Influenza vaccine effectiveness in preventing hospitalizations with laboratory-confirmed influenza in Greece during the 2014-2015 season: A test-negative study

J Med Virol. 2016 Nov;88(11):1896-904. doi: 10.1002/jmv.24551. Epub 2016 Apr 26.

Abstract

The 2014-2015 influenza season was marked by circulation of antigenically drifted A/H3N2 strains, raising the possibility of low seasonal influenza Vaccine Effectiveness (VE). We assessed VE against hospitalization with laboratory-confirmed influenza for the 2014-2015 season, using routine surveillance data. Non-sentinel swab samples from Greek hospital inpatients were tested for influenza by RT-PCR in three laboratories, covering the entire country. We estimated VE using a test-negative design. Out of 883 patients with known vaccination status, 161 (18.2%) were vaccinated, and 392/883 patients (44.4%) tested positive for influenza, of whom 162 (41.3%) had type B and 151 (38.5%) had A/H3N2. Adjusted VE was 31.6% (95%CI: 2.9-51.8%) against any influenza, 46.8%, 95%CI: 12.5-67.6%) against type B and -1.9%, 95%CI: -69.5 to 38.7%) against A/H3N2. VE against non-ICU hospitalization appeared to be higher, but the difference did not reach statistical significance. Circulating A/H3N2 viruses showed substantial antigenic drift, while about half of the type B strains were similar to the vaccine strain. Despite the antigenic drift of the A/H3N2 strains, the vaccine still offered substantial protection against hospitalization with laboratory-confirmed influenza, mostly due to a surge in type B influenza late in the season. Vaccine coverage was low, even among groups targeted for vaccination, and considerable effort should be made to improve it. J. Med. Virol. 88:1896-1904, 2016. © 2016 Wiley Periodicals, Inc.

Keywords: epidemiology; immunity/immunization; influenza virus; seasonal incidence; surveillance; vaccine effectiveness; vaccines/vaccine strains.

MeSH terms

  • Adolescent
  • Adult
  • Antigens, Viral / genetics
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Clinical Laboratory Techniques
  • Epidemiological Monitoring
  • Female
  • Genetic Drift
  • Greece / epidemiology
  • Hospitalization*
  • Humans
  • Infant
  • Influenza A Virus, H1N1 Subtype / genetics
  • Influenza A Virus, H1N1 Subtype / immunology
  • Influenza A Virus, H3N2 Subtype / genetics
  • Influenza A Virus, H3N2 Subtype / immunology
  • Influenza B virus / immunology
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / immunology*
  • Influenza, Human / diagnosis*
  • Influenza, Human / epidemiology
  • Influenza, Human / prevention & control*
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Research Design
  • Seasons
  • Vaccination
  • Vaccine Potency
  • Young Adult

Substances

  • Antigens, Viral
  • Influenza Vaccines