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Observational Study
. 2013 Jul 16;8(7):e68760.
doi: 10.1371/journal.pone.0068760. Print 2013.

Influenza vaccine effectiveness against hospitalisation with confirmed influenza in the 2010-11 seasons: a test-negative observational study

Allen C Cheng  1 , Mark Holmes, Louis B Irving, Simon G A Brown, Grant W Waterer, Tony M Korman, N Deborah Friedman, Sanjaya Senanayake, Dominic E Dwyer, Stephen Brady, Grahame Simpson, Richard Wood-Baker, John Upham, David Paterson, Christine Jenkins, Peter Wark, Paul M Kelly, Tom Kotsimbos
Affiliations
Observational Study

Influenza vaccine effectiveness against hospitalisation with confirmed influenza in the 2010-11 seasons: a test-negative observational study

Allen C Cheng et al. PLoS One. .

Abstract

Immunisation programs are designed to reduce serious morbidity and mortality from influenza, but most evidence supporting the effectiveness of this intervention has focused on disease in the community or in primary care settings. We aimed to examine the effectiveness of influenza vaccination against hospitalisation with confirmed influenza. We compared influenza vaccination status in patients hospitalised with PCR-confirmed influenza with patients hospitalised with influenza-negative respiratory infections in an Australian sentinel surveillance system. Vaccine effectiveness was estimated from the odds ratio of vaccination in cases and controls. We performed both simple multivariate regression and a stratified analysis based on propensity score of vaccination. Vaccination status was ascertained in 333 of 598 patients with confirmed influenza and 785 of 1384 test-negative patients. Overall estimated crude vaccine effectiveness was 57% (41%, 68%). After adjusting for age, chronic comorbidities and pregnancy status, the estimated vaccine effectiveness was 37% (95% CI: 12%, 55%). In an analysis accounting for a propensity score for vaccination, the estimated vaccine effectiveness was 48.3% (95% CI: 30.0, 61.8%). Influenza vaccination was moderately protective against hospitalisation with influenza in the 2010 and 2011 seasons.

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Conflict of interest statement

Competing Interests: ACC has received research funding to perform an investigator-initiated study of influenza vaccine safety from CSL Ltd. SB has received speaker/advisory board fees or travel grants from Astra Zeneca, GSK, and Novartis. DP is on the advisory boards for Merck, AstraZeneca, Leo Pharmaceuticals, Pfizer and Johnson and Johnson; speakers bureau of AstraZeneca, Johnson and Johnson and BioMerieux. JU has received speaker fees from Novartis, Astra Zeneca, GSK and Boehringer Ingelheim. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Observed vs model predicted vaccination status by decile of propensity score.
Figure 2
Figure 2. Estimated vaccine effectiveness (based on stratified analysis on propensity score) in subgroups and sensitivity analysis.
Dashed line represents estimated vaccine effectiveness in all patients in primary analysis. All estimates adjusted for age group, medical comorbidities and pregnancy status.
Figure 3
Figure 3. Estimated vaccine effectiveness, by method of analysis.
See this image and copyright information in PMC

References

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    1. Cheng AC, Kotsimbos AT, Kelly H, Irving L, Bowler S, et al. (2011) Effectiveness of H1N1/09 monovalent and trivalent influenza vaccines against hospitalization with laboratory-confirmed H1N1/09 influenza in Australia: a test-negative case control study. Vaccine 29: 7320–7325. - PubMed

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