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. 2018 Sep;23(39):1800092.
doi: 10.2807/1560-7917.ES.2018.23.39.1800092.

Uptake and effectiveness of influenza vaccine in those aged 65 years and older in the United Kingdom, influenza seasons 2010/11 to 2016/17

Richard G Pebody  1 , Fiona Warburton  1 , Nick Andrews  1 , Mary Sinnathamby  1 , Ivelina Yonova  2   3 , Arlene Reynolds  4 , Chris Robertson  5 , Simon Cottrell  6 , Muhammad Sartaj  7 , Rory Gunson  8 , Matthew Donati  9 , Catherine Moore  6 , Joanna Ellis  1 , Simon de Lusignan  2   3 , Jim McMenamin  4 , Maria Zambon  1
Affiliations

Uptake and effectiveness of influenza vaccine in those aged 65 years and older in the United Kingdom, influenza seasons 2010/11 to 2016/17

Richard G Pebody et al. Euro Surveill. 2018 Sep.

Abstract

BackgroundIn 2016/17, seasonal influenza vaccine was less effective in those aged 65 years and older in the United Kingdom. We describe the uptake, influenza-associated mortality and adjusted vaccine effectiveness (aVE) in this age group over influenza seasons 2010/11-2016/17. Methods: Vaccine uptake in 2016/17 and five previous seasons were measured using a sentinel general practitioners cohort in England; the test-negative case-control design was used to estimate pooled aVE by subtype and age group against laboratory-confirmed influenza in primary care from 2010-2017. Results: Vaccine uptake was 64% in 65-69-year-olds, 74% in 70-74-year-olds and 80% in those aged 75 and older. Overall aVE was 32.5% (95% CI: 11.6 to 48.5); aVE by sub-type was 60.8% (95% CI: 33.9 to 76.7) and 50.0% (95% CI: 21.6 to 68.1) against influenza A(H1N1)pdm09 and influenza B, respectively, but only 5.6% (95% CI: - 39.2 to 35.9) against A(H3N2). Against all laboratory-confirmed influenza aVE was 45.2% (95% CI: 25.1 to 60.0) in 65-74 year olds; - 26.2% (95% CI: - 149.3 to 36.0) in 75-84 year olds and - 3.2% (95% CI: - 237.8 to 68.5) in those aged 85 years and older. Influenza-attributable mortality was highest in seasons dominated by A(H3N2). Conclusions: Vaccine uptake with non-adjuvanted, normal-dose vaccines remained high, with evidence of effectiveness against influenza A(H1N1)pdm09 and B, though poor against A(H3N2), particularly in those aged 75 years and older. Forthcoming availability of newly licensed vaccines with wider use of antivirals can potentially further improve prevention and control of influenza in this group.

Keywords: United Kingdom; immunisation; influenza; vaccine uptake and effectiveness; viral infections.

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Conflict of interest statement

Conflict of interest: MD has lectured for Sanofi-Pasteur MSD on influenza vaccination, last lecture conducted in June 2016.

Figures

Figure 1
Figure 1
Flowchart to show case and control ascertainment, United Kingdom, influenza seasons 2010/11–2016/17 (n = 2,096)
Figure 2
Figure 2
Crude and adjusted vaccine effectiveness estimates in those aged 65 years or older, by influenza season and dominant viruses, United Kingdom, influenza seasons 2010/11–2016/17
See this image and copyright information in PMC

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