美国2023 - 2024年流感季节流感疫苗对儿童、青少年及成人住院治疗以及急诊或紧急护理就诊的有效性

Influenza vaccine effectiveness against hospitalizations and emergency department or urgent care encounters for children, adolescents, and adults during the 2023-2024 season, United States.

作者信息

Tenforde Mark W, Reeves Emily L, Weber Zachary A, Tartof Sara Y, Klein Nicola P, Dascomb Kristin, DeSilva Malini B, Yang Duck-Hye, Grannis Shaun J, Irving Stephanie A, Ong Toan C, Link-Gelles Ruth, Salas S Bianca, Sy Lina S, Lewin Bruno, Contreras Richard, Zerbo Ousseny, Fireman Bruce, Hansen John, Timbol Julius, Sheffield Tamara, Bride Daniel, Arndorfer Julie, VanOtterloo Josh, McEvoy Charlene E, Akinsete Omobosola O, Essien Inih J, Dixon Brian E, Rogerson Colin, Fadel William F, Duszynski Thomas, Naleway Allison L, Barron Michelle A, Rao Suchitra, Mayer David, Chavez Catia, Ball Sarah W, Payne Amanda B, Ray Caitlin, Dickerson Monica, Neelam Varsha, Adams Katherine, Flannery Brendan, DeCuir Jennifer, Garg Shikha

机构信息

National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States.

Westat, Rockville, Maryland, United States.

出版信息

Clin Infect Dis. 2024 Dec 4. doi: 10.1093/cid/ciae597.

DOI:10.1093/cid/ciae597

PMID:39656838

Abstract

BACKGROUND

The 2023-2024 influenza season had predominant influenza A(H1N1)pdm09 virus activity, but A(H3N2) and B viruses co-circulated. Seasonal influenza vaccine strains were well-matched to these viruses.

METHODS

Using health care encounters data from health systems in 8 states, we evaluated influenza vaccine effectiveness (VE) against influenza-associated medical encounters from October 2023-April 2024. Using a test-negative design, we compared the odds of vaccination between patients with an acute respiratory illness (ARI) who tested positive (cases) versus negative (controls) for influenza by molecular assay, adjusting for confounders. VE was stratified by age group, influenza type (overall, influenza A, influenza B), and care setting (hospitalization, emergency department or urgent care [ED/UC] encounter).

RESULTS

Overall, 74,000 encounters in children and adolescents aged 6 months - 17 years (3,479 hospitalizations, 70,521 ED/UC encounters) and 267,606 in adults aged ≥18 years (66,828 hospitalizations, 200,778 ED/UC encounters) were included. Across care settings, among children and adolescents 15% (2,758/17,833) of cases versus 32% (18,240/56,167) of controls had received vaccination. Among adults, 25% (11,632/46,614) of cases versus 44% (97,811/220,992) of controls across care settings had received vaccination. VE was 58% (95% confidence interval [95% CI]: 44-69%) against hospitalization and 58% (95% CI: 56-60%) against ED/UC encounters for children and adolescents, and 39% (95% CI: 35-43) against hospitalization and 47% (95% CI: 46-49%) against ED/UC encounters for adults. Across age groups, VE was higher against influenza B than influenza A.

CONCLUSIONS

Influenza vaccines provided protection against influenza-associated illness across health care settings and age groups during the 2023-2024 influenza season.

摘要

背景

2023 - 2024年流感季以甲型（H1N1）pdm09流感病毒活动为主，但甲型（H3N2）和乙型流感病毒也同时流行。季节性流感疫苗株与这些病毒匹配良好。

方法

利用8个州卫生系统的医疗就诊数据，我们评估了2023年10月至2024年4月期间流感疫苗针对流感相关医疗就诊的有效性（VE）。采用检测阴性设计，我们比较了通过分子检测流感呈阳性（病例）与阴性（对照）的急性呼吸道疾病（ARI）患者之间的接种几率，并对混杂因素进行了调整。VE按年龄组、流感类型（总体、甲型流感、乙型流感）和护理环境（住院、急诊科或紧急护理[ED/UC]就诊）进行分层。

结果

总共纳入了6个月至17岁儿童和青少年的74,000次就诊（3,479次住院、70,521次ED/UC就诊）以及18岁及以上成年人的267,606次就诊（66,828次住院、200,778次ED/UC就诊）。在所有护理环境中，儿童和青少年病例中有15%（2,758/17,833）接种了疫苗，而对照中有32%（18,240/56,167）接种了疫苗。在成年人中，所有护理环境下病例中有25%（11,632/46,614）接种了疫苗，而对照中有44%（97,811/220,992）接种了疫苗。儿童和青少年针对住院的VE为58%（95%置信区间[95%CI]：44 - 69%），针对ED/UC就诊的VE为58%（95%CI：56 - 60%）；成年人针对住院的VE为39%（95%CI：35 - 43），针对ED/UC就诊的VE为47%（95%CI：46 - 49%）。在所有年龄组中，针对乙型流感的VE高于甲型流感。