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. 2015 Jan 1;33(1):246-51.
doi: 10.1016/j.vaccine.2014.06.052. Epub 2014 Jun 21.

Waning vaccine protection against influenza A (H3N2) illness in children and older adults during a single season

Edward A Belongia  1 , Maria E Sundaram  2 , David L McClure  2 , Jennifer K Meece  2 , Jill Ferdinands  3 , Jeffrey J VanWormer  2
Affiliations

Waning vaccine protection against influenza A (H3N2) illness in children and older adults during a single season

Edward A Belongia et al. Vaccine. .

Abstract

Background: Recent studies have suggested that vaccine-induced protection against influenza may decline within one season. We reanalyzed data from a study of influenza vaccine effectiveness to determine if time since vaccination was an independent predictor of influenza A (H3N2).

Methods: Patients with acute respiratory illness were actively recruited during the 2007-2008 season. Respiratory swabs were tested for influenza, and vaccination dates were determined by a validated immunization registry. The association between influenza RT-PCR result and vaccination interval (days) was examined using multivariable logistic regression, adjusting for calendar time, age and other confounders.

Results: There were 629 vaccinated participants, including 177 influenza A (H3N2) cases and 452 test negative controls. The mean (SD) interval from vaccination to illness onset was 101.7 (25.9) days for influenza cases and 93.0 (29.9) days for controls. There was a significant association between vaccination interval and influenza result in the main effects model. The adjusted odds ratio (aOR) for influenza was 1.12 (CI 1.01, 1.26) for every 14 day increase in the vaccination interval. Age modified the association between vaccination interval and influenza (p=0.005 for interaction). Influenza was associated with increasing vaccination interval in young children and older adults, but not in adolescents or non-elderly adults. Similar results were found when calendar week of vaccine receipt was assessed as the primary exposure variable.

Conclusions: Identification of influenza A (H3N2) was associated with increasing time since vaccination among young children and older adults during a single influenza season.

Keywords: Immunity; Influenza; Influenza vaccine; Vaccine effectiveness.

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Conflict of interest statement

Conflict of interest

Dr. Belongia, Dr. Meece and Ms. Sundaram receive research support from MedImmune LLC. Other authors have no financial disclosures.

Figures

Fig. 1.
Fig. 1.
Number of influenza positives and negatives by week of vaccination, according to age. (A) Children < 18 years old. (B) Adults 18–64 years old. (C) Adults ≥65 years old.
Fig. 2.
Fig. 2.
Adjusted odds ratios and 95% confidence intervals for influenza A positive result per 14 day increase in vaccination interval at selected ages. Models were adjusted for calendar time (illness onset week) and interval from illness onset to swab collection.
See this image and copyright information in PMC

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