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2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018
BACKGROUND: During 2017–2018, influenza vaccine effectiveness (VE) against A(H3N2) illness was highest among children <5 years compared with all other ages. A child’s first influenza infection can shape later immune responses. The emergence of antigenically distinct influenza A(H3N2) viruses in 2...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810229/ http://dx.doi.org/10.1093/ofid/ofz360.2412 |
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author | Ladva, Chandresh N Belongia, Edward Monto, Arnold Martin, Emily T Gaglani, Manjusha Reis, Michael Jackson, Michael L Jackson, Lisa Zimmerman, Richard Nowalk, Mary Patricia McLean, Huong Patel, Manish Fry, Alicia M Flannery, Brendan |
author_facet | Ladva, Chandresh N Belongia, Edward Monto, Arnold Martin, Emily T Gaglani, Manjusha Reis, Michael Jackson, Michael L Jackson, Lisa Zimmerman, Richard Nowalk, Mary Patricia McLean, Huong Patel, Manish Fry, Alicia M Flannery, Brendan |
author_sort | Ladva, Chandresh N |
collection | PubMed |
description | BACKGROUND: During 2017–2018, influenza vaccine effectiveness (VE) against A(H3N2) illness was highest among children <5 years compared with all other ages. A child’s first influenza infection can shape later immune responses. The emergence of antigenically distinct influenza A(H3N2) viruses in 2014–2015 provided an opportunity to explore potential effects of first virus infection on vaccine effects. We compared VE against influenza A(H3N2) during 2016–2017 and 2017–2018 among children born after and before 2014. METHODS: Outpatient children aged 6 months–17 years with acute respiratory illness with cough were enrolled in the United States Influenza VE Network and tested for influenza infection by RT–PCR. Vaccination status was derived through medical records and immunization registries. Children with partial or unknown vaccination status were excluded. We used a test-negative design to estimate VE and 95% confidence intervals (CI) from logistic regression, adjusting for potential confounders. Cohorts were defined by birth after or before June 2014; we assumed exposure to the new A(H3N2) virus among children born after June 2014. RESULTS: During 2016–2017, among 2,545 children, 445 (18%) tested positive for A(H3N2) and 1,809 (71%) tested negative. VE against A(H3N2) did not differ among children born after June 2014 and among those born before June 2014 [49% (95% CI: −12%, 77%) vs. 43% (27%, 55%); interaction P < 0.75]. During 2017–2018, among 2,936 patients, 631 (22%) tested positive for A(H3N2), and 1,852 (63%) tested negative. VE against A(H3N2) was 59% (36%, 74%) among children born after June 2014 vs. 20% (−1%, 37%) among those born before June 2014 (interaction P < 0.01). CONCLUSION: We did not consistently see differences in VE against A(H3N2) between children potentially exposed to different A(H3N2) viruses. However, error in exposure assignment to A(H3N2) viruses and few seasons since the emergence of the new A(H3N2) viruses limit our interpretation. Future study will include additional A(H3N2) seasons as initial exposures to current circulating viruses increase among young children. Alternative explanations for age-related differences will also be explored, such as prior seasonal vaccination. DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6810229 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68102292019-10-28 2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018 Ladva, Chandresh N Belongia, Edward Monto, Arnold Martin, Emily T Gaglani, Manjusha Reis, Michael Jackson, Michael L Jackson, Lisa Zimmerman, Richard Nowalk, Mary Patricia McLean, Huong Patel, Manish Fry, Alicia M Flannery, Brendan Open Forum Infect Dis Abstracts BACKGROUND: During 2017–2018, influenza vaccine effectiveness (VE) against A(H3N2) illness was highest among children <5 years compared with all other ages. A child’s first influenza infection can shape later immune responses. The emergence of antigenically distinct influenza A(H3N2) viruses in 2014–2015 provided an opportunity to explore potential effects of first virus infection on vaccine effects. We compared VE against influenza A(H3N2) during 2016–2017 and 2017–2018 among children born after and before 2014. METHODS: Outpatient children aged 6 months–17 years with acute respiratory illness with cough were enrolled in the United States Influenza VE Network and tested for influenza infection by RT–PCR. Vaccination status was derived through medical records and immunization registries. Children with partial or unknown vaccination status were excluded. We used a test-negative design to estimate VE and 95% confidence intervals (CI) from logistic regression, adjusting for potential confounders. Cohorts were defined by birth after or before June 2014; we assumed exposure to the new A(H3N2) virus among children born after June 2014. RESULTS: During 2016–2017, among 2,545 children, 445 (18%) tested positive for A(H3N2) and 1,809 (71%) tested negative. VE against A(H3N2) did not differ among children born after June 2014 and among those born before June 2014 [49% (95% CI: −12%, 77%) vs. 43% (27%, 55%); interaction P < 0.75]. During 2017–2018, among 2,936 patients, 631 (22%) tested positive for A(H3N2), and 1,852 (63%) tested negative. VE against A(H3N2) was 59% (36%, 74%) among children born after June 2014 vs. 20% (−1%, 37%) among those born before June 2014 (interaction P < 0.01). CONCLUSION: We did not consistently see differences in VE against A(H3N2) between children potentially exposed to different A(H3N2) viruses. However, error in exposure assignment to A(H3N2) viruses and few seasons since the emergence of the new A(H3N2) viruses limit our interpretation. Future study will include additional A(H3N2) seasons as initial exposures to current circulating viruses increase among young children. Alternative explanations for age-related differences will also be explored, such as prior seasonal vaccination. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810229/ http://dx.doi.org/10.1093/ofid/ofz360.2412 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Ladva, Chandresh N Belongia, Edward Monto, Arnold Martin, Emily T Gaglani, Manjusha Reis, Michael Jackson, Michael L Jackson, Lisa Zimmerman, Richard Nowalk, Mary Patricia McLean, Huong Patel, Manish Fry, Alicia M Flannery, Brendan 2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018 |
title | 2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018 |
title_full | 2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018 |
title_fullStr | 2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018 |
title_full_unstemmed | 2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018 |
title_short | 2734. Lack of Influence of Early Exposure to Influenza A(H3N2) Viruses on Vaccine Effectiveness Against A(H3N2)-Associated Illness in US Children <18 Years, 2016–2018 |
title_sort | 2734. lack of influence of early exposure to influenza a(h3n2) viruses on vaccine effectiveness against a(h3n2)-associated illness in us children <18 years, 2016–2018 |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810229/ http://dx.doi.org/10.1093/ofid/ofz360.2412 |
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