2022-2023 年流感疫苗预防疾病和无症状感染的有效性：前瞻性队列研究

IF 8.2 1区医学 Q1 IMMUNOLOGY

Clinical Infectious Diseases Pub Date : 2024-10-24 DOI:10.1093/cid/ciae491

Elizabeth B White,Lauren Grant,Josephine Mak,Lauren Olsho,Laura J Edwards,Allison Naleway,Jefferey L Burgess,Katherine D Ellingson,Harmony Tyner,Manjusha Gaglani,Karen Lutrick,Alberto Caban-Martinez,Gabriella Newes-Adeyi,Jazmin Duque,Sarang K Yoon,Andrew L Phillips,Mark Thompson,Amadea Britton,Brendan Flannery,Ashley Fowlkes

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引用次数: 0

摘要

背景以前根据血清转换估计的预防无症状流感病毒感染的疫苗有效性（VE）差异很大，而且可能存在偏差。方法在 HEROES-RECOVER 队列中，美国 7 个地方的流感职业暴露风险较高的成年人每周提供症状报告和鼻拭子，用于反转录聚合酶链反应（RT-PCR）流感检测。实验室确诊的流感病毒感染分为有症状（≥1 个症状）和无症状。参与者通过调查报告人口统计学信息和疫苗接种情况；大多数研究机构通过病历和免疫登记审查核实疫苗接种情况。接种时间是指从特定地点的流感季节开始（2022 年 9 月至 10 月）到感染、退出研究或季节结束（2023 年 5 月）的天数。我们使用经地点和职业调整的 Cox 比例危险度回归法，比较了接种疫苗与未接种疫苗参与者的总体流感发病率、症状状态和甲型流感亚型。结果在 3785 名参与者中，共有 269 人（7.1%）经实验室确诊患有流感，其中 263 人（98%）感染了甲型流感病毒，201 人（75%）无症状。接种疫苗与未接种疫苗的参与者中，经实验室确诊的流感发病率分别为每 10 万人日 23.7 例和 33.2 例（VE：38%；95% CI：15%-55%）。结论接种疫苗可降低无症状流感病毒感染的发病率，但不能降低无症状流感病毒感染的发病率，这表明接种流感疫苗可减轻从感染到发病的过程。

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Influenza Vaccine Effectiveness Against Illness and Asymptomatic Infection in 2022-2023: A Prospective Cohort Study.

BACKGROUND Previous estimates of vaccine effectiveness (VE) against asymptomatic influenza virus infection based on seroconversion have varied widely and may be biased. We estimated 2022-2023 influenza VE against illness and asymptomatic infection in a prospective cohort. METHODS In the HEROES-RECOVER cohort, adults at increased occupational risk of influenza exposure across 7 US sites provided weekly symptom reports and nasal swabs for reverse transcription-polymerase chain reaction (RT-PCR) influenza testing. Laboratory-confirmed influenza virus infections were classified as symptomatic (≥1 symptom) or asymptomatic during the week of testing. Participants reported demographic information and vaccination through surveys; most sites verified vaccination through medical record and immunization registry review. Person-time was calculated as days from the site-specific influenza season start (September-October 2022) through date of infection, study withdrawal, or season end (May 2023). We compared influenza incidence among vaccinated versus unvaccinated participants overall, by symptom status, and by influenza A subtype, using Cox proportional hazards regression adjusted for site and occupation. We estimated VE as (1 - adjusted hazard ratio) × 100%. RESULTS In total, 269 of 3785 (7.1%) participants had laboratory-confirmed influenza, including 263 (98%) influenza A virus infections and 201 (75%) symptomatic illnesses. Incidence of laboratory-confirmed influenza illness among vaccinated versus unvaccinated participants was 23.7 and 33.2 episodes per 100 000 person-days, respectively (VE: 38%; 95% CI: 15%-55%). Incidence of asymptomatic influenza virus infection was 8.0 versus 11.6 per 100 000 (VE: 13%; 95% CI: -47%, 49%). CONCLUSIONS Vaccination reduced incidence of symptomatic but not asymptomatic influenza virus infection, suggesting that influenza vaccination attenuates progression from infection to illness.

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来源期刊

Clinical Infectious Diseases 医学-传染病学

CiteScore

25.00

自引率

2.50%

发文量

900

审稿时长

3 months

期刊介绍： Clinical Infectious Diseases (CID) is dedicated to publishing original research, reviews, guidelines, and perspectives with the potential to reshape clinical practice, providing clinicians with valuable insights for patient care. CID comprehensively addresses the clinical presentation, diagnosis, treatment, and prevention of a wide spectrum of infectious diseases. The journal places a high priority on the assessment of current and innovative treatments, microbiology, immunology, and policies, ensuring relevance to patient care in its commitment to advancing the field of infectious diseases.