美国 2019-2020 年流感疫苗对住院的有效性。
Influenza Vaccine Effectiveness Against Hospitalization in the United States, 2019-2020.
机构信息
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
出版信息
J Infect Dis. 2021 Sep 1;224(5):813-820. doi: 10.1093/infdis/jiaa800.
BACKGROUND
Influenza causes significant morbidity and mortality and stresses hospital resources during periods of increased circulation. We evaluated the effectiveness of the 2019-2020 influenza vaccine against influenza-associated hospitalization in the United States.
METHODS
We included adults hospitalized with acute respiratory illness at 14 hospitals and tested for influenza viruses by reserve-transcription polymerase chain reaction. Vaccine effectiveness (VE) was estimated by comparing the odds of current-season influenza vaccination in test-positive influenza cases vs test-negative controls, adjusting for confounders. VE was stratified by age and major circulating influenza types along with A(H1N1)pdm09 genetic subgroups.
RESULTS
A total of 3116 participants were included, including 18% (n = 553) influenza-positive cases. Median age was 63 years. Sixty-seven percent (n = 2079) received vaccination. Overall adjusted VE against influenza viruses was 41% (95% confidence interval [CI], 27%-52%). VE against A(H1N1)pdm09 viruses was 40% (95% CI, 24%-53%) and 33% against B viruses (95% CI, 0-56%). Of the 2 major A(H1N1)pdm09 subgroups (representing 90% of sequenced H1N1 viruses), VE against one group (5A + 187A,189E) was 59% (95% CI, 34%-75%) whereas no VE was observed against the other group (5A + 156K) (-1% [95% CI, -61% to 37%]).
CONCLUSIONS
In a primarily older population, influenza vaccination was associated with a 41% reduction in risk of hospitalized influenza illness.
背景
流感在流行期会导致严重的发病率和死亡率，并给医院资源带来压力。我们评估了 2019-2020 年流感疫苗对美国流感相关住院的效果。
方法
我们纳入了 14 家医院因急性呼吸道疾病住院的成年人，并通过储备转录聚合酶链反应检测流感病毒。通过比较阳性流感病例与阴性对照病例中当前季节流感疫苗接种的几率，调整混杂因素后估计疫苗有效性（VE）。VE 按年龄和主要循环流感类型以及 A（H1N1）pdm09 遗传亚群进行分层。
结果
共纳入 3116 名参与者，其中 18%（n=553）为流感阳性病例。中位年龄为 63 岁。67%（n=2079）接受了疫苗接种。总体调整后针对流感病毒的 VE 为 41%（95%可信区间[CI]，27%-52%）。针对 A（H1N1）pdm09 病毒的 VE 为 40%（95%CI，24%-53%），针对 B 病毒的 VE 为 33%（95%CI，0-56%）。在 2 个主要的 A（H1N1）pdm09 亚组（代表 90%测序的 H1N1 病毒）中，针对一组（5A+187A、189E）的 VE 为 59%（95%CI，34%-75%），而针对另一组（5A+156K）的 VE 为 0%（95%CI，-61%至 37%）。
结论
在以老年人为主的人群中，流感疫苗接种可使住院流感疾病的风险降低 41%。
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