了解社区中流感疫苗的保护作用：对澳大利亚维多利亚州 2013 年流感季节的评估。
Understanding influenza vaccine protection in the community: an assessment of the 2013 influenza season in Victoria, Australia.
机构信息
Victorian Infectious Diseases Reference Laboratory at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne 3000, VIC, Australia.
WHO Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne 3000, VIC, Australia.
出版信息
Vaccine. 2015 Jan 3;33(2):341-5. doi: 10.1016/j.vaccine.2014.11.019. Epub 2014 Nov 22.
BACKGROUND
The influenza virus undergoes frequent antigenic drift, necessitating annual review of the composition of the influenza vaccine. Vaccination is an important strategy for reducing the impact and burden of influenza, and estimating vaccine effectiveness (VE) each year informs surveillance and preventative measures. We aimed to describe the influenza season and to estimate the effectiveness of the influenza vaccine in Victoria, Australia, in 2013.
METHODS
Routine laboratory notifications, general practitioner sentinel surveillance (including a medical deputising service) data, and sentinel hospital admission surveillance data for the influenza season (29 April to 27 October 2013) were collated in Victoria, Australia, to describe influenza-like illness or confirmed influenza during the season. General practitioner sentinel surveillance data were used to estimate VE against medically-attended laboratory confirmed influenza. VE was estimated using the case test negative design as 1-adjusted odds ratio (odds of vaccination in cases compared with controls) × 100%. Cases tested positive for influenza while non-cases (controls) tested negative. Estimates were adjusted for age group, week of onset, time to swabbing and co-morbidities.
RESULTS
The 2013 influenza season was characterised by relatively low activity with a late peak. Influenza B circulation preceded that of influenza A(H1)pdm09, with very little influenza A(H3) circulation. Adjusted VE for all influenza was 55% (95%CI: -11, 82), for influenza A(H1)pdm09 was 43% (95%CI: -132, 86), and for influenza B was 56% (95%CI: -51, 87) Imputation of missing data raised the influenza VE point estimate to 64% (95%CI: 13, 85).
CONCLUSIONS
Clinicians can continue to promote a positive approach to influenza vaccination, understanding that inactivated influenza vaccines prevent at least 50% of laboratory-confirmed outcomes in hospitals and the community.
背景
流感病毒经常发生抗原漂移，因此需要每年审查流感疫苗的组成。接种疫苗是减少流感影响和负担的重要策略，每年评估疫苗效果（VE）可以为监测和预防措施提供信息。我们旨在描述澳大利亚维多利亚州 2013 年的流感季节，并估计该年度流感疫苗的效果。
方法
在澳大利亚维多利亚州，对常规实验室报告、全科医生哨点监测（包括医疗代理服务）数据和流感季节（2013 年 4 月 29 日至 10 月 27 日）的哨点医院入院监测数据进行了整理，以描述流感样疾病或确诊的流感在该季节的情况。利用全科医生哨点监测数据估计针对有医疗记录的实验室确诊流感的 VE。VE 采用病例检测阴性设计，用 1 调整优势比（病例组中接种疫苗的可能性与对照组相比）×100%进行估计。病例组检测出流感阳性，而对照组（对照组）检测出阴性。估计值按年龄组、发病周、采样时间和合并症进行了调整。
结果
2013 年流感季节的特点是活动相对较少，高峰期较晚。乙型流感的传播先于甲型 H1pdm09 流感，甲型 H3 流感的传播则很少。所有流感的调整 VE 为 55%（95%CI：-11，82），甲型 H1pdm09 流感为 43%（95%CI：-132，86），乙型流感为 56%（95%CI：-51，87）。缺失数据的插补将流感 VE 点估计值提高到 64%（95%CI：13，85）。
结论
临床医生可以继续提倡积极接种流感疫苗，因为灭活流感疫苗至少可以预防医院和社区中 50%的实验室确诊结果。
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