Waning of Measured Influenza Vaccine Effectiveness Over Time: The Potential Contribution of Leaky Vaccine Effect.

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Tytuł:: Waning of Measured Influenza Vaccine Effectiveness Over Time: The Potential Contribution of Leaky Vaccine Effect.
Autorzy:: Tokars JI; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Patel MM; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Foppa IM; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Battelle, Atlanta, Georgia, USA.
Reed C; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Fry AM; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Ferdinands JM; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Źródło:: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2020 Dec 17; Vol. 71 (10), pp. e633-e641.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Jan. 2011- : Oxford : Oxford University Press
Original Publication: Chicago, IL : The University of Chicago Press, c1992-
MeSH Terms:: Influenza A Virus, H1N1 Subtype*
Influenza Vaccines*
Influenza, Human*/epidemiology
Influenza, Human*/prevention & control
Humans ; Influenza A Virus, H3N2 Subtype ; Seasons ; Vaccination
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Grant Information:: CC999999 United States ImCDC Intramural CDC HHS
Contributed Indexing:: Keywords: influenza; leaky vaccine; statistical estimation; vaccine effectiveness; vaccine mechanism
Substance Nomenclature:: 0 (Influenza Vaccines)
Entry Date(s):: Date Created: 20200401 Date Completed: 20210428 Latest Revision: 20211218
Update Code:: 20240105
PubMed Central ID:: PMC8422999
DOI:: 10.1093/cid/ciaa340
PMID:: 32227109
: Czasopismo naukowe

Background: Several observational studies have shown decreases in measured influenza vaccine effectiveness (mVE) during influenza seasons. One study found decreases of 6-11%/month during the 2011-2012 to 2014-2015 seasons. These findings could indicate waning immunity but could also occur if vaccine effectiveness is stable and vaccine provides partial protection in all vaccinees ("leaky") rather than complete protection in a subset of vaccinees. Since it is unknown whether influenza vaccine is leaky, we simulated the 2011-2012 to 2014-2015 influenza seasons to estimate the potential contribution of leaky vaccine effect to the observed decline in mVE.
Methods: We used available data to estimate daily numbers of vaccinations and infections with A/H1N1, A/H3N2, and B viruses. We assumed that vaccine effect was leaky, calculated mVE as 1 minus the Mantel-Haenszel relative risk of vaccine on incident cases, and determined the mean mVE change per 30 days since vaccination. Because change in mVE was highly dependent on infection rates, we performed simulations using low (15%) and high (31%) total (including symptomatic and asymptomatic) seasonal infection rates.
Results: For the low infection rate, decreases (absolute) in mVE per 30 days after vaccination were 2% for A/H1N1 and 1% for A/H3N2and B viruses. For the high infection rate, decreases were 5% for A/H1N1, 4% for A/H3, and 3% for B viruses.
Conclusions: The leaky vaccine bias could account for some, but probably not all, of the observed intraseasonal decreases in mVE. These results underscore the need for strategies to deal with intraseasonal vaccine effectiveness decline.
(Published by Oxford University Press for the Infectious Diseases Society of America 2020.)

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