Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.
Moderna Inc., Cambridge, Massachusetts, USA.
Clin Infect Dis. 2024 Nov 22;79(5):1283-1292. doi: 10.1093/cid/ciae375.
Influenza causes substantial morbidity, particularly among older individuals. Updated data on the effectiveness of currently licensed vaccines in this population are needed.
At Kaiser Permanente Southern California, we conducted a retrospective cohort study to evaluate comparative vaccine effectiveness (cVE) of high-dose (HD), adjuvanted, and standard-dose (SD) cell-based influenza vaccines, relative to the SD egg-based vaccine. We included adults aged ≥65 years who received an influenza vaccine between 1 August 2022 and 31 December 2022, with follow-up up to 20 May 2023. Primary outcomes were: (1) influenza-related medical encounters and (2) polymerase chain reaction (PCR)-confirmed influenza-related hospitalization. Adjusted hazard ratios (aHR) were estimated by Cox proportional hazards regression, adjusting for confounders using inverse probability of treatment weighting (IPTW). cVE (%) was calculated as (1-aHR) × 100 when aHR ≤1, and ([1/aHR]-1) × 100 when aHR >1.
Our study population (n = 495 119) was 54.9% female, 46.3% non-Hispanic White, with a median age of 73 years (interquartile range [IQR] 69-79). Characteristics of all groups were well balanced after IPTW. Adjusted cVEs against influenza-related medical encounters in the HD, adjuvanted, and SD cell-based vaccine groups were 9.1% (95% confidence interval [CI]: .9, 16.7), 16.9% (95% CI: 1.7, 29.8), and -6.3 (95% CI: -18.3, 6.9), respectively. Adjusted cVEs against PCR-confirmed hospitalization in the HD, adjuvanted, and SD cell-based groups were 25.1% (95% CI: .2, 43.8), 61.6% (95% CI: 18.1, 82.0), and 26.4% (95% CI: -18.3, 55.7), respectively.
Compared to the SD egg-based vaccine, HD and adjuvanted vaccines conferred additional protection against influenza-related outcomes in the 2022-2023 season in adults ≥65 years. Our results provide real-world evidence of the comparative effectiveness of currently licensed vaccines.
流感会导致大量发病，尤其是在老年人中。需要更新有关当前许可疫苗在该人群中有效性的数据。
在凯撒永久南加州，我们进行了一项回顾性队列研究，以评估高剂量（HD）、佐剂和标准剂量（SD）细胞流感疫苗与 SD 卵基疫苗相比的疫苗相对有效性（cVE）。我们纳入了 2022 年 8 月 1 日至 2022 年 12 月 31 日期间接受流感疫苗接种、随访至 2023 年 5 月 20 日且年龄≥65 岁的成年人。主要结局是：（1）流感相关医疗就诊和（2）聚合酶链反应（PCR）确诊的流感相关住院。使用逆概率治疗加权（IPTW）调整协变量后，通过 Cox 比例风险回归估计调整后危险比（aHR）。当 aHR≤1 时，cVE（%）计算为（1-aHR）×100；当 aHR>1 时，计算为([1/aHR]-1)×100。
我们的研究人群（n=495119）中，54.9%为女性，46.3%为非西班牙裔白人，中位年龄为 73 岁（四分位距[IQR]69-79）。经 IPTW 后，所有组的特征均得到很好的平衡。HD、佐剂和 SD 细胞疫苗组中针对流感相关医疗就诊的调整后 cVE 分别为 9.1%（95%置信区间[CI]：.9，16.7）、16.9%（95% CI：1.7，29.8）和-6.3（95% CI：-18.3，6.9）。HD、佐剂和 SD 细胞疫苗组中针对 PCR 确诊住院的调整后 cVE 分别为 25.1%（95% CI：.2，43.8）、61.6%（95% CI：18.1，82.0）和 26.4%（95% CI：-18.3，55.7）。
与 SD 卵基疫苗相比，HD 和佐剂疫苗在 2022-2023 年季节中为≥65 岁成年人提供了针对流感相关结局的额外保护。我们的结果提供了当前许可疫苗相对有效性的真实世界证据。
