Seqirus Inc., Kirkland, Quebec, Canada.
Veradigm, San Francisco, California, USA.
Clin Infect Dis. 2021 Sep 7;73(5):816-823. doi: 10.1093/cid/ciab152.
The effectiveness of standard, egg-derived quadrivalent influenza vaccines (IIV4) may be reduced in adults ≥65 years of age, largely because of immunosenescence. An MF59-adjuvanted trivalent influenza vaccine (aIIV3) and a high-dose trivalent influenza vaccine (HD-IIV3) offer older adults enhanced protection versus standard vaccines. This study compared the relative effectiveness of aIIV3 with IIV4 and HD-IIV3 in preventing influenza-related medical encounters over 2 US influenza seasons.
This retrospective cohort study included US patients ≥65 years vaccinated with aIIV3, IIV4, or HD-IIV3. The outcome of interest was the occurrence of influenza-related medical encounters. Data were derived from a large dataset comprising primary and specialty care electronic medical records linked with pharmacy and medical claims. Adjusted odds ratios (OR) were derived from an inverse probability of treatment-weighted sample adjusted for age, sex, race, ethnicity, geographic region, vaccination week, and health status. Relative vaccine effectiveness (rVE) was determined using the formula (% VE = 1 - ORadjusted) × 100.
In 2017-2018, cohorts included: aIIV3, n = 524 223; IIV4, n = 917 609; and HD-IIV3, n = 3 377 860. After adjustment, 2017-2018 rVE of aIIV3 versus IIV4 was 18.2 (95% confidence interval [CI], 15.8-20.5); aIIV3 vs. HD-IIV3 was 7.7 (95% CI, 2.3-12.8). In 2018-2019, cohorts included: aIIV3, n = 1 031 145; IIV4, n = 915 380; HD-IIV3, n = 3 809 601, with adjusted rVEs of aIIV3 versus IIV4 of 27.8 (95% CI, 25.7-29.9) and vs. HD-IIV3 of 6.9 (95% CI, 3.1-10.6).
In the 2017-2018 and 2018-2019 influenza seasons in the United States, aIIV3 demonstrated greater reduction in influenza-related medical encounters than IIV4 and HD-IIV3 in adults ≥65 years.
标准的、源自鸡蛋的四价流感疫苗（IIV4）在≥65 岁的成年人中的有效性可能降低，主要是由于免疫衰老。含佐剂的三价流感疫苗（aIIV3）和高剂量三价流感疫苗（HD-IIV3）为老年人提供了比标准疫苗更好的保护。本研究比较了 aIIV3 与 IIV4 和 HD-IIV3 在预防美国两个流感季节中与流感相关的医疗接触方面的相对有效性。
这是一项回顾性队列研究，纳入了≥65 岁接种过 aIIV3、IIV4 或 HD-IIV3 的美国患者。研究的结局为与流感相关的医疗接触。数据来自一个大型数据集，该数据集由与药房和医疗索赔相关联的初级和专科保健电子病历组成。调整后的优势比（OR）是根据年龄、性别、种族、民族、地理位置、接种周和健康状况对治疗反概率加权样本进行调整后得出的。相对疫苗有效性（rVE）使用公式（%VE=1-ORadjusted）×100 确定。
2017-2018 年，队列包括：aIIV3，n=524223；IIV4，n=917609；HD-IIV3，n=3377860。调整后，2017-2018 年 aIIV3 与 IIV4 的 rVE 为 18.2（95%置信区间[CI]，15.8-20.5）；aIIV3 与 HD-IIV3 为 7.7（95%CI，2.3-12.8）。2018-2019 年，队列包括：aIIV3，n=1031145；IIV4，n=915380；HD-IIV3，n=3809601，调整后的 rVE 为 aIIV3 与 IIV4 的 27.8（95%CI，25.7-29.9）和与 HD-IIV3 的 6.9（95%CI，3.1-10.6）。
在美国 2017-2018 年和 2018-2019 年流感季节，aIIV3 与 IIV4 和 HD-IIV3 相比，在≥65 岁的成年人中，降低与流感相关的医疗接触的效果更好。
