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Review
. 2018 May 21;6(2):28.
doi: 10.3390/vaccines6020028.

Immune History and Influenza Vaccine Effectiveness

Joseph A Lewnard  1 , Sarah Cobey  2
Affiliations
Review

Immune History and Influenza Vaccine Effectiveness

Joseph A Lewnard et al. Vaccines (Basel). .

Abstract

The imperfect effectiveness of seasonal influenza vaccines is often blamed on antigenic mismatch, but even when the match appears good, effectiveness can be surprisingly low. Seasonal influenza vaccines also stand out for their variable effectiveness by age group from year to year and by recent vaccination status. These patterns suggest a role for immune history in influenza vaccine effectiveness, but inference is complicated by uncertainty about the contributions of bias to the estimates themselves. In this review, we describe unexpected patterns in the effectiveness of seasonal influenza vaccination and explain how these patterns might arise as consequences of study design, the dynamics of immune memory, or both. Resolving this uncertainty could lead to improvements in vaccination strategy, including the use of universal vaccines in experienced populations, and the evaluation of vaccine efficacy against influenza and other antigenically variable pathogens.

Keywords: imprinting; original antigenic sin; repeat vaccination; seasonal influenza vaccine; test-negative design; universal influenza vaccine; vaccine effectiveness.

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Conflict of interest statement

The authors declare no conflict of interest. The sponsors had no role in the writing of the manuscript or in the decision to publish.

Figures

Figure 1
Figure 1
Vaccine effectiveness from the U.S. and Canada (A) overall and by age group and (B) by recent vaccination history. Comparisons must be made with caution due to differences in study design and study population. Please see Table A1 in the Appendix A for details.
See this image and copyright information in PMC

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