Influenza Vaccine Effectiveness in the Netherlands from 2003/2004 through 2013/2014: The Importance of Circulating Influenza Virus Types and Subtypes

• Published in: PloS one 2017-01, Vol.12 (1), p.e0169528-e0169528
• Main Authors: Darvishian, Maryam, Dijkstra, Frederika, van Doorn, Eva, Bijlsma, Maarten J, Donker, Gé A, de Lange, Marit M A, Cadenau, Laura M, Hak, Eelko, Meijer, Adam
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biology and life sciences; Case-Control Studies; Child; Child, Preschool; Disease control; Epidemiology; Estimates; Female; Health aspects; Health surveillance; History, 21st Century; Humans; Illnesses; Immunization; Infant; Infant, Newborn; Infections; Infectious diseases; Influenza; Influenza A Virus, H1N1 Subtype - immunology; Influenza A Virus, H3N2 Subtype - immunology; Influenza B virus - immunology; Influenza vaccines; Influenza Vaccines - immunology; Influenza viruses; Influenza, Human - history; Influenza, Human - prevention & control; Influenza, Human - virology; Laboratories; Male; Medicine and Health Sciences; Middle Aged; Mortality; Netherlands - epidemiology; Orthomyxoviridae; Outcome Assessment (Health Care); Patient outcomes; Patients; People and Places; Pharmacoeconomics; Pharmacy; Population; Prevention; Primary care; Public health; Respiratory tract; Respiratory tract diseases; Seasons; Sentinel Surveillance; Surveillance; Vaccine efficacy; Vaccines; Viruses; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0169528

Influenza vaccine effectiveness (IVE) varies over different influenza seasons and virus (sub)types/lineages. To assess the association between IVE and circulating influenza virus (sub)types/lineages, we estimated the overall and (sub)type specific IVE in the Netherlands. We conducted a test-negative case control study among subjects with influenza-like illness or acute respiratory tract infection consulting the Sentinel Practices over 11 influenza seasons (2003/2004 through 2013/2014) in the Netherlands. The adjusted IVE was estimated using generalized linear mixed modelling and multiple logistic regression. In seven seasons vaccine strains did not match the circulating viruses. Overall adjusted IVE was 40% (95% CI 18 to 56%) and 20% (95% CI -5 to 38%) when vaccine (partially)matched and mismatched the circulating viruses, respectively. When A(H3N2) was the predominant virus, IVE was 38% (95% CI 14 to 55%). IVE against infection with former seasonal A(H1N1) virus was 83% (95% CI 52 to 94%), and with B virus 67% (95% CI 55 to 76%). In conclusion IVE estimates were particularly low when vaccine mismatched the circulating viruses and A(H3N2) was the predominant influenza virus subtype. Tremendous effort is required to improve vaccine production procedure and to explore the factors that influence the IVE against A(H3N2) virus.