Imran Mahrukh, Puig-Barbera Joan, Ortiz Justin R, Lopez-Gonzalez Lorena, Dean Alex, Bonafede Machaon, Haag Mendel D M
CSL Seqirus Inc., Kirkland, Quebec, Canada.
FISABIO, Valencia, Spain.
Influenza Other Respir Viruses. 2024 Apr;18(4):e13288. doi: 10.1111/irv.13288.
Adults ≥ 65 years of age have suboptimal influenza vaccination responses compared to younger adults due to age-related immunosenescence. Two vaccines were specifically developed to enhance protection: MF59-adjuvanted trivalent influenza vaccine (aIIV3) and high-dose egg-based trivalent influenza vaccine (HD-IIV3e).
In a retrospective cohort study conducted using US electronic medical records linked to claims data during the 2019-2020 influenza season, we compared the relative vaccine effectiveness (rVE) of aIIV3 with HD-IIV3e and a standard-dose non-adjuvanted egg-based quadrivalent inactivated influenza vaccine (IIV4e) for the prevention of cardiorespiratory hospitalizations, including influenza hospitalizations. We evaluated outcomes in the "any" diagnosis position and the "admitting" position on the claim. A doubly robust methodology using inverse probability of treatment weighting and logistic regression was used to adjust for covariate imbalance. rVE was calculated as 100 * (1 - OR).
The study included 4,299,594 adults ≥ 65 years of age who received aIIV3, HD-IIV3e, or IIV4e. Overall, aIIV3 was associated with lower proportions of cardiorespiratory hospitalizations with diagnoses in any position compared to HD-IIV3e (rVE = 3.9% [95% CI, 2.7-5.0]) or IIV4e (9.0% [95% CI, 7.7-10.4]). Specifically, aIIV3 was more effective compared with HD-IIV3e and IIV4e in preventing influenza hospitalizations (HD-IIV3e: 9.7% [95% CI, 1.9-17.0]; IIV4e: 25.3% [95% CI, 17.7-32.2]). Consistent trends were observed for admitting diagnoses.
Relative to both HD-IIV3e and IIV4e, aIIV3 provided improved protection from cardiorespiratory or influenza hospitalizations.
由于与年龄相关的免疫衰老，65岁及以上的成年人与年轻成年人相比，流感疫苗接种反应欠佳。专门研发了两种疫苗以增强保护效果：含MF59佐剂的三价流感疫苗（aIIV3）和基于鸡蛋的高剂量三价流感疫苗（HD-IIV3e）。
在一项回顾性队列研究中，我们利用2019 - 2020流感季节与理赔数据相关联的美国电子病历，比较了aIIV3与HD-IIV3e以及标准剂量非佐剂鸡蛋基四价灭活流感疫苗（IIV4e）预防心肺住院（包括流感住院）的相对疫苗效力（rVE）。我们评估了理赔中“任何”诊断位置和“入院”位置的结果。使用倾向评分加权和逻辑回归的双重稳健方法来调整协变量不平衡。rVE计算为100 *（1 - OR）。
该研究纳入了4,299,594名65岁及以上接受aIIV3、HD-IIV3e或IIV4e的成年人。总体而言，与HD-IIV3e（rVE = 3.9% [95% CI，2.7 - 5.0]）或IIV4e（9.0% [95% CI，7.7 - 10.4]）相比，aIIV3在任何位置诊断的心肺住院比例较低。具体而言，aIIV3在预防流感住院方面比HD-IIV3e和IIV4e更有效（HD-IIV3e：9.7% [95% CI，1.9 - 17.0]；IIV4e：25.3% [9% CI，17.7 - 32.2]）。入院诊断观察到一致的趋势。
相对于HD-IIV3e和IIV4e，aIIV3在预防心肺或流感住院方面提供了更好的保护。
