Vaccine effectiveness against influenza A(H3N2)-associated hospitalized illness, United States, 2022

Mark W Tenforde; Manish M Patel; Nathaniel M Lewis; Katherine Adams; Manjusha Gaglani; Jay S Steingrub; Nathan I Shapiro; Abhijit Duggal; Matthew E Prekker; Ithan D Peltan; David N Hager; Michelle N Gong; Matthew C Exline; Adit A Ginde; Nicholas M Mohr; Christopher Mallow; Emily T Martin; H Keipp Talbot; Kevin W Gibbs; Jennie H Kwon; James D Chappell; Natasha Halasa; Adam S Lauring; Christopher J Lindsell; Sydney A Swan; Kimberly W Hart; Kelsey N Womack; Adrienne Baughman; Carlos G Grijalva; Wesley H Self

doi:10.1093/cid/ciac869

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Vaccine effectiveness against influenza A(H3N2)-associated hospitalized illness, United States, 2022

Journal article

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Vaccine effectiveness against influenza A(H3N2)-associated hospitalized illness, United States, 2022

Mark W Tenforde, Manish M Patel, Nathaniel M Lewis, Katherine Adams, Manjusha Gaglani, Jay S Steingrub, Nathan I Shapiro, Abhijit Duggal, Matthew E Prekker, Ithan D Peltan, …

Clinical infectious diseases, Vol.76(6), pp.1030-1037

03/15/2023

DOI: 10.1093/cid/ciac869

PMCID: PMC10226741

PMID: 36327388

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Abstract

BACKGROUND The COVID-19 pandemic was associated with historically low influenza circulation during the 2020-2021 season, followed by increase in influenza circulation during the 2021-2022 US season. The 2a.2 subgroup of the influenza A(H3N2) 3C.2a1b subclade that predominated was antigenically different from the vaccine strain. METHODS To understand the effectiveness of the 2021-2022 vaccine against hospitalized influenza illness, a multi-state sentinel surveillance network enrolled adults aged ≥18 years hospitalized with acute respiratory illness (ARI) and tested for influenza by a molecular assay. Using the test-negative design, vaccine effectiveness (VE) was measured by comparing the odds of current season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative controls, adjusting for confounders. A separate analysis was performed to illustrate bias introduced by including SARS-CoV-2 positive controls. RESULTS A total of 2334 patients, including 295 influenza cases (47% vaccinated), 1175 influenza- and SARS-CoV-2 negative controls (53% vaccinated), and 864 influenza-negative and SARS-CoV-2 positive controls (49% vaccinated), were analyzed. Influenza VE was 26% (95%CI: -14 to 52%) among adults aged 18-64 years, -3% (95%CI: -54 to 31%) among adults aged ≥65 years, and 50% (95%CI: 15 to 71%) among adults 18-64 years without immunocompromising conditions. Estimated VE decreased with inclusion of SARS-CoV-2-positive controls. CONCLUSIONS During a season where influenza A(H3N2) was antigenically different from the vaccine virus, vaccination was associated with a reduced risk of influenza hospitalization in younger immunocompetent adults. However, vaccination did not provide protection in adults ≥65 years of age. Improvements in vaccines, antivirals, and prevention strategies are warranted.

Details

Title: Subtitle: Vaccine effectiveness against influenza A(H3N2)-associated hospitalized illness, United States, 2022
Creators: Mark W Tenforde - Centers for Disease Control and Prevention
Manish M Patel - Centers for Disease Control and Prevention
Nathaniel M Lewis - Centers for Disease Control and Prevention
Katherine Adams - Centers for Disease Control and Prevention
Manjusha Gaglani - Scott & White Hospital
Jay S Steingrub - Baystate Medical Center
Nathan I Shapiro - Beth Israel Deaconess Medical Center
Abhijit Duggal - Cleveland Clinic
Matthew E Prekker - Hennepin County Medical Center
Ithan D Peltan - Intermountain Medical Center
David N Hager - Johns Hopkins Medicine
Michelle N Gong - Montefiore Medical Center
Matthew C Exline - The Ohio State University
Adit A Ginde - University of Colorado Denver
Nicholas M Mohr - University of Iowa
Christopher Mallow - University of Miami
Emily T Martin - University of Michigan
H Keipp Talbot - Vanderbilt University Medical Center
Kevin W Gibbs - Wake Forest University
Jennie H Kwon - Washington University in St. Louis
James D Chappell - Vanderbilt University Medical Center
Natasha Halasa - Vanderbilt University Medical Center
Adam S Lauring - University of Michigan
Christopher J Lindsell - Vanderbilt University Medical Center
Sydney A Swan - Vanderbilt University Medical Center
Kimberly W Hart - Vanderbilt University Medical Center
Kelsey N Womack - Vanderbilt University Medical Center
Adrienne Baughman - Vanderbilt University Medical Center
Carlos G Grijalva - Vanderbilt University Medical Center
Wesley H Self - Vanderbilt University Medical Center
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.76(6), pp.1030-1037
DOI: 10.1093/cid/ciac869
PMID: 36327388
PMCID: PMC10226741
NLM abbreviation: Clin Infect Dis
ISSN: 1058-4838
eISSN: 1537-6591
Grant note: DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention; DOI: 10.13039/100000875, name: Clinical and Translational Science Award, award: UL1 TR002243; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences; DOI: 10.13039/100000002, name: NIH
Language: English
Electronic publication date: 11/03/2022
Date published: 03/15/2023
Academic Unit: Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
Record Identifier: 9984313059502771

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