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Multicenter Study
. 2011;6(8):e23085.
doi: 10.1371/journal.pone.0023085. Epub 2011 Aug 12.

Effectiveness of non-adjuvanted pandemic influenza A vaccines for preventing pandemic influenza acute respiratory illness visits in 4 U.S. communities

Marie R Griffin  1 , Arnold S Monto, Edward A Belongia, John J Treanor, Qingxia Chen, Jufu Chen, H Keipp Talbot, Suzanne E Ohmit, Laura A Coleman, Gerry Lofthus, Joshua G Petrie, Jennifer K Meece, Caroline Breese Hall, John V Williams, Paul Gargiullo, LaShondra Berman, David K Shay; U.S. Flu-VE Network
Collaborators, Affiliations
Multicenter Study

Effectiveness of non-adjuvanted pandemic influenza A vaccines for preventing pandemic influenza acute respiratory illness visits in 4 U.S. communities

Marie R Griffin et al. PLoS One. 2011.

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.

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Conflict of interest statement

Competing Interests: The authors have read the journal's policy and have the following conflicts: Marie R. Griffin received grant support from MedImmune and Pfizer (formerly Wyeth); Arnold S. Monto has been an ad hoc consultant to Baxter, CSL, GSK, Novartis, and sanofi-pasteur; John J. Treanor is an unpaid member of a data safety monitoring board for Novartis, and has received grant support for laboratory studies from GSK and Mercia Pharmam and for conducting clinical vaccine trials from CSL, Protein Sciences, Wyeth, Merck, and VaxInnate; H. Keipp Talbot received research support from Pfizer (Wyeth), Protein Sciences, sanofi-pasteur, and VaxInnate; Caroline Breese Hall has served as a consultant for MedImmune; John V. Williams has served as a consultant for MedImmune, Novartis, and Quidel. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials..

Figures

Figure 1
Figure 1. Number of influenza-positive cases and influenza-negative controls enrolled in the Flu-VE study by month of illness onset, October 2009 through April 2010, and percent vaccinated greater >14 days prior to illness onset.
(Vaccination rates were <1% in October).
See this image and copyright information in PMC

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