Influenza Vaccine Effectiveness in Older Adults Compared with Younger Adults Over Five Seasons

Russell, Kate; Chung, Jessie R.; Monto, Arnold S.; Martin, Emily T.; Belongia, Edward A.; McLean, Huong Q.; Gaglani, Manjusha; Murthy, Kempapura; Zimmerman, Richard K.; Nowalk, Mary Patricia; Jackson, Michael L.; Jackson, Lisa A.; Flannery, Brendan

doi:10.1016/j.vaccine.2018.01.045

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Influenza Vaccine Effectiveness in Older Adults Compared with Younger Adults Over Five Seasons

Published Date:

Feb 28 2018

Publisher's site:

http://dx.doi.org/10.1016/j.vaccine.2018.01.045 New Site Icon

Source:

Vaccine. 36(10):1272-1278

Language:

English

[PDF-147.25 KB]

Details:

Personal Authors:

Russell, Kate ; Chung, Jessie R. ; Monto, Arnold S. ; Martin, Emily T. ; Belongia, Edward A. ; ... More ▼

Keywords:

[+]

Pubmed ID:

29402578

Pubmed Central ID:

PMC5812289

Description:

Background

There have been inconsistent reports of decreased vaccine effectiveness (VE) against influenza viruses among older adults (aged ≥65 years) compared with younger adults in the United States. A direct comparison of VE over multiple seasons is needed to assess the consistency of these observations.

Methods

We performed a pooled analysis of VE over 5 seasons among adults aged ≥18 years who were systematically enrolled in the U.S. Flu VE Network. Outpatients with medically-attended acute respiratory illness (cough with illness onset ≤7 days prior to enrollment) were tested for influenza by reverse transcription polymerase chain reaction. We compared differences in VE and vaccine failures among older adult age group (65–74, ≥75, and ≥65 years) to adults aged 18–49 years by influenza type and subtype using interaction terms to test for statistical significance and stratified by prior season vaccination status.

Results

Analysis included 20,022 adults aged ≥18 years enrolled during the 2011–12 through 2015–16 influenza seasons; 4,785 (24%) tested positive for influenza. VE among patients aged ≥65 years was not significantly lower than VE among patients aged 18–49 years against any subtype with no significant interaction of age and vaccination. VE against A(H3N2) viruses was 14% (95% confidence interval [CI]−14% to 36%) for adults ≥65 years and 21% (CI 9%-32%) for adults 18–49 years. VE against A(H1N1)pdm09 was 49% (95% CI 22%-66%) for adults ≥65 years and 48% (95% CI 41%-54%) for adults 18–49 years and against B viruses was 62% (95% CI 44%–74%) for adults ≥65 years and 55% (95% CI 45%-63%) for adults 18–49 years. There was no significant interaction of age and vaccination for separate strata of prior vaccination status.

Conclusions

Over 5 seasons, influenza vaccination provided similar levels of protection among older and younger adults, with lower levels of protection against influenza A(H3N2) in all ages.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

U01 IP001034/IP/NCIRD CDC HHS/United States
UL1 TR001857/TR/NCATS NIH HHS/United States
U01 IP000473/IP/NCIRD CDC HHS/United States
CC999999/Intramural CDC HHS/United States
U01 IP000466/IP/NCIRD CDC HHS/United States
U01 IP000471/IP/NCIRD CDC HHS/United States
U01 IP000474/IP/NCIRD CDC HHS/United States
U01 IP001035/IP/NCIRD CDC HHS/United States
U01 IP001038/IP/NCIRD CDC HHS/United States
U01 IP000467/IP/NCIRD CDC HHS/United States

Supporting Files:

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	NIHMS939833-supplement-2.docx	application/vnd.openxmlformats-officedocument.wordprocessingml.document
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	nihms939833.nxml	text/xml
	nihms939833f1.gif	image/gif
	nihms939833f1.jpg	image/jpeg

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