Influenza Vaccine Effectiveness in Preventing Laboratory-Confirmed Influenza Cases and Hospitalizations in Navarre, Spain, 2022–2023

Author:

Martínez-Baz Iván123ORCID,Fernández-Huerta Miguel34,Navascués Ana34,Pozo Francisco25ORCID,Trobajo-Sanmartín Camino123ORCID,Casado Itziar123ORCID,Echeverria Aitziber13,Ezpeleta Carmen34,Castilla Jesús123ORCID

Affiliation:

1. Instituto de Salud Pública de Navarra, 31003 Pamplona, Spain

2. CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain

3. Navarre Institute for Health Research (IdiSNA), 31008 Pamplona, Spain

4. Clinical Microbiology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain

5. National Centre for Microbiology, Instituto de Salud Carlos III, 28222 Majadahonda, Spain

Abstract

We estimated influenza vaccine effectiveness (IVE) in preventing outpatient and hospitalized cases in the 2022–2023 season. A test-negative design included a representative sample of outpatients and all hospitalized patients with influenza-like illness (ILI) from October 2022 to May 2023 in Navarre, Spain. ILI patients were tested by PCR for influenza virus. Influenza vaccination status was compared between confirmed influenza cases and test-negative controls. Among 3321 ILI patients tested, IVE to prevent influenza cases was 34% (95% confidence interval (CI): 16 to 48) overall, 85% (95%CI: 63 to 94) against influenza B, and 28% (95%CI: 3 to 46) against A(H3N2). Among 558 outpatients, 222 (40%) were confirmed for influenza: 55% A(H3N2), 11% A(H1N1), and 31% B. Overall, IVE to prevent outpatient cases was 48% (95%CI: 8 to 70), 88% (95%CI: 3 to 98) against influenza B, and 50% (95%CI: −4 to 76) against A(H3N2). Of 2763 hospitalized patients, 349 (13%) were positive for influenza: 64% A(H3N2), 17% A(H1N1), and 8% B. IVE to prevent hospitalization was 24% (95%CI: −1 to 42) overall, 82% (95%CI: 49 to 93) against influenza B, and 16% (95%CI: −17 to 40) against A(H3N2). No IVE was observed in preventing influenza A(H1N1). IVE was high to prevent influenza B, moderate against A(H3N2) and null against A(H1N1). A lower proportion of influenza B cases may explain the smaller IVE in hospitalized patients than in outpatients. The null IVE against A(H1N1) was consistent with the observed antigenic drift and supports the new composition of the 2023–2024 influenza vaccine.

Funder

European Centre for Disease Prevention and Control

European Regional Development Fund

Publisher

MDPI AG

Subject

Pharmacology (medical),Infectious Diseases,Drug Discovery,Pharmacology,Immunology

Reference29 articles.

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2. European Centre for Disease Prevention and Control (ECDC) (2023, August 11). Influenza Virus Characterization. Summary Report, Europe, February 2023. Available online: https://www.ecdc.europa.eu/sites/default/files/documents/Influenza-characterisation-February-2023.pdf.

3. World Health Organization (WHO) (2023, August 11). Recommended Composition of Influenza Virus Vaccines for Use in the 2022–2023 Northern Hemisphere Influenza Season. February 2022, Available online: https://www.who.int/publications/m/item/recommended-composition-of-influenza-virus-vaccines-for-use-in-the-2022-2023-northern-hemisphere-influenza-season.

4. Interim 2022/23 influenza vaccine effectiveness: Six European studies, October 2022 to January 2023;Kissling;Eurosurveillance,2023

5. Vaccine effectiveness estimates from an early-season influenza A(H3N2) epidemic, including unique genetic diversity with reassortment, Canada, 2022/23;Skowronski;Eurosurveillance,2023

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