Journal
CLINICAL INFECTIOUS DISEASES
Volume 60, Issue 8, Pages 1170-1175Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/civ019
Keywords
influenza; split-virion vaccine; subunit vaccine; clinical effectiveness; older adults
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Funding
- Centers for Disease Control and Prevention (CDC) [1U181P000184-01]
- RTI International/CDC [200-2008-24624]
- National Heart, Lung, and Blood Institute [R21HL097334]
- National Institute on Aging [1R01AG043419]
- National Center for Research Resources, National Institutes of Health [1 UL1 RR024975]
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Background. Inactivated influenza vaccines are manufactured using either split-virion or subunit methods. These 2 methods produce similar hemagglutinin antibody responses, but different cellular immune responses. Methods. We compared the effectiveness of split-virion influenza vaccines to that of subunit influenza vaccines using prospectively collected data from adults aged >= 50 years who sought care for acute respiratory illness during 3 influenza seasons: 2008-2009, 2010-2011, and 2011-2012 using a case-positive, control test-negative study design. Results. Complete data were available for 539 participants, of whom 68 (12.6%) had influenza detected. Influenza-infected patients were younger (P <.001), were more likely to have received no vaccine or the subunit influenza vaccine than the split-virion vaccine (P <.001), and more likely to have sought care in either the emergency department or the acute care clinic than the hospital (P =.001). Split-virion vaccine effectiveness was 77.8% (95% confidence interval [CI], 58.5%-90.3%) compared with subunit vaccine effectiveness of 44.2% (95% CI, -11.8% to 70.9%), giving a difference in vaccine effectiveness of 33.5% (95% CI, 6.9%-86.7%). Conclusions. Studies need to be done to further explore if there are differences in clinical effectiveness in older adults for the 2 vaccine manufacturing methods.
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