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Influenza vaccine effectiveness by A(H3N2) phylogenetic sub-cluster and prior vaccination history: 2016-17 and 2017-18 epidemics in Canada
The Journal of Infectious Diseases ( IF 5.0 ) Pub Date : 2020-03-26 , DOI: 10.1093/infdis/jiaa138
Danuta M Skowronski 1, 2 , Siobhan Leir 1 , Suzana Sabaiduc 1 , Catharine Chambers 1 , Macy Zou 1 , Caren Rose 1, 2 , Romy Olsha 3 , James A Dickinson 4 , Anne-Luise Winter 3 , Agatha Jassem 1, 2 , Jonathan B Gubbay 3, 5 , Steven J Drews 6, 7 , Hugues Charest 8 , Tracy Chan 1 , Rebecca Hickman 1 , Nathalie Bastien 9 , Yan Li 9 , Mel Krajden 1, 2 , Gaston De Serres 8, 10, 11
Affiliation  

Background
The influenza A(H3N2) vaccine was updated from clade 3C.3a in 2015-16 to a clade 3C.2a strain for both 2016-17 and 2017-18. Circulating 3C.2a viruses showed considerable diversity in the hemagglutinin glycoprotein and the egg-adapted vaccine strain also bore mutations, notably T160K loss-of-glycosylation.
Methods
Vaccine effectiveness (VE) in 2016-17 and 2017-18 was assessed by test-negative-design, explored by A(H3N2) phylogenetic sub-cluster and prior season's vaccination history.
Results
In 2016-17, A(H3N2) VE was 36%(95%CI=18-50%): comparable with (43%;95%CI=24-58%) or without (33%;95%CI=-16-64%) prior vaccination in 2015-16. In 2017-18,VE was 14%(95%CI=-8-31%):lower with (9%;95%CI=-18-30%) versus without (45%;95%CI=-7-71%) prior vaccination in 2016-17.
Conclusions
Exploring VE by phylogenetic sub-cluster and prior vaccination history reveals informative heterogeneity, but requires enhanced sample-size. Pivotal mutations conferring loss-of-glycosylation, and repeat vaccination with unchanged antigen, may be associated with reduced VE.


中文翻译:


按 A(H3N2) 系统发育亚群和既往疫苗接种史划分的流感疫苗有效性:加拿大 2016-17 和 2017-18 流行病


 背景

甲型H3N2流感疫苗从2015-16年的进化枝3C.3a更新为2016-17年和2017-18年的进化枝3C.2a毒株。循环的 3C.2a 病毒在血凝素糖蛋白方面表现出相当大的多样性,并且卵适应的疫苗株也存在突变,特别是 T160K 糖基化缺失。
 方法

2016-17 和 2017-18 年度的疫苗有效性 (VE) 通过测试阴性设计进行评估,并通过 A(H3N2) 系统发育亚群和上一季节的疫苗接种史进行探索。
 结果

2016-17 年,A(H3N2) VE 为 36%(95%CI=18-50%):与 (43%;95%CI=24-58%) 或没有 (33%;95%CI=- 16-64%)在 2015-16 年之前接种过疫苗。 2017-18 年,VE 为 14%(95%CI=-8-31%):使用 (9%;95%CI=-18-30%) 与不使用 (45%;95%CI=-7-) 相比较低71%)在 2016-17 年之前接种过疫苗。
 结论

通过系统发育亚簇和既往疫苗接种史探索 VE 揭示了信息异质性,但需要增加样本量。关键突变导致糖基化丧失,以及用未改变的抗原重复接种疫苗,可能与 VE 降低有关。
更新日期:2020-03-27
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