title: Effectiveness of non-adjuvanted pandemic influenza A vaccines for preventing pandemic influenza acute respiratory illness visits in 4 U.S. communities.
abstract: We estimated the effectiveness of four monovalent pandemic influenza A (H1N1) vaccines (three unadjuvanted inactivated, one live attenuated) available in the U.S. during the pandemic. Patients with acute respiratory illness presenting to inpatient and outpatient facilities affiliated with four collaborating institutions were prospectively recruited, consented, and tested for influenza. Analyses were restricted to October 2009 through April 2010, when pandemic vaccine was available. Patients testing positive for pandemic influenza by real-time RT-PCR were cases; those testing negative were controls. Vaccine effectiveness was estimated in logistic regression models adjusted for study community, patient age, timing of illness, insurance status, enrollment site, and presence of high-risk medical conditions. Pandemic virus was detected in 1,011 (15%) of 6,757 enrolled patients. Fifteen (1%) of 1,011 influenza positive cases and 1,042 (18%) of 5,746 test-negative controls had record-verified pandemic vaccination >14 days prior to illness onset. Adjusted effectiveness (95% confidence interval) for pandemic vaccines combined was 56% (23%, 75%). Adjusted effectiveness for inactivated vaccines alone (79% of total) was 62% (25%, 81%) overall and 32% (-92%, 76%), 89% (15%, 99%), and -6% (-231%, 66%) in those aged 0.5 to 9, 10 to 49, and 50+ years, respectively. Effectiveness for the live attenuated vaccine in those aged 2 to 49 years was only demonstrated if vaccination >7 rather than >14 days prior to illness onset was considered (61%∶ 12%, 82%). Inactivated non-adjuvanted pandemic vaccines offered significant protection against confirmed pandemic influenza-associated medical care visits in young adults.
authors.affiliation: Department of Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America. marie.griffin@vanderbilt.edu
authors.forename: Marie R
authors.initials: MR
authors.lastname: Griffin
authors.forename: Arnold S
authors.initials: AS
authors.lastname: Monto
authors.forename: Edward A
authors.initials: EA
authors.lastname: Belongia
authors.forename: John J
authors.initials: JJ
authors.lastname: Treanor
authors.forename: Qingxia
authors.initials: Q
authors.lastname: Chen
authors.forename: Jufu
authors.initials: J
authors.lastname: Chen
authors.forename: H Keipp
authors.initials: HK
authors.lastname: Talbot
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Ohmit
authors.forename: Laura A
authors.initials: LA
authors.lastname: Coleman
authors.forename: Gerry
authors.initials: G
authors.lastname: Lofthus
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Petrie
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Meece
authors.forename: Caroline Breese
authors.initials: CB
authors.lastname: Hall
authors.forename: John V
authors.initials: JV
authors.lastname: Williams
authors.forename: Paul
authors.initials: P
authors.lastname: Gargiullo
authors.forename: LaShondra
authors.initials: L
authors.lastname: Berman
authors.forename: David K
authors.initials: DK
authors.lastname: Shay
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology* / Q000627:therapeutic use; D007251:Influenza, Human / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058873:Pandemics / Q000517:prevention & control; D011247:Pregnancy; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014613:Vaccines, Attenuated / Q000276:immunology / Q000627:therapeutic use; D015164:Vaccines, Inactivated / Q000276:immunology / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated