Effectiveness of the trivalent MF59 adjuvated influenza vaccine in preventing hospitalization due to influenza B and A(H1N1)pdm09 viruses in the elderly in Italy, 2017 - 2018 season

Antonino Bella, Francesco Gesualdo, Andrea Orsi, Claudia Arcuri, Maria Chironna, Daniela Loconsole, Christian Napoli, Giovanni Battista Orsi, Ilaria Manini, Emanuele Montomoli, Valeria Alfonsi, Maria Rita Castrucci, Caterina Rizzo

Research output: Contribution to journalArticle

Abstract

Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidity in the elderly is weak. Our aim was to measure the VE against severe outcomes in the elderly. Methods: We conducted a multicentre hospital-based test-negative design (TND) case-control study, during the 2017/18 season, in four Italian hospitals. The study population included individuals aged ≥65 years hospitalized with Severe Acute Respiratory Infections (SARI). Patients were classified as cases and controls based on the results of the PCR influenza testing. We estimated VE by virus subtypes and specific VE for the trivalent adjuvanted vaccine (TIVadj). Results: 502 patients with SARI were enrolled: 118 (23.5%) tested positive (cases) and 384 (76.5%) tested negative (controls) for influenza. The adjusted VE of 48.5% for all vaccines was comparable to the adjusted VE for the TIVadj vaccine (48.3%). Adjusted VE for the TIVadj vaccine was 67.5% for A(H1N1)pdm09 and 44.5% for B viruses. Conclusion: We show a moderate adjusted VE of the TIVadj against all viruses, a good adjusted VE against A(H1N1)pdm09 strains and a moderate adjusted VE against B strains, despite a mismatch between the B circulating lineage and the lineage included in the vaccine. This is likely due to the cross-protection among B strains induced by the TIVadj in elderly patients.

Original languageEnglish
Pages (from-to)671-679
Number of pages9
JournalExpert Review of Vaccines
Volume18
Issue number6
DOIs
Publication statusPublished - Jun 2019

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H1N1 Subtype Influenza A Virus
Influenza Vaccines
Human Influenza
Italy
Hospitalization
Vaccines
MF59 oil emulsion
Respiratory Tract Infections
Cross Protection
Viruses
Cercopithecine Herpesvirus 1

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Effectiveness of the trivalent MF59 adjuvated influenza vaccine in preventing hospitalization due to influenza B and A(H1N1)pdm09 viruses in the elderly in Italy, 2017 - 2018 season. / Bella, Antonino; Gesualdo, Francesco; Orsi, Andrea; Arcuri, Claudia; Chironna, Maria; Loconsole, Daniela; Napoli, Christian; Orsi, Giovanni Battista; Manini, Ilaria; Montomoli, Emanuele; Alfonsi, Valeria; Castrucci, Maria Rita; Rizzo, Caterina.

In: Expert Review of Vaccines, Vol. 18, No. 6, 06.2019, p. 671-679.

Research output: Contribution to journalArticle

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title = "Effectiveness of the trivalent MF59 adjuvated influenza vaccine in preventing hospitalization due to influenza B and A(H1N1)pdm09 viruses in the elderly in Italy, 2017 - 2018 season",
abstract = "Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidity in the elderly is weak. Our aim was to measure the VE against severe outcomes in the elderly. Methods: We conducted a multicentre hospital-based test-negative design (TND) case-control study, during the 2017/18 season, in four Italian hospitals. The study population included individuals aged ≥65 years hospitalized with Severe Acute Respiratory Infections (SARI). Patients were classified as cases and controls based on the results of the PCR influenza testing. We estimated VE by virus subtypes and specific VE for the trivalent adjuvanted vaccine (TIVadj). Results: 502 patients with SARI were enrolled: 118 (23.5{\%}) tested positive (cases) and 384 (76.5{\%}) tested negative (controls) for influenza. The adjusted VE of 48.5{\%} for all vaccines was comparable to the adjusted VE for the TIVadj vaccine (48.3{\%}). Adjusted VE for the TIVadj vaccine was 67.5{\%} for A(H1N1)pdm09 and 44.5{\%} for B viruses. Conclusion: We show a moderate adjusted VE of the TIVadj against all viruses, a good adjusted VE against A(H1N1)pdm09 strains and a moderate adjusted VE against B strains, despite a mismatch between the B circulating lineage and the lineage included in the vaccine. This is likely due to the cross-protection among B strains induced by the TIVadj in elderly patients.",
author = "Antonino Bella and Francesco Gesualdo and Andrea Orsi and Claudia Arcuri and Maria Chironna and Daniela Loconsole and Christian Napoli and Orsi, {Giovanni Battista} and Ilaria Manini and Emanuele Montomoli and Valeria Alfonsi and Castrucci, {Maria Rita} and Caterina Rizzo",
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T1 - Effectiveness of the trivalent MF59 adjuvated influenza vaccine in preventing hospitalization due to influenza B and A(H1N1)pdm09 viruses in the elderly in Italy, 2017 - 2018 season

AU - Bella, Antonino

AU - Gesualdo, Francesco

AU - Orsi, Andrea

AU - Arcuri, Claudia

AU - Chironna, Maria

AU - Loconsole, Daniela

AU - Napoli, Christian

AU - Orsi, Giovanni Battista

AU - Manini, Ilaria

AU - Montomoli, Emanuele

AU - Alfonsi, Valeria

AU - Castrucci, Maria Rita

AU - Rizzo, Caterina

PY - 2019/6

Y1 - 2019/6

N2 - Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidity in the elderly is weak. Our aim was to measure the VE against severe outcomes in the elderly. Methods: We conducted a multicentre hospital-based test-negative design (TND) case-control study, during the 2017/18 season, in four Italian hospitals. The study population included individuals aged ≥65 years hospitalized with Severe Acute Respiratory Infections (SARI). Patients were classified as cases and controls based on the results of the PCR influenza testing. We estimated VE by virus subtypes and specific VE for the trivalent adjuvanted vaccine (TIVadj). Results: 502 patients with SARI were enrolled: 118 (23.5%) tested positive (cases) and 384 (76.5%) tested negative (controls) for influenza. The adjusted VE of 48.5% for all vaccines was comparable to the adjusted VE for the TIVadj vaccine (48.3%). Adjusted VE for the TIVadj vaccine was 67.5% for A(H1N1)pdm09 and 44.5% for B viruses. Conclusion: We show a moderate adjusted VE of the TIVadj against all viruses, a good adjusted VE against A(H1N1)pdm09 strains and a moderate adjusted VE against B strains, despite a mismatch between the B circulating lineage and the lineage included in the vaccine. This is likely due to the cross-protection among B strains induced by the TIVadj in elderly patients.

AB - Background: Evidence on influenza vaccine effectiveness (VE) in preventing mortality and morbidity in the elderly is weak. Our aim was to measure the VE against severe outcomes in the elderly. Methods: We conducted a multicentre hospital-based test-negative design (TND) case-control study, during the 2017/18 season, in four Italian hospitals. The study population included individuals aged ≥65 years hospitalized with Severe Acute Respiratory Infections (SARI). Patients were classified as cases and controls based on the results of the PCR influenza testing. We estimated VE by virus subtypes and specific VE for the trivalent adjuvanted vaccine (TIVadj). Results: 502 patients with SARI were enrolled: 118 (23.5%) tested positive (cases) and 384 (76.5%) tested negative (controls) for influenza. The adjusted VE of 48.5% for all vaccines was comparable to the adjusted VE for the TIVadj vaccine (48.3%). Adjusted VE for the TIVadj vaccine was 67.5% for A(H1N1)pdm09 and 44.5% for B viruses. Conclusion: We show a moderate adjusted VE of the TIVadj against all viruses, a good adjusted VE against A(H1N1)pdm09 strains and a moderate adjusted VE against B strains, despite a mismatch between the B circulating lineage and the lineage included in the vaccine. This is likely due to the cross-protection among B strains induced by the TIVadj in elderly patients.

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DO - 10.1080/14760584.2019.1627206

M3 - Article

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JO - Expert Review of Vaccines

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SN - 1476-0584

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ER -