2013-2014 年中国北京地区老年人群中流感疫苗对 A(H1N1)pdm09 病毒的效果为中等，对 A(H3N2)病毒的效果较低。
Moderate influenza vaccine effectiveness against influenza A(H1N1)pdm09 virus and low effectiveness against A(H3N2) virus among older adults during 2013-2014 influenza season in Beijing, China.
机构信息
a Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control , Beijing , China.
b Beijing Research Center for Preventive Medicine , Beijing , China.
出版信息
Hum Vaccin Immunother. 2018 Jun 3;14(6):1323-1330. doi: 10.1080/21645515.2018.1441655. Epub 2018 Apr 11.
BACKGROUND
Since 2007, trivalent inactivated influenza vaccine has been provided free-of-charge to older adults aged ≥60 years in Beijing, China, but the data regarding influenza vaccine effectiveness (VE) among these people are very limited so far. We sought to estimate influenza VE against medically-attended laboratory-confirmed influenza illness among older adults during the 2013-2014 season.
METHODS
The influenza-like illness (ILI) patients aged 60 years and older who participated in the influenza virological surveillance of Beijing during 2013-2014 influenza season were recruited in this study. A test-negative design was employed to estimate influenza VE among older adults by using logistic regression models. VE was estimated using logistic regression, adjusted for sex, age, interval (days) between illness onset and specimen collection, and week of illness onset.
RESULTS
Between 1 November, 2013 and 30 April, 2014, a total of 487 elderly ILI patients were enrolled in the study, including 133 influenza-positive cases (of whom 6.8% were vaccinated) and 354 influenza-negative controls (of whom 10.2% were vaccinated). Among 133 influenza-positive cases, 51 tested positive for A(H1N1)pdm09 virus, 22 positive for A(H3N2) virus, 52 tested positive for B/Yamagata-lineage virus, 2 positive for B/Victoria-lineage virus, 1 positive for both A(H1N1)pdm09 and A(H3N2) viruses, and 5 tested positive for viruses of unknown subtype or lineage. The adjusted overall VE was estimated as 32% (95% CI:-48-69), with 59% (95% CI: -79-90) against A(H1N1)pdm09, 22% (95% CI: -253-83) against A(H3N2) and -20% (95% CI: -239-58) against B/Yamagata-lineage viruses.
CONCLUSIONS
These results suggested a modest protective effect of the 2013-2014 influenza vaccine among older adults in Beijing which was not statistically significant, with higher VE against the A(H1N1)pdm09 viruses compared to A(H3N2) and B viruses.
背景
自 2007 年以来，中国北京为年龄≥60 岁的老年人免费提供三价灭活流感疫苗，但到目前为止，关于这些人群中流感疫苗有效性（VE）的数据非常有限。我们旨在评估 2013-2014 年季节中老年人因医疗就诊的实验室确诊流感病例的流感 VE。
方法
本研究纳入了 2013-2014 年流感季节参加北京流感病毒学监测的年龄≥60 岁的流感样疾病（ILI）患者。采用病例对照研究设计，使用逻辑回归模型估计老年人的流感 VE。通过逻辑回归估计 VE，调整了性别、年龄、发病与标本采集之间的间隔（天）以及发病周。
结果
2013 年 11 月 1 日至 2014 年 4 月 30 日期间，共纳入 487 例老年 ILI 患者，其中 133 例流感阳性病例（6.8%接种过疫苗）和 354 例流感阴性对照（10.2%接种过疫苗）。在 133 例流感阳性病例中，51 例为 A(H1N1)pdm09 病毒阳性，22 例为 A(H3N2)病毒阳性，52 例为 B/Yamagata 谱系病毒阳性，2 例为 B/Victoria 谱系病毒阳性，1 例同时为 A(H1N1)pdm09 和 A(H3N2)病毒阳性，5 例为病毒亚/谱系未知。总体调整后的 VE 估计为 32%（95%CI：-48-69），对 A(H1N1)pdm09 的保护率为 59%（95%CI：-79-90），对 A(H3N2)的保护率为 22%（95%CI：-253-83），对 B/Yamagata 谱系的保护率为-20%（95%CI：-239-58）。
结论
这些结果表明，2013-2014 年流感疫苗对北京老年人具有适度的保护作用，但无统计学意义，对 A(H1N1)pdm09 病毒的保护效果高于 A(H3N2)和 B 病毒。
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