Diefenbach-Elstob Tanya, Chilver Monique B, Spirkoska Violeta, Carville Kylie S, Dapat Clyde, Turra Mark, Tran Thomas, Deng Yi-Mo, Peck Heidi, Barr Ian G, Stocks Nigel, Sullivan Sheena G
WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
Australian Sentinel Practices Research Network (ASPREN), Discipline of General Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Influenza Other Respir Viruses. 2025 Jul;19(7):e70137. doi: 10.1111/irv.70137.
Vaccine effectiveness (VE) estimates provide important post-marketing assessment of how well seasonal influenza vaccines prevent medically attended influenza disease. We present VE estimates for primary care in Australia for the 2017-2019 seasons.
The study used a test-negative design. Influenza VE was estimated from adjusted logistic regression models comparing the odds of vaccination among influenza-test-positive cases and test-negative non-cases. Estimates were made overall and separately by influenza type, subtype, lineage and clade and stratified by age group. Antigenic similarity of influenza viruses to vaccine strains was assessed using the haemagglutination inhibition assay, and phylogenetic analysis was performed on sequenced viruses.
The study included 2879, 1973 and 3371 general practice patients with swabs collected during 2017, 2018 and 2019 respectively. Influenza A(H3N2) was predominant in 2017 and 2019, while influenza A(H1N1)pdm09 predominated in 2018. VE was estimated at 37% (95% CI 22, 48) for the 2017 season, 53% (95% CI 33, 67) for 2018 and 50% (95% CI 40, 58) for 2019. In general, estimates were higher against A(H1N1)pdm09 and influenza B viruses and lower against A(H3N2) viruses. Across the three seasons, antigenic data identified a greater proportion of A(H1N1)pdm09 and influenza B viruses than A(H3N2) viruses as antigenically similar to the cell-propagated reference viruses. VE estimates by clade generally indicated higher VE among viruses in the same clade as the vaccine viruses.
Influenza VE varied across influenza seasons and by influenza type/subtype. Given the ongoing evolution of circulating influenza viruses, vaccine improvements are needed, especially for influenza A(H3N2).
疫苗效力（VE）估计为季节性流感疫苗预防就医流感疾病的效果提供了重要的上市后评估。我们展示了2017 - 2019年澳大利亚初级保健的疫苗效力估计值。
该研究采用检测阴性设计。通过调整后的逻辑回归模型估计流感疫苗效力，该模型比较流感检测呈阳性病例和检测呈阴性的非病例的接种几率。总体以及按流感类型、亚型、谱系和进化枝分别进行估计，并按年龄组分层。使用血凝抑制试验评估流感病毒与疫苗株的抗原相似性，并对测序病毒进行系统发育分析。
该研究分别纳入了2017年、2018年和2019年采集拭子的2879例、1973例和3371例全科患者。甲型（H3N2）流感在2017年和2019年占主导，而甲型（H1N1）pdm09流感在2018年占主导。2017年的疫苗效力估计为37%（95%置信区间22, 48），2018年为53%（95%置信区间33, 67），2019年为50%（95%置信区间40, 58）。总体而言，针对甲型（H1N1）pdm09流感病毒和乙型流感病毒的估计值较高，而针对甲型（H3N2）流感病毒的估计值较低。在这三个季节中，抗原数据显示与细胞培养的参考病毒抗原相似的甲型（H1N1）pdm09流感病毒和乙型流感病毒的比例高于甲型（H3N2）流感病毒。按进化枝的疫苗效力估计通常表明与疫苗病毒处于同一进化枝的病毒中疫苗效力较高。
流感疫苗效力在不同流感季节以及不同流感类型/亚型之间有所不同。鉴于流行流感病毒的持续演变，需要改进疫苗，尤其是针对甲型（H3N2）流感。
