Preliminary End-of-Season Estimates of 2014/15 Influenza Vaccine Effectiveness in Preventing Laboratory-Confirmed Influenza-Related Hospitalization From the Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)
Notice bibliographique
Résumé
Background. Canada's 2014/15 influenza season was characterized by early, intense influenza A(H3N2) activity followed by a smaller influenza B peak. Characterization of circulating viruses demonstrated poor match with the A(H3N2) component of the 2014/15 vaccine suggesting vaccine effectiveness (VE) would be suboptimal. We provide end-of-season estimates of influenza VE for prevention of influenza-related hospitalization in adults. Methods. The SOS Network conducted active surveillance for influenza in hospitalized adults from 15 November 2014 to 30 April 2015 in 16 hospitals. A nasopharyngeal swab for influenza PCR was obtained from all adult patients admitted with acute respiratory illness. Cases were PCR-positive; those influenza-PCR negative within 7 days of symptom onset with known influenza vaccination status were controls. Crude VE estimates were adjusted using multivariable logistic regression with stepwise backward selection of covariates with a p-value of <0.1 in the univariate analysis. VE was estimated as (1 − OR) × 100. Results. 1693 cases and 1936 controls were enrolled; cases were older (mean age 76.1 versus 72.6y; p < .0001); 62.4% cases were >75y. Cases were more likely than controls to have received antivirals (AV) before admission (0.6% versus 0.1%; p = .009) and to be pregnant (1.3% versus 0.2%; p < .0005). 68.2% cases and 69.6% controls had received influenza vaccine ≥2 wks prior to symptom onset. Among all age groups, VE was −0.4% (95% CI −24.5 to 19.0%) against all strains, −32.7% (−91.2 to 7.9%) against A(H3N2) and 20.1% (−15.9 to 44.9%) against influenza B. Age, prior receipt of AV, BMI and ≥1 comorbidity were adjusted in the final regression model. In ≥ 65y, VE was −0.9% (−29.6 to 21.4%) against all strains, −36.2% (−105.9 to 9.9%) against A(H3N2) and 17.8% (−28.7 to 47.5%) against B. Conclusion. The 2014/15 season in Canada was dominated by circulation of a drifted influenza A(H3N2). Although VE cannot be predicted directly from virologic surveillance, mismatch between the circulating strain and vaccine strain this season did result in failure of the vaccine to provide protection against influenza-associated hospitalization. Influenza programs should ensure real-time VE assessment to inform adjunctive public health strategies to minimize influenza disease burden. Disclosures. S. Mcneil, GlaxoSmithKline: Grant Investigator and Investigator, Research grant; M. K. Andrew, GlaxoSmithKline: Grant Investigator, Research grant; G. Dos Santos, GSK Vaccines: Consultant, Salary; F. Haguinet, GSK Vaccines: Employee, Salary; T. Hatchette, GlaxoSmithKline: Grant Investigator, Research grant; J. Leblanc, GlaxoSmithKline: Grant Investigator, Research grant; J. E. Mcelhaney, Sanofi Pasteur: Independent Contractor, Speaker honorarium; R. Sharma, GSK Vaccines: Employee, Salary; V. Shinde, GSK Vaccines: Employee, Salary; L. Valiquette, Pfizer: Grant Investigator, Research grant. Merck: Grant Investigator, Research grant. GSK: Grant Investigator, Research grant
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».