Potential effect of virus interference on influenza vaccine effectiveness estimates in test-negative designs.
A hypothetical influenza infection-induced non-specific immunity may reduce the risk of subsequent non-influenza respiratory virus (NIRV) infection and bias the influenza vaccine effectiveness (VE) estimates in test-negative designs (TNDs). We conducted a simulation study using a simple TND model and explored the degree of bias in the VE estimates. The bias was marginal during the usual seasons and most of the time during pandemics; the bias only became large when the influenza infection attack rate increased to pandemic levels (>50%), the true VE was low to moderate, and the non-specific immunity almost completely protected from NIRV infections and lasted at least half the influenza season.
Department of Clinical Medicine, Institute of Tropical Medicine,Nagasaki University,Nagasaki,Japan.
M
M
Suzuki
Department of Infectious Disease Epidemiology,London School of Hygiene & Tropical Medicine,London,UK.
A
A
Camacho
Department of Clinical Medicine, Institute of Tropical Medicine,Nagasaki University,Nagasaki,Japan.
K
K
Ariyoshi
D003198:Computer Simulation; D004196:Disease Outbreaks; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology*; D016896:Treatment Outcome; D014762:Viral Interference
D007252:Influenza Vaccines