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Influenza Vaccine Efficacy/Effectiveness: With Special Reference to Current Epidemiological Methodology

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Abstract

Influenza vaccination is the primary strategy for preventing influenza and its severe complications. Because influenza vaccine has been used internationally for a long time, the methodologies used to evaluate influenza vaccine efficacy/effectiveness have also changed over time. In this chapter, we provide an overview of the epidemiological approaches to assess influenza vaccine efficacy/effectiveness with reference to the fundamental principles of epidemiology. We also highlight the test-negative design, a modified case-control study, because it is currently the most desirable epidemiological approach for evaluating influenza vaccine effectiveness against laboratory-confirmed influenza. Evidence of vaccine effectiveness from test-negative design studies, global trends to monitor vaccine effectiveness using test-negative design across the seasons, inherent limitations of the current influenza vaccines in terms of effectiveness, available influenza vaccines worldwide, as well as future perspectives for vaccine development are also discussed.

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References

  1. Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2019-20 influenza season. MMWR Recomm Rep. 2019;68(3):1–21.

    Article  Google Scholar 

  2. Sheikh S, Biundo E, Courcier S, Damm O, Launay O, Maes E, et al. A report on the status of vaccination in Europe. Vaccine. 2018;36(33):4979–92.

    Article  Google Scholar 

  3. Fukushima W, Hirota Y. Basic principles of test-negative design in evaluating influenza vaccine effectiveness. Vaccine. 2017;35(36):4796–800.

    Article  Google Scholar 

  4. Jackson ML, Nelson JC. The test-negative design for estimating influenza vaccine effectiveness. Vaccine. 2013;31(17):2165–8.

    Article  Google Scholar 

  5. Foppa IM, Haber M, Ferdinands JM, Shay DK. The case test-negative design for studies of the effectiveness of influenza vaccine. Vaccine. 2013;31(30):3104–9.

    Article  Google Scholar 

  6. Sullivan SG, Tchetgen Tchetgen EJ, Cowling BJ. Theoretical basis of the test-negative study design for assessment of influenza vaccine effectiveness. Am J Epidemiol. 2016;184(5):345–53.

    Article  Google Scholar 

  7. Ozasa K, Fukushima W. Commentary: test negative design reduces confounding by healthcare-seeking attitude in case-control studies. J Epidemiol. 2019;29(8):279–81.

    Article  Google Scholar 

  8. Belongia EA, Simpson MD, King JP, Sundaram ME, Kelley NS, Osterholm MT, et al. Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. Lancet Infect Dis. 2016;16(8):942–51.

    Article  CAS  Google Scholar 

  9. Skowronski DM, Janjua NZ, De Serres G, Sabaiduc S, Eshaghi A, Dickinson JA, et al. Low 2012-13 influenza vaccine effectiveness associated with mutation in the egg-adapted H3N2 vaccine strain not antigenic drift in circulating viruses. PLoS One. 2014;9(3):e92153.

    Article  Google Scholar 

  10. Zost SJ, Parkhouse K, Gumina ME, Kim K, Diaz Perez S, Wilson PC, et al. Contemporary H3N2 influenza viruses have a glycosylation site that alters binding of antibodies elicited by egg-adapted vaccine strains. Proc Natl Acad Sci U S A. 2017;114(47):12578–83.

    Article  CAS  Google Scholar 

  11. Skowronski DM, Chambers C, Sabaiduc S, De Serres G, Winter AL, Dickinson JA, et al. Beyond antigenic match: possible agent-host and immuno-epidemiological influences on influenza vaccine effectiveness during the 2015-2016 season in Canada. J Infect Dis. 2017;216(12):1487–500.

    Article  Google Scholar 

  12. Cobey S, Gouma S, Parkhouse K, Chambers BS, Ertl HC, Schmader KE, et al. Poor immunogenicity, not vaccine strain egg adaptation, may explain the low H3N2 influenza vaccine effectiveness in 2012-2013. Clin Infect Dis. 2018;67(3):327–33.

    Article  CAS  Google Scholar 

  13. Rondy M, El Omeiri N, Thompson MG, Levêque A, Moren A, Sullivan SG. Effectiveness of influenza vaccines in preventing severe influenza illness among adults: a systematic review and meta-analysis of test-negative design case-control studies. J Infect. 2017;75(5):381–94.

    Article  Google Scholar 

  14. Ferdinands JM, Fry AM, Reynolds S, Petrie J, Flannery B, Jackson ML, et al. Intraseason waning of influenza vaccine protection: evidence from the US Influenza Vaccine Effectiveness Network, 2011-12 through 2014-15. Clin Infect Dis. 2017;64(5):544–50.

    PubMed  Google Scholar 

  15. Kissling E, Rondy M, I-MOVE/I-MOVE+ study team. Early 2016/17 vaccine effectiveness estimates against influenza A(H3N2): I-MOVE multicentre case control studies at primary care and hospital levels in Europe. Euro Surveill. 2017;22(7):30464.

    Article  Google Scholar 

  16. Skowronski DM, Zou M, Sabaiduc S, Murti M, Olsha R, Dickinson JA, et al. Interim estimates of 2019/20 vaccine effectiveness during early-season co-circulation of influenza A and B viruses, Canada, February 2020. Euro Surveill. 2020;25(7):2000103.

    Article  Google Scholar 

  17. Cheng AC, Holmes M, Dwyer DE, Senanayake S, Cooley L, Irving LB, et al. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2018: the Influenza Complications Alert Network (FluCAN). Commun Dis Intell (2018). 2019:43. https://pubmed.ncbi.nlm.nih.gov/31738866/

  18. Fukushima W, Morikawa S, Matsumoto K, Fujioka M, Matsushita T, Kubota M, et al. for the study group funded by Ministry of Health, Labour and Welfare Japan. Influenza vaccine effectiveness in Japanese children under 6 years: summary findings from 2013-14 season to 2017-18 season. IASR. 2019;40:194–5. [in Japanese]

    Google Scholar 

  19. World Health Organization. Recommended composition of influenza virus vaccines for use in the 2020-2021 northern hemisphere influenza season. https://www.who.int/influenza/vaccines/virus/recommendations/202002_recommendation.pdf?ua=1. Accessed 28 Mar 2020.

  20. Sano K, Ainai A, Suzuki T, Hasegawa H. Intranasal inactivated influenza vaccines for the prevention of seasonal influenza epidemics. Expert Rev Vaccines. 2018;17(8):687–96.

    Article  CAS  Google Scholar 

  21. Sekiya T, Mifsud EJ, Ohno M, Nomura N, Sasada M, Fujikura D, et al. Inactivated whole virus particle vaccine with potent immunogenicity and limited IL-6 induction is ideal for influenza. Vaccine. 2019;37(15):2158–66.

    Article  CAS  Google Scholar 

  22. Pleguezuelos O, Dille J, de Groen S, Oftung F, Niesters HGM, Islam MA, et al. Immunogenicity, safety, and efficacy of a standalone universal influenza vaccine, FLU-v, in healthy adults: a randomized clinical trial. Ann Intern Med. 2020;172(7):453–62.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan

    Wakaba Fukushima

  2. Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan

    Wakaba Fukushima

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  1. Wakaba Fukushima
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Correspondence to Wakaba Fukushima .

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Editors and Affiliations

  1. Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Jiro Fujita

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Fukushima, W. (2021). Influenza Vaccine Efficacy/Effectiveness: With Special Reference to Current Epidemiological Methodology. In: Fujita, J. (eds) Influenza. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-15-9109-9_20

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  • DOI: https://doi.org/10.1007/978-981-15-9109-9_20

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-9108-2

  • Online ISBN: 978-981-15-9109-9

  • eBook Packages: MedicineMedicine (R0)

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