Izurieta Hector S, Chillarige Yoganand, Kelman Jeffrey, Wei Yuqin, Lu Yun, Xu Wenjie, Lu Michael, Pratt Douglas, Wernecke Michael, MaCurdy Thomas, Forshee Richard
Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
Acumen LLC, Burlingame, California, USA.
J Infect Dis. 2020 Jun 29;222(2):278-287. doi: 10.1093/infdis/jiaa080.
Studies among individuals ages ≥65 years have found a moderately higher relative vaccine effectiveness (RVE) for the high-dose (HD) influenza vaccine compared with standard-dose (SD) products for most seasons. Studies during the A(H3N2)-dominated 2017-2018 season showed slightly higher RVE for the cell-cultured vaccine compared with SD egg-based vaccines. We investigated the RVE of influenza vaccines among Medicare beneficiaries ages ≥65 years during the 2018-2019 season.
This is a retrospective cohort study using inverse probability of treatment weighting and Poisson regression to evaluate RVE in preventing influenza hospital encounters.
Among 12 777 214 beneficiaries, the egg-based adjuvanted (RVE, 7.7%; 95% confidence interval [CI], 3.9%-11.4%) and HD (RVE, 4.9%; 95% CI, 1.7%-8.1%) vaccines were marginally more effective than the egg-based quadrivalent vaccines. The cell-cultured quadrivalent vaccine was not significantly more effective than the egg-based quadrivalent vaccine (RVE, 2.5%; 95% CI, -2.4% to 7.3%).
We did not find major effectiveness differences between licensed vaccines used among the elderly during the 2018-2019 season. Consistent with prior research, we found that the egg-based adjuvanted and HD vaccines were slightly more effective than the egg-based quadrivalent vaccines.
针对65岁及以上人群的研究发现，在大多数季节中，与标准剂量（SD）流感疫苗相比，高剂量（HD）流感疫苗的相对疫苗效力（RVE）略高。在以A（H3N2）为主导的2017 - 2018季节的研究表明，与基于鸡蛋的SD疫苗相比，细胞培养疫苗的RVE略高。我们调查了2018 - 2019季节65岁及以上医疗保险受益人群中流感疫苗的RVE。
这是一项回顾性队列研究，使用治疗权重的逆概率和泊松回归来评估预防流感住院的RVE。
在12777214名受益人中，基于鸡蛋的佐剂疫苗（RVE，7.7%；95%置信区间[CI]，3.9% - 11.4%）和HD疫苗（RVE，4.9%；95%CI，1.7% - 8.1%）比基于鸡蛋的四价疫苗略有效。细胞培养四价疫苗并不比基于鸡蛋的四价疫苗显著更有效（RVE，2.5%；95%CI， - 2.4%至7.3%）。
我们未发现2018 - 2019季节老年人使用的已获许可疫苗之间存在重大效力差异。与先前研究一致，我们发现基于鸡蛋的佐剂疫苗和HD疫苗比基于鸡蛋的四价疫苗略有效。
