Journal
CLINICAL INFECTIOUS DISEASES
Volume 63, Issue 12, Pages 1564-1573Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciw635
Keywords
influenza vaccine; vaccine effectiveness
Categories
Funding
- CDC
- University of Michigan [U01 IP000474]
- Group Health Research Institute [U01 IP000466]
- Marshfield Clinic Research Foundation [U01 IP000471]
- University of Pittsburgh [U01 IP000467]
- Baylor Scott and White Health [U01 IP000473]
- NIH [UL1 RR024153, UL1TR000005]
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Background. Circulating A/H3N2 influenza viruses drifted significantly after strain selection for the 2014-2015 vaccines. Also in 2014-2015, the Advisory Committee on Immunization Practices recommended preferential use of live attenuated influenza vaccine (LAIV) over inactivated influenza vaccine (IIV) among children aged 2-8 years. Methods. Vaccine effectiveness (VE) across age groups and vaccine types was examined among outpatients with acute respiratory illness at 5 US sites using a test-negative design, that compared the odds of vaccination among reverse transcription polymerase chain reaction-confirmed influenza positives and negatives. Results. Of 9311 enrollees with complete data, 7078 (76%) were influenza negative, 1840 (19.8%) were positive for influenza A (A/H3N2, n = 1817), and 395 (4.2%) were positive for influenza B (B/Yamagata, n = 340). The overall adjusted VE was 19% (95% confidence interval [CI], 10% to 27%) and was statistically significant in all age strata except those aged 18-64 years. The adjusted VE of 6% (95% CI, -5% to 17%) against A/H3N2-associated illness was not statistically significant, unlike VE for influenza B/Yamagata, which was 55% (95% CI, 43% to 65%). Among those aged 2-8 years, VE against A/H3N2 was 15% (95% CI, - 16% to 38%) for IIV and -3% (CI, -50% to 29%) for LAIV; VE against B/Yamagata was 40% (95% CI, -20% to 70%) for IIV and 74% (95% CI, 25% to 91%) for LAIV. Conclusions. The 2014-2015 influenza vaccines offered little protection against the predominant influenza A/H3N2 virus but were effective against influenza B. Preferential use of LAIV among young children was not supported.
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