Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.
Int J Infect Dis. 2022 Dec;125:164-169. doi: 10.1016/j.ijid.2022.10.041. Epub 2022 Nov 2.
In this study, we aimed to investigate the relative vaccine effectiveness (rVE) of the MF59-adjuvanted trivalent (aTIV) and non-adjuvanted quadrivalent (QIVe) egg-based standard-dose vaccines against severe laboratory-confirmed influenza.
This test-negative case-control study was conducted in a hospital setting during four recent Italian influenza seasons (from 2018/19 to 2021/22). The clinical outcome was severe acute respiratory infection (SARI) with laboratory confirmation diagnosed among subjects aged ≥65 years. rVE of aTIV versus QIVe was estimated through propensity score matching followed by logistic regression.
The influenza virus circulated to a significant extent only during the 2018/19 and 2019/20 seasons. The final population included 512 vaccinated older adults, of which 83 were cases and 429 were test-negative controls. aTIV and QIVe users differed substantially from the point of view of several baseline characteristics. The propensity score adjusted rVE of aTIV vs QIVe was 59.2% (95% CI: 14.6%, 80.5%), 54.7% (95% CI: -28.7%, 84.0%) and 56.9% (95% CI: -7.8%, 82.8%) against any influenza, A(H1N1)pdm09 and A(H3N2), respectively.
aTIV was more effective than QIVe in preventing laboratory-confirmed SARI. The benefits of aTIV may be obscured by confounding indication.
本研究旨在探讨 MF59 佐剂三价（aTIV）和非佐剂四价（QIVe）流感疫苗对严重实验室确诊流感的相对疫苗有效性（rVE）。
这是一项在医院环境中进行的病例对照研究，涵盖了四个意大利流感季节（2018/19 年至 2021/22 年）。临床结局为年龄≥65 岁的患者中经实验室确诊的严重急性呼吸道感染（SARI）。通过倾向评分匹配和逻辑回归来估计 aTIV 与 QIVe 的 rVE。
流感病毒仅在 2018/19 年和 2019/20 年期间广泛传播。最终纳入了 512 名接种疫苗的老年患者，其中 83 例为病例，429 例为阴性对照。从几个基线特征来看，aTIV 和 QIVe 的使用者存在显著差异。调整倾向评分后，aTIV 相对于 QIVe 的 rVE 分别为 59.2%（95%CI：14.6%，80.5%）、54.7%（95%CI：-28.7%，84.0%）和 56.9%（95%CI：-7.8%，82.8%），分别针对任何流感、A（H1N1）pdm09 和 A（H3N2）。
aTIV 在预防实验室确诊的 SARI 方面比 QIVe 更有效。aTIV 的益处可能因混杂的指示而被掩盖。
