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2010/2011 年度英格兰和威尔士季节性流感疫苗预防有医疗记录的流感感染的效果:基于初级保健的队列研究。

Effectiveness of seasonal influenza vaccine in preventing medically attended influenza infection in England and Wales during the 2010/2011 season: a primary care-based cohort study.

机构信息

Statistics Unit, Public Health England, London, UK.

出版信息

Influenza Other Respir Viruses. 2013 Nov;7(6):1175-80. doi: 10.1111/irv.12163. Epub 2013 Sep 16.

Abstract

BACKGROUND

Estimates of seasonal influenza vaccine effectiveness (VE) are affected by factors such as the strain of the current circulating influenza virus and characteristics of the host.

OBJECTIVE

The objective of this study was to provide VE estimates for the 2010/2011 seasonal trivalent influenza vaccine (TIV) in preventing medically attended influenza in England and Wales for the season 2010/2011.

METHODS

A cohort study design was employed using electronic health records extracted from 104 GP practices in the Royal College of General Practitioners (RCGP) primary care sentinel network. Endpoints included influenza-like illness (ILI), lower respiratory tract infection (LTRI) as well as PCR-confirmed influenza from patients swabbed from practices participating in a swabbing scheme. Adjustment was made for age, month, underlying chronic condition, region and number of consultations in the 12 months prior to the study period. In addition to the cohort analysis, a nested test-negative case-control analysis (TNCC) was carried out using the swab-negative results as controls.

RESULTS

In the cohort analysis, VE against LRTI was -0·5% [95% CI: (-7·0%, 7·5%)], against ILI was 37·8% [95% CI: (32·3%, 43·0%)] and against PCR-confirmed influenza was 50·0% [95% CI:(25·9%, 65·6%)] for type A and 44·4% [95% CI: (10·1%, 65·6%)] for type B. Using the TNCC design, the type A VE was 56·5% [95% CI: (30·4%, 72·7%)] and for type B was 54·0% [95% CI: (21·0%, 73·3%)].

CONCLUSIONS

This study shows that the 2010/2011 TIV provided moderate protection against the circulating influenza strains for the 2010/2011 season. It also suggests that VE against the less specific diagnosis of ILI can be found, but less specific endpoints such as LRTI are not useful.

摘要

背景

季节性流感疫苗效力(VE)的估计受到当前流行流感病毒株以及宿主特征等因素的影响。

目的

本研究旨在为英格兰和威尔士 2010/2011 年季节提供 2010/2011 年三价流感疫苗(TIV)预防医疗性流感的 VE 估计值。

方法

采用队列研究设计,使用从皇家全科医生学院(RCGP)初级保健监测网络中的 104 个全科医生实践中提取的电子健康记录。终点包括流感样疾病(ILI)、下呼吸道感染(LRTI)以及从参与拭子方案的实践中采集拭子的患者的 PCR 确诊流感。根据研究前 12 个月的年龄、月份、潜在慢性疾病、区域和就诊次数进行调整。除了队列分析外,还使用拭子阴性结果作为对照进行了嵌套的测试阴性病例对照分析(TNCC)。

结果

在队列分析中,针对 LRTI 的 VE 为-0.5%(95% CI:[-7.0%,7.5%]),针对 ILI 的 VE 为 37.8%(95% CI:[32.3%,43.0%]),针对 PCR 确诊流感的 VE 为 50.0%(95% CI:[25.9%,65.6%])针对 A 型,针对 B 型为 44.4%(95% CI:[10.1%,65.6%])。使用 TNCC 设计,A 型 VE 为 56.5%(95% CI:[30.4%,72.7%]),B 型为 54.0%(95% CI:[21.0%,73.3%])。

结论

本研究表明,2010/2011 年 TIV 为 2010/2011 季节提供了针对循环流感株的中等保护。它还表明,可以发现针对不太具体的 ILI 诊断的 VE,但不太具体的终点(如 LRTI)则没有用处。

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