: 26.0, 60.1) against influenza A(H1N1)pdm09 and 35.1% (95% CI: −3.7,59.3) against A(H3N2). Overall aVE was 49.9% (95%CI: −13.7, 77.9) for all those ≥ 65 years of age and 62.0% (95% CI: 3.4, 85.0) for those who received aTIV. Overall aVE for 2–17 year olds receiving LAIV was 48.6% (95% CI: −4.4, 74.7). The paper provides evidence of overall significant influenza VE in 2018/19, most notably against influenza A(H1N1)pdm09, however, as seen in 2017/18, there was reduced, non-significant VE against A(H3N2). aTIV provided significant protection for those 65 years of age and over.

KW - effectiveness

KW - influenza

KW - primary care

KW - vaccine

UR - https://www.scopus.com/pages/publications/85074525422

UR - https://www.sciencedirect.com/journal/vaccine

U2 - 10.1016/j.vaccine.2019.10.071

DO - 10.1016/j.vaccine.2019.10.071

M3 - Article

C2 - 31685296

AN - SCOPUS:85074525422

SN - 0264-410X

JO - Vaccine

JF - Vaccine

ER -

End of season influenza vaccine effectiveness in primary care in adults and children in the United Kingdom in 2018/19

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