2015-2016 至 2017-2018 季节中，流感相关肺炎导致的急性呼吸道疾病住院患者的疫苗有效性：美国住院成人流感疫苗有效性网络（HAIVEN）。

Vaccine Effectiveness Against Acute Respiratory Illness Hospitalizations for Influenza-Associated Pneumonia During the 2015-2016 to 2017-2018 Seasons: US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN).

机构信息

Baylor Scott & White Health, Temple, Texas, USA.

Texas A&M University College of Medicine, Temple, Texas, USA.

出版信息

Clin Infect Dis. 2022 Apr 28;74(8):1329-1337. doi: 10.1093/cid/ciab654.

DOI:10.1093/cid/ciab654

PMID:34320171

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9049268/

Abstract

BACKGROUND

Evidence for vaccine effectiveness (VE) against influenza-associated pneumonia has varied by season, location, and strain. We estimate VE against hospitalization for radiographically identified influenza-associated pneumonia during 2015-2016 to 2017-2018 seasons in the US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN).

METHODS

Among adults aged ≥18 years admitted to 10 US hospitals for acute respiratory illness (ARI), clinician-investigators used keywords from reports of chest imaging performed during 3 days around hospital admission to assign a diagnosis of "definite/probable pneumonia." We used a test-negative design to estimate VE against hospitalization for radiographically identified laboratory-confirmed influenza-associated pneumonia, comparing reverse transcriptase-polymerase chain reaction-confirmed influenza cases with test-negative subjects. Influenza vaccination status was documented in immunization records or self-reported, including date and location. Multivariable logistic regression models were used to adjust for age, site, season, calendar-time, and other factors.

RESULTS

Of 4843 adults hospitalized with ARI included in the primary analysis, 266 (5.5%) had "definite/probable pneumonia" and confirmed influenza. Adjusted VE against hospitalization for any radiographically confirmed influenza-associated pneumonia was 38% (95% confidence interval [CI], 17-53%); by type/subtype, it was 74% (95% CI, 52-87%) influenza A (H1N1)pdm09, 25% (95% CI, -15% to 50%) A (H3N2), and 23% (95% CI, -32% to 54%) influenza B. Adjusted VE against intensive care for any influenza was 57% (95% CI, 19-77%).

CONCLUSIONS

Influenza vaccination was modestly effective among adults in preventing hospitalizations and the need for intensive care associated with influenza pneumonia. VE was significantly higher against A (H1N1)pdm09 and was low against A (H3N2) and B.

摘要

背景

针对流感相关肺炎的疫苗有效性（VE）的证据因季节、地点和菌株而异。我们估计了 2015-2016 至 2017-2018 季节期间，美国住院成人流感疫苗有效性网络（HAIVEN）中，针对影像学确诊的流感相关肺炎住院的 VE。

方法

在因急性呼吸道疾病（ARI）入住 10 家美国医院的成年人中，临床医师研究者使用入院前 3 天进行的胸部影像学报告中的关键词，对“明确/可能肺炎”进行诊断。我们使用病例对照研究设计，比较流感确诊病例和阴性对照，估计针对影像学确诊的实验室确诊流感相关肺炎的 VE。流感疫苗接种情况记录在免疫记录或自我报告中，包括日期和地点。多变量逻辑回归模型用于调整年龄、地点、季节、日历时间和其他因素。

结果

在纳入主要分析的 4843 名因 ARI 住院的成年人中，有 266 人（5.5%）患有“明确/可能肺炎”和确诊流感。针对任何影像学确诊的流感相关肺炎住院的调整 VE 为 38%（95%置信区间 [CI]，17-53%）；按类型/亚型，甲型流感（H1N1）pdm09 的 VE 为 74%（95% CI，52-87%），甲型流感（H3N2）的 VE 为 25%（95% CI，-15%至 50%），乙型流感的 VE 为 23%（95% CI，-32%至 54%）。针对任何流感的重症监护治疗的调整 VE 为 57%（95% CI，19-77%）。