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Relative Effectiveness of the Cell-Cultured Quadrivalent Influenza Vaccine Compared to Standard, Egg-Derived Quadrivalent Influenza Vaccines in Preventing Influenza-Like Illness in 2017-2018.

ABSTRACT: Influenza viral antigens may undergo adaptive mutations during egg-based vaccine production. In the 2017-2018 influenza season, quadrivalent ccIIV (ccIIV4) vaccine was produced using an A(H3N2) seed virus propagated exclusively in cell culture, thus lacking egg adaptive changes. This study aimed to estimate the relative vaccine effectiveness (rVE) of ccIIV4 versus egg-derived quadrivalent vaccines (egg-derived IIV4) in 2017-2018 in the US. Vaccination, outcome, and covariate data were ascertained retrospectively from a primary care electronic medical record (EMR) dataset and analyzed as a retrospective cohort study. The cohort included patients ?4 years of age who presented at a primary care facility enrolled in the EMR database. rVE was estimated against influenza-like illness (ILI) using diagnostic ICD-9 and ICD-10 codes. The adjusted odds ratios used to derive rVE estimates were estimated from multivariable logistic regression models adjusted for age, sex, race/ethnicity, geographic region, and health status. Overall 92,187 individuals had a primary care EMR record of ccIIV4 and 1,261,675 had a record of egg-derived IIV4. In the ccIIV4 group, 1,705 narrowly defined ILI events occurred, and 25,645 occurred in the standard egg-derived IIV4 group. The crude rVE was 9.2% (4.6% to 13.6%). When adjusted for age, sex, health status, comorbidities, and geographic region, the estimated rVE changed to 36.2% (26.1% to 44.9%). ccIIV4, derived from an A(H3N2) seed virus propagated exclusively in cell culture, was more effective than egg-derived IIV4 in preventing ILI during the 2017-2018 influenza season. This result suggests cell-derived influenza vaccines may have greater effectiveness than standard egg-derived vaccines.

SUBMITTER: Boikos C

PROVIDER: S-EPMC7745007 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Relative Effectiveness of the Cell-Cultured Quadrivalent Influenza Vaccine Compared to Standard, Egg-derived Quadrivalent Influenza Vaccines in Preventing Influenza-like Illness in 2017-2018.

Boikos Constantina C Sylvester Gregg C GC Sampalis John S JS Mansi James A JA

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20201201 10

<h4>Background</h4>Influenza antigens may undergo adaptive mutations during egg-based vaccine production. In the 2017-2018 influenza season, quadrivalent, inactivated cell-derived influenza vaccine (ccIIV4) vaccine was produced using A(H3N2) seed virus propagated exclusively in cell culture, thus lacking egg adaptive changes. This United States study estimated relative vaccine effectiveness (rVE) of ccIIV4 vs egg-derived quadrivalent vaccines (egg-derived IIV4) for that season.<h4>Methods</h4>Va ...[more]

PMID: 32253431

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Project description:BackgroundSeasonal influenza causes a considerable burden to healthcare services every year. To better measure the impact of severe influenza cases in Romania, we analyzed active surveillance data collected during the 2017-2018 season from patients admitted for influenza-like illness (ILI) at a tertiary care hospital in Bucharest.MethodsPatients admitted for acute ILI were included if they were resident in the Bucharest-Ilfov region, had been hospitalized for at least 24?h, and had onset of symptoms within 7?days before admission. Patient demographics, healthcare use, vaccination status, and outcome data were collected by questionnaire or by searching clinical records. Respiratory swabs were also obtained from each patient to confirm influenza A (A/H1 and A/H3 subtypes) or influenza B (Yamagata and Victoria lineages) infection by real-time reverse-transcription polymerase chain reaction assay.ResultsThe study included 502 patients, many (45.2%) of whom were aged <?5?years. Overall, 108 patients (21.5%) had one or more comorbidities. Seventeen adults aged 18-64?years (3.4%) had been vaccinated against influenza. Patients were hospitalized for a median of 5?days and most (90.4%) were prescribed antiviral treatment. More than one-half of the patients (n?=?259, 51.6%) were positive for influenza. Most influenza cases were caused by B viruses (172/259, 66.4%), which were mostly of the B/Yamagata lineage (85 of 94 characterized, 90.4%). Most of the subtyped A viruses were A/H1 (59/74, 79.7%). A/H1 viruses were frequently detected in influenza-positive admissions throughout the 2017-2018 season, whereas the predominant B/Yamagata viruses were detected around the middle of the season, with a peak in cases at week 7 of 2018. Eleven patients were admitted to an intensive care unit; of these, one patient with confirmed B/Yamagata infection died.ConclusionsThese results show that seasonal influenza results in considerable hospitalization in Bucharest-Ilfov, Romania and suggest vaccine coverage should be extended, especially to the youngest age groups. The data from this study should help inform and optimize national influenza healthcare policies.

Dataset Information

Relative Effectiveness of the Cell-Cultured Quadrivalent Influenza Vaccine Compared to Standard, Egg-Derived Quadrivalent Influenza Vaccines in Preventing Influenza-Like Illness in 2017-2018.

Publications

Relative Effectiveness of the Cell-Cultured Quadrivalent Influenza Vaccine Compared to Standard, Egg-derived Quadrivalent Influenza Vaccines in Preventing Influenza-like Illness in 2017-2018.

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