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Abstract

Introduction

Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE).

Aim

The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort.

Methods

We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0–14, 15–64, ≥ 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32–54-year-olds (1964–86) sharing potential childhood imprinting to serine at haemagglutinin position 159.

Results

Influenza A(H3N2) VE among all ages was −1% (95% confidence interval (CI): −24 to 18) and 46% (95% CI: 8–68), −26% (95% CI: −66 to 4) and 20% (95% CI: −20 to 46) among 0–14, 15–64 and ≥ 65-year-olds, respectively. Among 15–64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: −34 to 50) and −74% (95% CI: −259 to 16), respectively. VE was −18% (95% CI: −140 to 41), −53% (95% CI: −131 to −2) and −12% (95% CI: −74 to 28) among 15–31-year-olds (1987–2003), 32–54-year-olds (1964–86) and 55–64-year-olds (1954–63), respectively.

Discussion

The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964–86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15–64-year-olds and the public health impact of the I-REV hypothesis warrant further study.

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2019-11-28
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Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15–64-year-olds in Europe: exploration by birth cohort
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Esther+Kissling&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kissling Esther</a>, <a href="/search?value1=Francisco+Pozo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pozo Francisco</a>, <a href="/search?value1=Silke+Buda&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Buda Silke</a>, <a href="/search?value1=Ana-Maria+Vilcu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vilcu Ana-Maria</a>, <a href="/search?value1=Alin+Gherasim&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gherasim Alin</a>, <a href="/search?value1=Mia+Brytting&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brytting Mia</a>, <a href="/search?value1=Lisa+Domegan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Domegan Lisa</a>, <a href="/search?value1=Ver%C3%B3nica+G%C3%B3mez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gómez Verónica</a>, <a href="/search?value1=Adam+Meijer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meijer Adam</a>, <a href="/search?value1=Mihaela+Lazar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lazar Mihaela</a>, <a href="/search?value1=Vesna+Vi%C5%A1ekruna+Vu%C4%8Dina&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vučina Vesna Višekruna</a>, <a href="/search?value1=Ralf+D%C3%BCrrwald&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dürrwald Ralf</a>, <a href="/search?value1=Sylvie+van+der+Werf&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van der Werf Sylvie</a>, <a href="/search?value1=Amparo+Larrauri&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Larrauri Amparo</a>, <a href="/search?value1=Theresa+Enkirch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Enkirch Theresa</a>, <a href="/search?value1=Joan+O%E2%80%99Donnell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">O’Donnell Joan</a>, <a href="/search?value1=Raquel+Guiomar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guiomar Raquel</a>, <a href="/search?value1=Mari%C3%ABtte+Hooiveld&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hooiveld Mariëtte</a>, <a href="/search?value1=Goranka+Petrovi%C4%87&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Petrović Goranka</a>, <a href="/search?value1=Elena+Stoian&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stoian Elena</a>, <a href="/search?value1=Pasi+Penttinen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Penttinen Pasi</a>, <a href="/search?value1=Marta+Valenciano&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Valenciano Marta</a>, <a href="/search?value1=I-MOVE+primary+care+study+team&option1=author&noRedirect=true" class="nonDisambigAuthorLink">I-MOVE primary care study team</a></span>. Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15–64-year-olds in Europe: exploration by birth cohort. <a href="/content/ecdc">Euro Surveill.</a> 2019;24(48):pii=1900604. <a href="https://doi.org/10.2807/1560-7917.ES.2019.24.48.1900604" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2019.24.48.1900604</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 30 Sept 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 06 Nov 2019 </span> </p>
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