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2003/2004年至2013/2014年荷兰流感疫苗的有效性：流行的流感病毒类型和亚型的重要性

Influenza Vaccine Effectiveness in the Netherlands from 2003/2004 through 2013/2014: The Importance of Circulating Influenza Virus Types and Subtypes.

作者信息

Darvishian Maryam, Dijkstra Frederika, van Doorn Eva, Bijlsma Maarten J, Donker Gé A, de Lange Marit M A, Cadenau Laura M, Hak Eelko, Meijer Adam

机构信息

Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, the Netherlands.

出版信息

PLoS One. 2017 Jan 9;12(1):e0169528. doi: 10.1371/journal.pone.0169528. eCollection 2017.

DOI:10.1371/journal.pone.0169528
PMID:28068386
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5222508/
Abstract

Influenza vaccine effectiveness (IVE) varies over different influenza seasons and virus (sub)types/lineages. To assess the association between IVE and circulating influenza virus (sub)types/lineages, we estimated the overall and (sub)type specific IVE in the Netherlands. We conducted a test-negative case control study among subjects with influenza-like illness or acute respiratory tract infection consulting the Sentinel Practices over 11 influenza seasons (2003/2004 through 2013/2014) in the Netherlands. The adjusted IVE was estimated using generalized linear mixed modelling and multiple logistic regression. In seven seasons vaccine strains did not match the circulating viruses. Overall adjusted IVE was 40% (95% CI 18 to 56%) and 20% (95% CI -5 to 38%) when vaccine (partially)matched and mismatched the circulating viruses, respectively. When A(H3N2) was the predominant virus, IVE was 38% (95% CI 14 to 55%). IVE against infection with former seasonal A(H1N1) virus was 83% (95% CI 52 to 94%), and with B virus 67% (95% CI 55 to 76%). In conclusion IVE estimates were particularly low when vaccine mismatched the circulating viruses and A(H3N2) was the predominant influenza virus subtype. Tremendous effort is required to improve vaccine production procedure and to explore the factors that influence the IVE against A(H3N2) virus.

摘要

流感疫苗效力（IVE）在不同的流感季节以及病毒（亚）型/谱系之间存在差异。为了评估IVE与流行的流感病毒（亚）型/谱系之间的关联，我们估算了荷兰的总体及（亚）型特异性IVE。我们在荷兰11个流感季节（2003/2004至2013/2014）期间，对因流感样疾病或急性呼吸道感染而咨询定点医疗机构的受试者开展了一项检测阴性病例对照研究。采用广义线性混合模型和多重逻辑回归估算调整后的IVE。在七个季节中，疫苗毒株与流行病毒不匹配。当疫苗（部分）匹配和不匹配流行病毒时，总体调整后的IVE分别为40%（95%CI 18%至56%）和20%（95%CI -5%至38%）。当A(H3N2)为主要病毒时，IVE为38%（95%CI 14%至55%）。针对既往季节性A(H1N1)病毒感染的IVE为83%（95%CI 52%至94%），针对B病毒感染的IVE为67%（95%CI 55%至76%）。总之，当疫苗与流行病毒不匹配且A(H3N2)为主要流感病毒亚型时，IVE估计值特别低。需要付出巨大努力来改进疫苗生产程序，并探索影响针对A(H3N2)病毒的IVE的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f30d/5222508/1b975891b4aa/pone.0169528.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f30d/5222508/2f7334344fd2/pone.0169528.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f30d/5222508/1b975891b4aa/pone.0169528.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f30d/5222508/2f7334344fd2/pone.0169528.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f30d/5222508/1b975891b4aa/pone.0169528.g002.jpg

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