加拿大安大略省 2010/11 至 2015/16 流感季节使用 10 年疫苗接种史进行重复疫苗接种对老年人流感保护的影响：一项基于检测阴性设计的研究。
The impact of repeated vaccination using 10-year vaccination history on protection against influenza in older adults: a test-negative design study across the 2010/11 to 2015/16 influenza seasons in Ontario, Canada.
机构信息
ICES, Toronto, Ontario, Canada.
Public Health Ontario, Toronto, Ontario, Canada.
出版信息
Euro Surveill. 2020 Jan;25(1). doi: 10.2807/1560-7917.ES.2020.25.1.1900245.
IntroductionAnnual influenza vaccination is recommended for older adults, but evidence regarding the impact of repeated vaccination has been inconclusive.AimWe investigated vaccine effectiveness (VE) against laboratory-confirmed influenza and the impact of repeated vaccination over 10 previous seasons on current season VE among older adults.MethodsWe conducted an observational test-negative study in community-dwelling adults aged > 65 years in Ontario, Canada for the 2010/11 to 2015/16 seasons by linking laboratory and health administrative data. We estimated VE using multivariable logistic regression. We assessed the impact of repeated vaccination by stratifying by previous vaccination history.ResultsWe included 58,304 testing episodes for respiratory viruses, with 11,496 (20%) testing positive for influenza and 31,004 (53%) vaccinated. Adjusted VE against laboratory-confirmed influenza for the six seasons combined was 21% (95% confidence interval (CI): 18 to 24%). Patients who were vaccinated in the current season, but had received no vaccinations in the previous 10 seasons, had higher current season VE (34%; 95%CI: 9 to 52%) than patients who had received 1-3 (26%; 95%CI: 13 to 37%), 4-6 (24%; 95%CI: 15 to 33%), 7-8 (13%; 95%CI: 2 to 22%), or 9-10 (7%; 95%CI: -4 to 16%) vaccinations (trend test p = 0.001). All estimates were higher after correcting for misclassification of current season vaccination status. For patients who were not vaccinated in the current season, residual protection rose significantly with increasing numbers of vaccinations received previously.ConclusionsAlthough VE appeared to decrease with increasing numbers of previous vaccinations, current season vaccination likely provides some protection against influenza regardless of the number of vaccinations received over the previous 10 influenza seasons.
简介
每年都建议老年人接种流感疫苗，但关于重复接种疫苗的影响的证据尚无定论。
目的
我们调查了实验室确诊流感的疫苗有效性 (VE)，以及过去 10 个季节中重复接种对老年人当前季节 VE 的影响。
方法
我们通过链接实验室和健康管理数据，在加拿大安大略省的社区居住的年龄>65 岁的成年人中进行了 2010/11 至 2015/16 季节的观察性阴性测试研究。我们使用多变量逻辑回归估计 VE。我们通过分层以前的接种史来评估重复接种的影响。
结果
我们共纳入了 58304 个呼吸道病毒检测病例，其中 11496 例（20%）流感检测阳性，31004 例（53%）接种了疫苗。6 个季节合并的调整后针对实验室确诊流感的 VE 为 21%（95%置信区间 (CI)：18%至 24%）。在当前季节接种疫苗但在过去 10 个季节中未接种疫苗的患者，当前季节 VE 较高（34%；95%CI：9%至 52%），高于接种 1-3 剂（26%；95%CI：13%至 37%）、4-6 剂（24%；95%CI：15%至 33%）、7-8 剂（13%；95%CI：2%至 22%）或 9-10 剂（7%；95%CI：-4%至 16%）的患者（趋势检验 p=0.001）。在纠正当前季节接种状态的错误分类后，所有估计值均较高。对于当前季节未接种疫苗的患者，随着以前接种疫苗次数的增加，残留保护作用显著上升。
结论
尽管 VE 似乎随着以前接种疫苗次数的增加而降低，但当前季节的接种可能会提供一些针对流感的保护，无论过去 10 个流感季节接种了多少剂疫苗。
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