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

被引:128
作者
Izurieta, Hector S. [1 ,4 ]
Chillarige, Yoganand [2 ]
Kelman, Jeffrey [3 ]
Wei, Yuqin [2 ]
Lu, Yun [1 ]
Xu, Wenjie [2 ]
Lu, Michael [2 ]
Pratt, Douglas [1 ]
Chu, Steve [3 ]
Wernecke, Michael [2 ]
MaCurdy, Thomas [2 ]
Forshee, Richard [1 ]
机构
[1] US FDA, Ctr Biol Evaluat & Res, 10903 New Hampshire Ave, Silver Spring, MD 20993 USA
[2] Acumen, Burlingame, CA USA
[3] Ctr Medicare & Medicaid Serv, Washington, DC USA
[4] Univ Rey Juan Carlos, Dept Epidemiol, Madrid, Spain
关键词
influenza vaccine; vaccine effectiveness; relative vaccine effectiveness; cell-cultured vaccine; SEASONAL INFLUENZA; GLYCOSYLATION SITE; HOSPITALIZATIONS; VACCINATION; VIRUS; OLDER;
D O I
10.1093/infdis/jiy716
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. 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. Methods. Retrospective cohort study on Medicare beneficiaries aged >= 65 years who received an influenza vaccine (cell-cultured, egg-based quadrivalent; egg-based high-dose, adjuvanted, or standard-dose trivalent) during the 2017-2018 season. We used Poisson regression to evaluate relative VE (RVE) in preventing influenza-related hospital encounters. Results. Of >13 million beneficiaries, RVE for cell-cultured vaccines relative to egg-based quadrivalent vaccines was 10% (95% confidence interval [CI], 7%-13%). In a midseason interim analysis, this estimate was 16.5% (95% CI, 10.3%-22.2%). In a 5-way comparison, cell-cultured (RVE, 11%; 95% CI, 8%-14%) and egg-based high-dose (RVE, 9%; 95% CI, 7%-11%) vaccines were more effective than egg-based quadrivalent vaccines. Conclusions. The modest VE difference between cell-cultured and egg-based vaccines only partially explains the low overall VE reported by the Centers for Disease Control and Prevention, suggesting that egg adaptation was not the main contributor to the low VE found among individuals aged >= 65 years. The midseason interim analysis we performed demonstrates that our methods can be used to evaluate VE actively during the influenza season.
引用
收藏
页码:1255 / 1264
页数:10
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