Vaccine Effectiveness Against Influenza-Associated Urgent Care, Emergency Department, and Hospital Encounters During the 2021-2022 Season, VISION Network.
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Tenforde Mark W, Weber Zachary A, DeSilva Malini B, Stenehjem Edward, Yang Duck-Hye, Fireman Bruce, Gaglani Manjusha, Kojima Noah, Irving Stephanie A, Rao Suchitra, Grannis Shaun J, Naleway Allison L, Kirshner Lindsey, Kharbanda Anupam B, Dascomb Kristin, Lewis Ned, Dalton Alexandra F, Ball Sarah W, Natarajan Karthik, Ong Toan C, Hartmann Emily, Embi Peter J, McEvoy Charlene E, Grisel Nancy, Zerbo Ousseny, Dunne Margaret M, Arndorfer Julie, Goddard Kristin, Dickerson Monica, Patel Palak, Timbol Julius, Griggs Eric P, Hansen John, Thompson Mark G, Flannery Brendan, Klein Nicola P
Аннотация
METHODS: We conducted a test-negative case-control analysis among adults ≥18 years of age at 3 sites within the VISION Network. Encounters included emergency department/urgent care (ED/UC) visits or hospitalizations with ≥1 acute respiratory illness (ARI) discharge diagnosis codes and molecular testing for influenza. Vaccine effectiveness (VE) was calculated by comparing the odds of influenza vaccination ≥14 days before the encounter date between influenza-positive cases (type A) and influenza-negative and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative controls, applying inverse probability-to-be-vaccinated weights, and adjusting for confounders.
RESULTS: In total, 86 732 ED/UC ARI-associated encounters (7696 [9%] cases) and 16 805 hospitalized ARI-associated encounters (649 [4%] cases) were included. VE against influenza-associated ED/UC encounters was 25% (95% confidence interval (CI), 20%-29%) and 25% (95% CI, 11%-37%) against influenza-associated hospitalizations. VE against ED/UC encounters was lower in adults ≥65 years of age (7%; 95% CI, -5% to 17%) or with immunocompromising conditions (4%; 95% CI, -45% to 36%).
CONCLUSIONS: During an influenza A(H3N2)-predominant influenza season, modest VE was observed. These findings highlight the need for improved vaccines, particularly for A(H3N2) viruses that are historically associated with lower VE.