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Abstract

Introduction

Annual influenza vaccination is recommended for older adults, but evidence regarding the impact of repeated vaccination has been inconclusive.

Aim

We investigated vaccine effectiveness (VE) against laboratory-confirmed influenza and the impact of repeated vaccination over 10 previous seasons on current season VE among older adults.

Methods

We conducted an observational test-negative study in community-dwelling adults aged > 65 years in Ontario, Canada for the 2010/11 to 2015/16 seasons by linking laboratory and health administrative data. We estimated VE using multivariable logistic regression. We assessed the impact of repeated vaccination by stratifying by previous vaccination history.

Results

We included 58,304 testing episodes for respiratory viruses, with 11,496 (20%) testing positive for influenza and 31,004 (53%) vaccinated. Adjusted VE against laboratory-confirmed influenza for the six seasons combined was 21% (95% confidence interval (CI): 18 to 24%). Patients who were vaccinated in the current season, but had received no vaccinations in the previous 10 seasons, had higher current season VE (34%; 95%CI: 9 to 52%) than patients who had received 1–3 (26%; 95%CI: 13 to 37%), 4–6 (24%; 95%CI: 15 to 33%), 7–8 (13%; 95%CI: 2 to 22%), or 9–10 (7%; 95%CI: −4 to 16%) vaccinations (trend test p = 0.001). All estimates were higher after correcting for misclassification of current season vaccination status. For patients who were not vaccinated in the current season, residual protection rose significantly with increasing numbers of vaccinations received previously.

Conclusions

Although VE appeared to decrease with increasing numbers of previous vaccinations, current season vaccination likely provides some protection against influenza regardless of the number of vaccinations received over the previous 10 influenza seasons.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2020.25.1.1900245
2020-01-09
2024-11-24
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2020.25.1.1900245
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The impact of repeated vaccination using 10-year vaccination history on protection against influenza in older adults: a test-negative design study across the 2010/11 to 2015/16 influenza seasons in Ontario, Canada
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Jeffrey+C+Kwong&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kwong Jeffrey C</a>, <a href="/search?value1=Hannah+Chung&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chung Hannah</a>, <a href="/search?value1=James+KH+Jung&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jung James KH</a>, <a href="/search?value1=Sarah+A+Buchan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Buchan Sarah A</a>, <a href="/search?value1=Aaron+Campigotto&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Campigotto Aaron</a>, <a href="/search?value1=Michael+A+Campitelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Campitelli Michael A</a>, <a href="/search?value1=Natasha+S+Crowcroft&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Crowcroft Natasha S</a>, <a href="/search?value1=Jonathan+B+Gubbay&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gubbay Jonathan B</a>, <a href="/search?value1=Timothy+Karnauchow&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Karnauchow Timothy</a>, <a href="/search?value1=Kevin+Katz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Katz Kevin</a>, <a href="/search?value1=Allison+J+McGeer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McGeer Allison J</a>, <a href="/search?value1=J+Dayre+McNally&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McNally J Dayre</a>, <a href="/search?value1=David+C+Richardson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Richardson David C</a>, <a href="/search?value1=Susan+E+Richardson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Richardson Susan E</a>, <a href="/search?value1=Laura+C+Rosella&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rosella Laura C</a>, <a href="/search?value1=Kevin+L+Schwartz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schwartz Kevin L</a>, <a href="/search?value1=Andrew+Simor&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Simor Andrew</a>, <a href="/search?value1=Marek+Smieja&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Smieja Marek</a>, <a href="/search?value1=George+Zahariadis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zahariadis George</a>, <a href="/search?value1=on+behalf+of+the+Canadian+Immunization+Research+Network+%28CIRN%29+investigators&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the Canadian Immunization Research Network (CIRN) investigators</a></span>. The impact of repeated vaccination using 10-year vaccination history on protection against influenza in older adults: a test-negative design study across the 2010/11 to 2015/16 influenza seasons in Ontario, Canada. <a href="/content/ecdc">Euro Surveill.</a> 2020;25(1):pii=1900245. <a href="https://doi.org/10.2807/1560-7917.ES.2020.25.1.1900245" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2020.25.1.1900245</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 13 Apr 2019;&nbsp;&nbsp; <span class="generated">Accepted</span>: 04 Dec 2019 </span> </p>
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