Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza pneumonia among adults aged ≥65 years in Japan

doi:10.1016/j.vaccine.2018.04.037

Multicenter Study

. 2018 May 17;36(21):2960-2967.

doi: 10.1016/j.vaccine.2018.04.037.

Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza pneumonia among adults aged ≥65 years in Japan

Affiliations

¹ Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Adult Pneumonia Study Group-Japan, Japan. Electronic address: mosuzuki@nagasaki-u.ac.jp.
² Adult Pneumonia Study Group-Japan, Japan; Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan; Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
⁴ Adult Pneumonia Study Group-Japan, Japan; Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan.
⁵ Adult Pneumonia Study Group-Japan, Japan; Department of General Internal Medicine, Kameda Medical Center, Kamogawa, Japan.
⁶ Adult Pneumonia Study Group-Japan, Japan; Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Japan.
⁷ Adult Pneumonia Study Group-Japan, Japan; Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Japan.
⁸ Adult Pneumonia Study Group-Japan, Japan; Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
⁹ Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Adult Pneumonia Study Group-Japan, Japan.

PMID: 29685596
PMCID: PMC7126450
DOI: 10.1016/j.vaccine.2018.04.037

Multicenter Study

Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza pneumonia among adults aged ≥65 years in Japan

Motoi Suzuki et al. Vaccine. 2018.

. 2018 May 17;36(21):2960-2967.

doi: 10.1016/j.vaccine.2018.04.037.

Authors

Affiliations

¹ Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Adult Pneumonia Study Group-Japan, Japan. Electronic address: mosuzuki@nagasaki-u.ac.jp.
² Adult Pneumonia Study Group-Japan, Japan; Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan; Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
⁴ Adult Pneumonia Study Group-Japan, Japan; Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan.
⁵ Adult Pneumonia Study Group-Japan, Japan; Department of General Internal Medicine, Kameda Medical Center, Kamogawa, Japan.
⁶ Adult Pneumonia Study Group-Japan, Japan; Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Japan.
⁷ Adult Pneumonia Study Group-Japan, Japan; Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Japan.
⁸ Adult Pneumonia Study Group-Japan, Japan; Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
⁹ Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Adult Pneumonia Study Group-Japan, Japan.

PMID: 29685596
PMCID: PMC7126450
DOI: 10.1016/j.vaccine.2018.04.037

Abstract

Background: The effectiveness of inactivated influenza vaccine (IIV) against laboratory-confirmed influenza pneumonia in older adults remains to be established.

Methods: Pneumonia patients aged ≥65 years who visited a study hospital in Chiba, Japan, were prospectively enrolled from February 2012 to January 2014. Sputum samples were collected from participants and tested for influenza virus by polymerase chain reaction assays. Influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza pneumonia was estimated by a test-negative design.

Results: Among a total of 814 pneumonia patients, 42 (5.2%) tested positive for influenza: 40 were positive for influenza A virus, and two were positive for influenza B virus. The IVE against laboratory-confirmed influenza pneumonia was 58.3% (95% confidence interval, 28.8-75.6%). The IVE against influenza pneumonia hospital admission, severe pneumonia, and death was 60.2% (95% CI, 22.8-79.4%), 65.5% (95% CI, 44.3-78.7%), and 71% (95% CI, -62.9% to 94.8%), respectively. In the subgroup analyses, the IVE against influenza pneumonia was higher for patients with immunosuppressive conditions (85.9%; 95% CI, 67.4-93.9%) than for those without (48.7%; 95% CI, 2.7-73%) but did not differ by patients' statin use status.

Conclusion: IIV effectively reduces the risk of laboratory-confirmed influenza pneumonia in older adults.

Keywords: Inactivated influenza vaccine; Influenza pneumonia; Test-negative case-control design; Vaccine effectiveness.

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References

1. Mertz D., Kim T.H., Johnstone J., Lam P.P., Science M., Kuster S.P. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. Bmj. 2013;347:f5061. - PMC - PubMed
1. Morimoto K., Suzuki M., Ishifuji T., Yaegashi M., Asoh N., Hamashige N. The burden and etiology of community-onset pneumonia in the aging Japanese population: a multicenter prospective study. PloS One. 2015;10:e0122247. - PMC - PubMed
1. Osterholm M.T., Kelley N.S., Sommer A., Belongia E.A. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:36–44. - PubMed
1. Belongia E.A., Simpson M.D., King J.P., Sundaram M.E., Kelley N.S., Osterholm M.T. Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. Lancet Infect Dis. 2016;16:942–951. - PubMed
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[1] Mertz D., Kim T.H., Johnstone J., Lam P.P., Science M., Kuster S.P. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. Bmj. 2013;347:f5061. - PMC - PubMed

[2] Mertz D., Kim T.H., Johnstone J., Lam P.P., Science M., Kuster S.P. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. Bmj. 2013;347:f5061. - PMC - PubMed

[3] Morimoto K., Suzuki M., Ishifuji T., Yaegashi M., Asoh N., Hamashige N. The burden and etiology of community-onset pneumonia in the aging Japanese population: a multicenter prospective study. PloS One. 2015;10:e0122247. - PMC - PubMed

[4] Morimoto K., Suzuki M., Ishifuji T., Yaegashi M., Asoh N., Hamashige N. The burden and etiology of community-onset pneumonia in the aging Japanese population: a multicenter prospective study. PloS One. 2015;10:e0122247. - PMC - PubMed

[5] Osterholm M.T., Kelley N.S., Sommer A., Belongia E.A. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:36–44. - PubMed

[6] Osterholm M.T., Kelley N.S., Sommer A., Belongia E.A. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:36–44. - PubMed

[7] Belongia E.A., Simpson M.D., King J.P., Sundaram M.E., Kelley N.S., Osterholm M.T. Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. Lancet Infect Dis. 2016;16:942–951. - PubMed

[8] Belongia E.A., Simpson M.D., King J.P., Sundaram M.E., Kelley N.S., Osterholm M.T. Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. Lancet Infect Dis. 2016;16:942–951. - PubMed

[9] WHO. WHO vaccine-preventable diseases: monitoring system; 2017.

[10] WHO. WHO vaccine-preventable diseases: monitoring system; 2017.

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Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza pneumonia among adults aged ≥65 years in Japan

Affiliations

Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza pneumonia among adults aged ≥65 years in Japan

Authors

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