Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia.
Influenza Other Respir Viruses. 2013 Sep;7(5):729-37. doi: 10.1111/irv.12018. Epub 2012 Oct 19.
Influenza vaccines are licensed annually based on immunogenicity studies. We used five sequential years of data to estimate influenza vaccine effectiveness (VE), the critical outcome in the field.
Between 2007 and 2011, we performed annual prospective test-negative design case-control studies among adults aged 20-64 years recruited from sentinel general practices in the Australian state of Victoria. We used PCR-confirmed influenza as the endpoint to estimate influenza VE for all years. We compared annual VE estimates with the match between circulating and vaccine strains, determined by haemagglutination inhibition assays.
The adjusted VE estimate for all years (excluding 2009) was 62% (95% CI 43, 75). By type and subtype, the point estimates of VE by year ranged between 31% for seasonal influenza A(H1N1) and 88% for influenza A(H1N1)pdm09. In 2007, when circulating strains were assessed as incompletely matched, the point estimate of the adjusted VE against all influenza was 58%. The point estimate was 59% in 2011 when all strains were assessed as well matched.
Trivalent inactivated vaccines provided moderate protection against laboratory-confirmed influenza in adults of working age, although VE estimates were sensitive to the model used. VE estimates correlated poorly with circulating strain match, as assessed by haemagglutination inhibition assays, suggesting a need for VE studies that incorporate antigenic characterization data.
流感疫苗是基于免疫原性研究每年获得许可的。我们使用连续五年的数据来估计流感疫苗的有效性（VE），这是该领域的关键结果。
在 2007 年至 2011 年期间，我们在澳大利亚维多利亚州的哨点普通实践中，对 20-64 岁的成年人进行了年度前瞻性测试阴性设计病例对照研究。我们使用 PCR 确诊的流感作为终点来估计所有年份的流感 VE。我们将每年的 VE 估计值与通过血凝抑制测定确定的循环和疫苗株之间的匹配进行了比较。
所有年份（不包括 2009 年）的调整 VE 估计值为 62%（95%CI 43,75）。按类型和亚型，每年 VE 的点估计值范围在季节性流感 A（H1N1）的 31%至 A（H1N1）pdm09 的 88%之间。在 2007 年，当评估循环株时，调整后的 VE 点估计值为 58%。在所有株均被评估为完全匹配的 2011 年，点估计值为 59%。
三价灭活疫苗为工作年龄成年人提供了针对实验室确诊流感的中度保护，尽管 VE 估计值对所使用的模型敏感。VE 估计值与通过血凝抑制测定评估的循环株匹配相关性较差，表明需要进行 VE 研究，纳入抗原特征数据。
