Relative Effectiveness of Cell-Cultured and Egg-Based Influenza Vaccines Among Elderly Persons in the United States, 2017–2018

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Abstract

The low influenza vaccine effectiveness (VE) observed during the A(H3N2)-dominated 2017-2018 season may be due to vaccine virus adaptation to growth in eggs. We compared the effectiveness of cell-cultured and egg-based vaccines among Medicare beneficiaries.

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Most cited references 16

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Efficacy of high-dose versus standard-dose influenza vaccine in older adults.

Carlos DiazGranados, Andrew J Dunning, Murray Kimmel … (2014)

As compared with a standard-dose vaccine, a high-dose, trivalent, inactivated influenza vaccine (IIV3-HD) improves antibody responses to influenza among adults 65 years of age or older. This study evaluated whether IIV3-HD also improves protection against laboratory-confirmed influenza illness.

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Hospitalizations associated with influenza and respiratory syncytial virus in the United States, 1993-2008.

Hong Xing Zhou, William W Thompson, Cecile G. Viboud … (2012)

Age-specific comparisons of influenza and respiratory syncytial virus (RSV) hospitalization rates can inform prevention efforts, including vaccine development plans. Previous US studies have not estimated jointly the burden of these viruses using similar data sources and over many seasons. We estimated influenza and RSV hospitalizations in 5 age categories (<1, 1-4, 5-49, 50-64, and ≥65 years) with data for 13 states from 1993-1994 through 2007-2008. For each state and age group, we estimated the contribution of influenza and RSV to hospitalizations for respiratory and circulatory disease by using negative binomial regression models that incorporated weekly influenza and RSV surveillance data as covariates. Mean rates of influenza and RSV hospitalizations were 63.5 (95% confidence interval [CI], 37.5-237) and 55.3 (95% CI, 44.4-107) per 100000 person-years, respectively. The highest hospitalization rates for influenza were among persons aged ≥65 years (309/100000; 95% CI, 186-1100) and those aged <1 year (151/100000; 95% CI, 151-660). For RSV, children aged <1 year had the highest hospitalization rate (2350/100000; 95% CI, 2220-2520) followed by those aged 1-4 years (178/100000; 95% CI, 155-230). Age-standardized annual rates per 100000 person-years varied substantially for influenza (33-100) but less for RSV (42-77). Overall US hospitalization rates for influenza and RSV are similar; however, their age-specific burdens differ dramatically. Our estimates are consistent with those from previous studies focusing either on influenza or RSV. Our approach provides robust national comparisons of hospitalizations associated with these 2 viral respiratory pathogens by age group and over time.

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Influenza and the rates of hospitalization for respiratory disease among infants and young children.

Hector Izurieta, William W Thompson, Piotr Kramarz … (2000)

Young children may be at increased risk for serious complications from influenzavirus infection. However, in population-based studies it has been difficult to separate the effects of influenzavirus from those of respiratory syncytial virus. Respiratory syncytial virus often circulates with influenzaviruses and is the most frequent cause of hospitalization for lower respiratory tract infections in infants and young children. We studied the rates of hospitalization for acute respiratory-disease among infants and children during periods when the circulation of influenzaviruses predominated over the circulation of respiratory syncytial virus. For each season from October to May during the period from 1992 to 1997, we used local viral surveillance data to define periods in Washington State and northern California when the circulation of influenzaviruses predominated over that of respiratory syncytial virus. We calculated the rates of hospitalization for acute respiratory disease, excess rates attributable to influenzavirus, and incidence-rate ratios for all infants and children younger than 18 years of age who were enrolled in either the Kaiser Permanente Medical Care Program of Northern California or the Group Health Cooperative of Puget Sound. The rates of hospitalization for acute respiratory disease among children who did not have conditions that put them at high risk for complications of influenza (e.g., asthma, cardiovascular diseases, or premature birth) and who were younger than two years of age were 231 per 100,000 person-months at Northern California Kaiser sites (from 1993 to 1997) and 193 per 100,000 person-months at Group Health Cooperative sites (from 1992 to 1997). These rates were approximately 12 times as high as the rates among children without high-risk conditions who were 5 to 17 years of age (19 per 100,000 person-months at Northern California Kaiser sites and 16 per 100,000 person-months at Group Health Cooperative sites) and approached the rates among children with chronic health conditions who were 5 to 17 years of age (386 per 100,000 person-months and 216 per 100,000 person-months, respectively). Infants and young children without chronic or serious medical conditions are at increased risk for hospitalization during influenza seasons. Routine influenza vaccination should be considered in these children.

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Author and article information

Journal

Title: The Journal of Infectious Diseases

Publisher: Oxford University Press (OUP)

ISSN (Print): 0022-1899

ISSN (Electronic): 1537-6613

Publication date Created: December 18 2018

Publication date (Electronic): December 18 2018

Affiliations

[1 ]Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland

[2 ]Department of Epidemiology, Universidad Rey Juan Carlos, Spain

[3 ]Acumen, Burlingame, California

[4 ]Centers for Medicare & Medicaid Services, Washington DC

Article

DOI: 10.1093/infdis/jiy716

PubMed ID: 30561688

SO-VID: eb594c35-aa8a-4d7c-843d-bc4ef0535c0b

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https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

Relative Effectiveness of Cell-Cultured and Egg-Based Influenza Vaccines Among Elderly Persons in the United States, 2017–2018

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Vaccines

Most cited references 16

Efficacy of high-dose versus standard-dose influenza vaccine in older adults.

Hospitalizations associated with influenza and respiratory syncytial virus in the United States, 1993-2008.

Influenza and the rates of hospitalization for respiratory disease among infants and young children.

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