1887
  1. Home
  2. Eurosurveillance
  3. Volume 24, Issue 31, 01/Aug/2019
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV).

Aim

To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue.

Methods

This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples.

Results

Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15% (95% confidence interval (CI): −6.3 to 32) against all influenza; −16.4% (95% CI: −59.3 to 14.9) against A(H3N2); 24.7% (95% CI: 1.1 to 42.7) against B and 66.3% (95% CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9% (95% CI: −32.6 to 59.7) against all influenza; −75.5% (95% CI: −289.6 to 21) against A(H3N2); 60.8% (95% CI: 8.2 to 83.3) against B and 90.3% (95% CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9% (95% CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds.

Conclusions

Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2019.24.31.1800488
2019-08-01
2024-11-17
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.31.1800488
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/24/31/eurosurv-24-31-3.html?itemId=/content/10.2807/1560-7917.ES.2019.24.31.1800488&mimeType=html&fmt=ahah

References

  1. Hakin B, Cosford P, Harvey F. The flu immunisation programme 2013/14– extension to children. London: Department of Health; 26 Jul 2013. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/225360/Children_s_flu_letter_2013.pdf
  2. Public Health England, Department of Health. Flu Plan Winter. 2017-18. London: NHS England; March 2017. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/600532/annual_flu_plan_2017to2018.pdf
  3. World Health Organization (WHO). WHO recommended composition for 2017/18 Northern hemisphere influenza season. Geneva: WHO; 2 March 2017. Available from: https://www.who.int/influenza/vaccines/virus/recommendations/2017_18_north/en/
  4. Pebody R, Warburton F, Ellis J, Andrews N, Potts A, Cottrell S, et al. Effectiveness of seasonal influenza vaccine for adults and children in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2015/16 end-of-season results. Euro Surveill. 2016;21(38):30348.  https://doi.org/10.2807/1560-7917.ES.2016.21.38.30348  PMID: 27684603 
  5. Grohskopf LA, Sokolow LZ, Broder KR, Olsen SJ, Karron RA, Jernigan DB, et al. Prevention and Control of Seasonal Influenza with Vaccines. MMWR Recomm Rep. 2016;65(5):1-54.  https://doi.org/10.15585/mmwr.rr6505a1  PMID: 27560619 
  6. Penttinen PM, Friede MH. Decreased effectiveness of the influenza A(H1N1)pdm09 strain in live attenuated influenza vaccines: an observational bias or a technical challenge? Euro Surveill. 2016;21(38):30350.  https://doi.org/10.2807/1560-7917.ES.2016.21.38.30350  PMID: 27684999 
  7. Skowronski DM, Janjua NZ, De Serres G, Sabaiduc S, Eshaghi A, Dickinson JA, et al. Low 2012-13 influenza vaccine effectiveness associated with mutation in the egg-adapted H3N2 vaccine strain not antigenic drift in circulating viruses. PLoS One. 2014;9(3):e92153.  https://doi.org/10.1371/journal.pone.0092153  PMID: 24667168 
  8. Public Health England (PHE). Annual National Flu Report: Surveillance of influenza and other respiratory viruses in the UK: Winter 2017 to 2018. London: PHE; May 2018. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/710483/Surveillance_of_influenza_and_other_respiratory_viruses_in_the_UK_2017_to_2018.pdf
  9. Fleming DM, Andrews NJ, Ellis JS, Bermingham A, Sebastianpillai P, Elliot AJ, et al. Estimating influenza vaccine effectiveness using routinely collected laboratory data. J Epidemiol Community Health. 2010;64(12):1062-7.  https://doi.org/10.1136/jech.2009.093450  PMID: 19910645 
  10. Gunson R, Maclean A, Davies E, Bennett S, Miller R, Carman WF. Development of a multiplex real-time RT-PCR that allows universal detection of influenza A viruses and simultaneous typing of influenza A/H1N1/2009 virus. J Virol Methods. 2010;163(2):258-61.  https://doi.org/10.1016/j.jviromet.2009.10.006  PMID: 19854220 
  11. Matrosovich M, Matrosovich T, Carr J, Roberts NA, Klenk HD. Overexpression of the alpha-2,6-sialyltransferase in MDCK cells increases influenza virus sensitivity to neuraminidase inhibitors. J Virol. 2003;77(15):8418-25.  https://doi.org/10.1128/JVI.77.15.8418-8425.2003  PMID: 12857911 
  12. Zambon M. Laboratory Diagnosis of Influenza. In: Nicholson K, Hay A, Webster RG, editors. Textbook of Influenza. Oxford: Blackwell Science; 1998. pp. 291-313].
  13. Tamura K, Stecher G, Peterson D, Filipski A, Kumar S. MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol Biol Evol. 2013;30(12):2725-9.  https://doi.org/10.1093/molbev/mst197  PMID: 24132122 
  14. World Health Organization (WHO). Composition recommandée des vaccins antigrippaux pour la saison grippale 2017-2018 dans l’hémisphère Nord. [Recommended composition of influenza virus vaccines for use in the 2017–2018 northern hemisphere influenza season]. Wkly Epidemiol Rec. 2017;92(11):117-28. PMID: 28303704 
  15. Zost SJ, Parkhouse K, Gumina ME, Kim K, Diaz Perez S, Wilson PC, et al. Contemporary H3N2 influenza viruses have a glycosylation site that alters binding of antibodies elicited by egg-adapted vaccine strains. Proc Natl Acad Sci USA. 2017;114(47):12578-83.  https://doi.org/10.1073/pnas.1712377114  PMID: 29109276 
  16. Rondy M, Kissling E, Emborg HD, Gherasim A, Pebody R, Trebbien R, et al. Interim 2017/18 influenza seasonal vaccine effectiveness: combined results from five European studies. Euro Surveill. 2018;23(9):1800086.  https://doi.org/10.2807/1560-7917.ES.2018.23.9.18-00086  PMID: 29510782 
  17. Flannery B, Chung JR, Belongia EA, McLean HQ, Gaglani M, Murthy K, et al. Interim Estimates of 2017-18 Seasonal Influenza Vaccine Effectiveness - United States, February 2018. MMWR Morb Mortal Wkly Rep. 2018;67(6):180-5.  https://doi.org/10.15585/mmwr.mm6706a2  PMID: 29447141 
  18. Skowronski DM, Chambers C, De Serres G, Sabaiduc S, Winter AL, Dickinson JA, et al. Vaccine effectiveness against lineage matched and mismatched influenza B viruses across 8 seasons in Canada, 2010-11 to 2017-18. Clin Infect Dis. 2018;68(10):1754-7.  https://doi.org/10.1093/cid/ciy876  PMID: 30312364 
  19. McLean HQ, Thompson MG, Sundaram ME, Kieke BA, Gaglani M, Murthy K, et al. Influenza vaccine effectiveness in the United States during 2012-2013: variable protection by age and virus type. J Infect Dis. 2015;211(10):1529-40.  https://doi.org/10.1093/infdis/jiu647  PMID: 25406334 
  20. de Boer PT, van Maanen BM, Damm O, Ultsch B, Dolk FCK, Crépey P, et al. A systematic review of the health economic consequences of quadrivalent influenza vaccination. Expert Rev Pharmacoecon Outcomes Res. 2017;17(3):249-65.  https://doi.org/10.1080/14737167.2017.1343145  PMID: 28613092 
  21. Thorrington D, van Leeuwen E, Ramsay M, Pebody R, Baguelin M. Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England. BMC Med. 2017;15(1):166.  https://doi.org/10.1186/s12916-017-0932-3  PMID: 28882149 
  22. Hodgson D, Baguelin M, van Leeuwen E, Panovska-Griffiths J, Ramsay M, Pebody R, et al. Effect of mass paediatric influenza vaccination on existing influenza vaccination programmes in England and Wales: a modelling and cost-effectiveness analysis. Lancet Public Health. 2017;2(2):e74-81.  https://doi.org/10.1016/S2468-2667(16)30044-5  PMID: 28299371 
  23. Pebody R, Warburton F, Ellis J, Andrews N, Potts A, Cottrell S, et al. End-of-season influenza vaccine effectiveness in adults and children, United Kingdom, 2016/17. Euro Surveill. 2017;22(44): 1700306.  https://doi.org/10.2807/1560-7917.ES.2017.22.44.17-00306  PMID: 29113630 
  24. Skowronski DM, Chambers C, Sabaiduc S, Dickinson JA, Winter AL, De Serres G, et al. Interim estimates of 2016/17 vaccine effectiveness against influenza A(H3N2), Canada, January 2017. Euro Surveill. 2017;22(6):30460.  https://doi.org/10.2807/1560-7917.ES.2017.22.6.30460  PMID: 28205503 
  25. Belongia EA, Simpson MD, King JP, Sundaram ME, Kelley NS, Osterholm MT, et al. Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. Lancet Infect Dis. 2016;16(8):942-51.  https://doi.org/10.1016/S1473-3099(16)00129-8  PMID: 27061888 
  26. Lin Y, Wharton SA, Whittaker L, Dai M, Ermetal B, Lo J, et al. The characteristics and antigenic properties of recently emerged subclade 3C.3a and 3C.2a human influenza A(H3N2) viruses passaged in MDCK cells. Influenza Other Respir Viruses. 2017;11(3):263-74.  https://doi.org/10.1111/irv.12447  PMID: 28164446 
  27. World Health Organization (WHO). Recommended composition of influenza virus vaccines for use in the 2018 southern hemisphere influenza season. Geneva: WHO; 28 September 2017. Available from: https://www.who.int/influenza/vaccines/virus/recommendations/201709_recommendation.pdf?ua=1
  28. Zost SJ, Parkhouse K, Gumina ME, Kim K, Diaz Perez S, Wilson PC, et al. Contemporary H3N2 influenza viruses have a glycosylation site that alters binding of antibodies elicited by egg-adapted vaccine strains. Proc Natl Acad Sci USA. 2017;114(47):12578-83.  https://doi.org/10.1073/pnas.1712377114  PMID: 29109276 
  29. Shay DK, Chillarige Y, Kelman J, Forshee RA, Foppa IM, Wernecke M, et al. Comparative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccines Among US Medicare Beneficiaries in Preventing Postinfluenza Deaths During 2012-2013 and 2013-2014. J Infect Dis. 2017;215(4):510-7.  https://doi.org/10.1093/infdis/jiw641  PMID: 28329311 
  30. Izurieta HS, Chillarige Y, Kelman J, Wei Y, Lu Y, Xu W, et al. Relative effectiveness of cell-cultured and egg-based influenza vaccines among the U.S. elderly, 2017-18. J Infect Dis. 2018.  https://doi.org/10.1093/infdis/jiy716  PMID: 30561688 
  31. Ambrose CS, Bright H, Mallory R. Letter to the editor: Potential causes of the decreased effectiveness of the influenza A(H1N1)pdm09 strain in live attenuated influenza vaccines. Euro Surveill. 2016;21(45):30394.  https://doi.org/10.2807/1560-7917.ES.2016.21.45.30394  PMID: 27918259 
  32. Mallory R. Results of Randomized Trial of a New H1N1 LAIV Strain in US Children. Presentation to ACIP 21 Feb 2018. page 53. Available from: https://www.cdc.gov/vaccines/acip/meetings/downloads/min-archive/min-2018-02-508.pdf
  33. Public Health England, Department of Health. Annual Flu Letter. 2018/19. London: NHS; 26 March 2018. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/694779/Annual_national_flu_programme_2018-2019.pdf
End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Richard+Pebody&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pebody Richard</a>, <a href="/search?value1=Abdelmajid+Djennad&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Djennad Abdelmajid</a>, <a href="/search?value1=Joanna+Ellis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ellis Joanna</a>, <a href="/search?value1=Nick+Andrews&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Andrews Nick</a>, <a href="/search?value1=Diogo+F+P+Marques&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marques Diogo F P</a>, <a href="/search?value1=Simon+Cottrell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cottrell Simon</a>, <a href="/search?value1=Arlene+J+Reynolds&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reynolds Arlene J</a>, <a href="/search?value1=Rory+Gunson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gunson Rory</a>, <a href="/search?value1=Monica+Galiano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Galiano Monica</a>, <a href="/search?value1=Katja+Hoschler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoschler Katja</a>, <a href="/search?value1=Angie+Lackenby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lackenby Angie</a>, <a href="/search?value1=Chris+Robertson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Robertson Chris</a>, <a href="/search?value1=Mark+O%E2%80%99Doherty&option1=author&noRedirect=true" class="nonDisambigAuthorLink">O’Doherty Mark</a>, <a href="/search?value1=Mary+Sinnathamby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sinnathamby Mary</a>, <a href="/search?value1=Nikolaos+Panagiotopoulos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Panagiotopoulos Nikolaos</a>, <a href="/search?value1=Ivelina+Yonova&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Yonova Ivelina</a>, <a href="/search?value1=Rebecca+Webb&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Webb Rebecca</a>, <a href="/search?value1=Catherine+Moore&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Moore Catherine</a>, <a href="/search?value1=Matthew+Donati&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Donati Matthew</a>, <a href="/search?value1=Muhammad+Sartaj&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sartaj Muhammad</a>, <a href="/search?value1=Samantha+J+Shepherd&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Shepherd Samantha J</a>, <a href="/search?value1=Jim+McMenamin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McMenamin Jim</a>, <a href="/search?value1=Simon+de+Lusignan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Lusignan Simon</a>, <a href="/search?value1=Maria+Zambon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zambon Maria</a></span>. End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(31):pii=1800488. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.31.1800488</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 31 Aug 2018;&nbsp;&nbsp; <span class="generated">Accepted</span>: 11 Jun 2019 </span> </p>
/content/10.2807/1560-7917.ES.2019.24.31.1800488
/content/10.2807/1560-7917.ES.2019.24.31.1800488
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error