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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]

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