2006 - 2007年通过加拿大一个哨点监测网络监测的三价流感疫苗的特定组分有效性

Component-specific effectiveness of trivalent influenza vaccine as monitored through a sentinel surveillance network in Canada, 2006-2007.

作者信息

Skowronski Danuta M, De Serres Gaston, Dickinson Jim, Petric Martin, Mak Annie, Fonseca Kevin, Kwindt Trijntje L, Chan Tracy, Bastien Nathalie, Charest Hugues, Li Yan

机构信息

British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.

出版信息

J Infect Dis. 2009 Jan 15;199(2):168-79. doi: 10.1086/595862.

DOI:10.1086/595862

PMID:19086914

Abstract

BACKGROUND

Trivalent inactivated influenza vaccine (TIV) is reformulated annually to contain representative strains of 2 influenza A subtypes (H1N1 and H3N2) and 1 B lineage (Yamagata or Victoria). We describe a sentinel surveillance approach to link influenza variant detection with component-specific vaccine effectiveness (VE) estimation.

METHODS

The 2006-2007 TIV included A/NewCaledonia/20/1999(H1N1)-like, A/Wisconsin/67/2005(H3N2)-like, and B/Malaysia/2506/2004(Victoria)-like components. Included participants were individuals >or=9 years of age who presented within 1 week after influenza like illness onset to a sentinel physician between November 2006 and April 2007. Influenza was identified by real-time reverse-transcriptase polymerase chain reaction and/or culture. Isolates were characterized by hemagglutination inhibition assay (HI) and HA1 gene sequence. VE was estimated as 1-[odds ratio for influenza in vaccinated versus nonvaccinated persons].

RESULTS

A total of 841 participants contributed: 69 (8%) were >or=65 years of age; 166 (20%) received the 2006-2007 TIV. Influenza was detected in 337 subjects (40%), distributed as follows: A/H3N2, 242 (72%); A/H1N1, 55 (16%); and B, 36 (11%). All but 1 of the A/H1N1 isolates were well matched, half of A/H3N2 isolates were strain mismatched, and all B isolates were lineage-level mismatched to vaccine. Age-adjusted estimated VE for A/H1N1, A/H3N2, and B components was 92% (95% CI, 40%-91%), 41% (95% CI, 6%-63%), and 19% (95% CI, -112% to 69%), respectively, with an overall VE estimate of 47% (95% CI, 18%-65%). Restriction of the analysis to include only working-age adults resulted in lower VE estimates with wide confidence intervals but similar component-specific trends.

CONCLUSIONS

Sentinel surveillance provides a broad platform to link new variant detection and the composite of circulating viruses to annual monitoring of component-specific VE.

摘要

背景

三价灭活流感疫苗（TIV）每年都会重新配制，以包含2种甲型流感病毒亚型（H1N1和H3N2）和1种乙型流感病毒系（山形株或维多利亚株）的代表性毒株。我们描述了一种哨点监测方法，将流感变异株检测与特定组分疫苗效力（VE）评估联系起来。

方法

2006 - 2007年的TIV包含A/新喀里多尼亚/20/1999（H1N1）类似株、A/威斯康星/67/2005（H3N2）类似株和B/马来西亚/2506/2004（维多利亚）类似株组分。纳入的参与者为2006年11月至2007年4月期间在流感样疾病发病后1周内就诊于哨点医生的9岁及以上个体。通过实时逆转录聚合酶链反应和/或培养鉴定流感病毒。分离株通过血凝抑制试验（HI）和HA1基因序列进行特征鉴定。VE估计值为1 - [接种疫苗者与未接种疫苗者患流感的比值比]。

结果

共有841名参与者纳入研究：69名（8%）年龄≥65岁；166名（20%）接种了2006 - 2007年的TIV。337名受试者（40%）检测到流感病毒，分布如下：A/H3N2，242例（72%）；A/H1N1，55例（16%）；B型，36例（11%）。除1株A/H1N1分离株外，其余均与疫苗匹配良好，一半的A/H3N2分离株与毒株不匹配，所有B型分离株与疫苗在系水平上不匹配。A/H1N1、A/H3N2和B组分的年龄调整后VE估计值分别为92%（95%CI，40% - 91%）、41%（95%CI，6% - 63%）和19%（95%CI， - 112%至69%），总体VE估计值为47%（95%CI，18% - 65%）。仅将分析限制在工作年龄成年人中，VE估计值较低且置信区间较宽，但特定组分的趋势相似。