2012-2013 季节性流感疫苗对流感住院的有效性：来自全球流感住院监测网络的结果。

2012-2013 Seasonal influenza vaccine effectiveness against influenza hospitalizations: results from the global influenza hospital surveillance network.

机构信息

Foundation for the Promotion of Health and Biomedical Research in the Valencia Region FISABIO - Public Health, Valencia, Spain.

Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC 1417 and the French Vaccine Research Network (REIVAC), Paris, France.

出版信息

PLoS One. 2014 Jun 19;9(6):e100497. doi: 10.1371/journal.pone.0100497. eCollection 2014.

BACKGROUND

The effectiveness of currently licensed vaccines against influenza has not been clearly established, especially among individuals at increased risk for complications from influenza. We used a test-negative approach to estimate influenza vaccine effectiveness (IVE) against hospitalization with laboratory-confirmed influenza based on data collected from the Global Influenza Hospital Surveillance Network (GIHSN).

METHODS AND FINDINGS

This was a multi-center, prospective, active surveillance, hospital-based epidemiological study during the 2012-2013 influenza season. Data were collected from hospitals participating in the GIHSN, including five in Spain, five in France, and four in the Russian Federation. Influenza was confirmed by reverse transcription-polymerase chain reaction. IVE against hospitalization for laboratory-confirmed influenza was estimated for adult patients targeted for vaccination and who were swabbed within 7 days of symptom onset. The overall adjusted IVE was 33% (95% confidence interval [CI], 11% to 49%). Point estimates of IVE were 23% (95% CI, -26% to 53%) for influenza A(H1N1)pdm09, 30% (95% CI, -37% to 64%) for influenza A(H3N2), and 43% (95% CI, 17% to 60%) for influenza B/Yamagata. IVE estimates were similar in subjects <65 and ≥65 years of age (35% [95% CI, -15% to 63%] vs.31% [95% CI, 4% to 51%]). Heterogeneity in site-specific IVE estimates was high (I2 = 63.4%) for A(H1N1)pdm09 in patients ≥65 years of age. IVE estimates for influenza B/Yamagata were homogenous (I2 = 0.0%).

CONCLUSIONS

These results, which were based on data collected from the GIHSN during the 2012-2013 influenza season, showed that influenza vaccines provided low to moderate protection against hospital admission with laboratory-confirmed influenza in adults targeted for influenza vaccination. In this population, IVE estimates against A(H1N1)pdm09 were sensitive to age group and study site. Influenza vaccination was moderately effective in preventing admissions with influenza B/Yamagata for all sites and age groups.

背景

目前已获许可的流感疫苗的效果尚不清楚，尤其是在有流感并发症风险增加的人群中。我们使用了一种阴性测试方法，根据全球流感医院监测网络（GIHSN）收集的数据，来估算针对实验室确诊的流感住院的流感疫苗有效性（IVE）。

方法和发现

这是一项 2012-2013 年流感季节进行的多中心、前瞻性、主动监测、基于医院的流行病学研究。数据来自参与 GIHSN 的医院收集，包括西班牙的五家、法国的五家和俄罗斯联邦的四家。通过逆转录-聚合酶链反应确认流感。对在症状出现后 7 天内接受疫苗接种并接受拭子检查的成年患者，估算了针对实验室确诊的流感住院的 IVE。总体调整后的 IVE 为 33%（95%置信区间[CI]，11%至 49%）。A（H1N1）pdm09 的 IVE 点估计值为 23%（95%CI，-26%至 53%），A（H3N2）为 30%（95%CI，-37%至 64%），B/Yamagata 为 43%（95%CI，17%至 60%）。<65 岁和≥65 岁的患者的 IVE 估计值相似（35%[95%CI，-15%至 63%]与 31%[95%CI，4%至 51%]）。对于≥65 岁的患者，A（H1N1）pdm09 的特定地点 IVE 估计值存在很高的异质性（I2=63.4%）。B/Yamagata 的 IVE 估计值是同质的（I2=0.0%）。

结论

这些结果基于 2012-2013 年流感季节从 GIHSN 收集的数据，表明流感疫苗对目标人群接种流感疫苗的成年人因实验室确诊的流感住院提供了低至中等程度的保护。在该人群中，A（H1N1）pdm09 的 IVE 估计值对年龄组和研究地点敏感。流感疫苗在所有地点和年龄组对预防 B/Yamagata 引起的流感住院均具有中等有效性。