Vaccine Effectiveness Against Influenza A–Associated Hospitalization, Organ Failure, and Death: United States, 2022–2023
Author:
Lewis Nathaniel M1ORCID, Zhu Yuwei2, Peltan Ithan D3, Gaglani Manjusha4ORCID, McNeal Tresa5, Ghamande Shekhar6ORCID, Steingrub Jay S7, Shapiro Nathan I8, Duggal Abhijit9, Bender William S10, Taghizadeh Leyla11, Brown Samuel M3, Hager David N12, Gong Michelle N13, Mohamed Amira14, Exline Matthew C14, Khan Akram15, Wilson Jennifer G16, Qadir Nida17, Chang Steven Y17, Ginde Adit A18, Mohr Nicholas M19, Mallow Christopher20, Lauring Adam S21, Johnson Nicholas J22, Gibbs Kevin W23, Kwon Jennie H24, Columbus Cristie25, Gottlieb Robert L26ORCID, Raver Catherine25, Vaughn Ivana A27, Ramesh Mayur28ORCID, Johnson Cassandra2, Lamerato Lois27, Safdar Basmah29ORCID, Casey Jonathan D30, Rice Todd W30, Halasa Natasha31, Chappell James D31, Grijalva Carlos G32, Talbot H Keipp33, Baughman Adrienne34, Womack Kelsey N35, Swan Sydney A2, Harker Elizabeth1, Price Ashley1, DeCuir Jennifer1, Surie Diya1, Ellington Sascha1, Self Wesley H36, Calhoun Nicole, Murthy Kempapura, Cravens Joselyn, Herrick Judy, McKillop Amanda, Hoffman Eric, Graves Ashley, Zayed Martha, Smith Michael, Scott Baylor, Health White, Fisher Tammy, Hurutado-Rodriguez Mariana, Kruse Taryn, Dunkley Symone, Perez Gabriela, Bychkowski Ashley, Grefsrud Therissa, Calhoun Nicole, Murthy Kempapura, Herrick Judy, Smith Michael, Steingrub Jay, Kozikowski Lori-Ann, De Souza Lesley, Ouellette Scott, Shapiro Nathan I, Bolstad Michael, Coviello Brianna, Ciottone Robert, Devilla Arnaldo, Grafals Ana, Higgins Conor, Ottanelli Carlo, Redman Kimberly, Scaffidi Douglas, Weingart Alexander, Surie Diya, McMorrow Meredith, DeCuir Jennifer, Lewis Nathaniel, Harker Elizabeth, Ellington Sascha, Mehkri Omar, Mitchell Megan, Griffith Zachary, Brennan Connery, Ashok Kiran, Poynter Bryan, Duggal Abhijit, Busse Laurence, Lohuis Caitlin ten, Stanley Nicholas, Zhang Sophia, Prekker Matthew E, Frosch Anne EP, Hendrickson Audrey, Douglas Stephen, Hurreh Kowsar, Peltan Ithan, Smith Cassie, Marshall Hunter, Hager David N, Ali Harith, Phan Minh, Gong Michelle, Mohamed Amira, Nair Rahul, Chen Jen-Ting (Tina), Exline Matthew, Karow Sarah, Khan Maryiam, So Madison, Snyder Connor, Swoope Gabrielle, Smith David, Lee Brooke, Rasul Amanie, Pathak Manisha, Lewald Zachery, Wilson Reece, Khan Akram, Peña José, Briceno Genesis, Ahmed Cassandra, Martinez Jesus, Pocius Edvinas, Oh Minn, Hyde Jessica, Gause Sherie, Wilson Jennifer G, Gordon Alexandra June, Perez Cynthia, Lau Lily, Bekiroglu Ismail Hakki, Tran Cody, Frankel Trevor, Garner Omai, Chandrasekaran Sukantha, Ginde Adit, Douin David, Martinez Amanda, Huynh David, Steinwand Aimee, Sullivan Amy, Withers Cori, Mohr Nicholas, Zepeski Anne, Nassar Paul, Landers Shannon, Nielsen Karin, Briggs Noble, Fairfield Cathy, Peebles Alex, Mallow Chris, Rivas Carolina, Martin Emily, Monto Arnold, Lauring Adam, McSpadden EJ, Truscon Rachel, Kaniclides Anne, Thomas Lara, Bielak Ramsay, Valvano Weronika Damek, Fong Rebecca, Fitzsimmons William J, Blair Christopher N, Gilbert Julie, Papalambros Leigh, Holz Ankur, Johnson Nicholas, Srinivasan Vasisht, Crider Christine D, Steinbock Kyle A, Paulsen Thomas C, Anderson Layla A, Self Wesley H, Talbot H Keipp, Grijalva Carlos, Jones Ian, Halasa Natasha, Chappell James, Womack Kelsey, Rhoads Jillian, Baughman Adrienne, Kampe Christy, Johnson Jakea, Swan Sydney, Johnson Cassandra, Zhu Yuwei, Rice Todd, Casey Jonathan, Stubblefield William B, Zhu Yuwei, Short Laura L, Ezzell Lauren J, Whitsett Margaret E, McHenry Rendie E, Hargrave Samarian J, Blair Marcia, Luther Jennifer L, Pulido Claudia Guevara, Peterson Bryan P M, Files D Clark, Gibbs Kevin, Landreth Leigha, Hicks Madeline, Parks Lisa, Kwon Jennie, Parikh Bijal, McDonald David, Samuels Carleigh, Vogt Lucy, O’Neil Caroline, Valencia Alyssa, Hink Tiffany, Bychkowski Ashley, Dunkley Symone, Fisher Tammy, Grefsrud Therissa, Hurutado-Rodriguez Mariana H, Perez Gabriela Cantu, Beney Kim, Jayaprakash Rachna, Koneru Sindhuja, Lava Jean Ashley, Pinderi Zina, Resk Melissa, Goyal Anirudh, DeLamielleure Lauren, Kosover Michael, Brokowski Carolyn,
Affiliation:
1. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC) , Atlanta, Georgia , USA 2. Department of Biostatistics, Vanderbilt University Medical Center , Nashville, Tennessee , USA 3. Department of Medicine, Intermountain Medical Center, Murray, Utah, and University of Utah , Salt Lake City, Utah , USA 4. Baylor Scott and White Health, Temple and Dallas, Texas, and Texas A&M University College of Medicine , Temple, Texas , USA 5. Baylor Scott and White Health, and Baylor College of Medicine , Temple, Texas , USA 6. Baylor Scott and White Health, Texas A&M University College of Medicine , Temple, Texas , USA 7. Department of Medicine, Baystate Medical Center , Springfield, Massachusetts , USA 8. Department of Emergency Medicine, Beth Israel Deaconess Medical Center , Boston, Massachusetts , USA 9. Department of Medicine, Cleveland Clinic , Cleveland, Ohio , USA 10. Department of Medicine, Emory University , Atlanta, Georgia , USA 11. Department of Emergency Medicine, Hennepin County Medical Center , Minneapolis, Minnesota , USA 12. Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA 13. Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, New York , USA 14. Department of Medicine, The Ohio State University , Columbus, Ohio , USA 15. Department of Medicine, Oregon Health and Sciences University , Portland, Oregon , USA 16. Department of Emergency Medicine, Stanford University School of Medicine , Stanford, California , USA 17. Department of Medicine, University of California-Los Angeles , Los Angeles, California , USA 18. Department of Emergency Medicine, University of Colorado School of Medicine , Aurora, Colorado , USA 19. Carver College of Medicine, University of Iowa , Iowa City, Iowa , USA 20. Department of Medicine, University of Miami , Miami, Florida , USA 21. Departments of Internal Medicine and Microbiology and Immunology, University of Michigan , Ann Arbor, Michigan , USA 22. Department of Emergency Medicine and Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington , Seattle, Washington , USA 23. Department of Medicine, Wake Forest School of Medicine , Winston-Salem, North Carolina , USA 24. Department of Medicine, Washington University , St.Louis, Missouri , USA 25. Baylor, Scott and White Health , Dallas, Texas , USA 26. Baylor University Medical Center Dallas, Baylor, Scott & White Heart and Vascular Hospital, Baylor, Scott and White Research Institute , Dallas, Texas , USA 27. Department of Public Health Sciences, Henry Ford Health , Detroit, Michigan , USA 28. Division of Infectious Diseases, Henry Ford Health , Detroit, Michigan , USA 29. Emergency Medicine, Yale University School of Medicine , New Haven, Connecticut , USA 30. Department of Medicine, Vanderbilt University Medical Center , Nashville, Tennessee , USA 31. Department of Pediatrics, Vanderbilt University Medical Center , Nashville, Tennessee , USA 32. Department of Health Policy, Vanderbilt University Medical Center , Nashville, Tennessee , USA 33. Departments of Medicine and Health Policy, Vanderbilt University Medical Center , Nashville, Tennessee , USA 34. Department of Emergency Medicine, Vanderbilt University Medical Center , Nashville, Tennessee , USA 35. Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center , Nashville, Tennessee , USA 36. Department of Emergency Medicine, Vanderbilt Institute for Clinical and Translational Research, and Vanderbilt University Medical Center , Nashville, Tennessee , USA
Abstract
Abstract
Background
Influenza circulation during the 2022–2023 season in the United States largely returned to pre–coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain.
Methods
To understand effectiveness of the 2022–2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2–negative control-patients.
Results
A total of 3707 patients, including 714 influenza cases (33% vaccinated) and 2993 influenza- and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–negative controls (49% vaccinated) were analyzed. VE against influenza-associated hospitalization was 37% (95% confidence interval [CI]: 27%–46%) and varied by age (18–64 years: 47% [30%–60%]; ≥65 years: 28% [10%–43%]), and virus (A[H3N2]: 29% [6%–46%], A[H1N1]: 47% [23%–64%]). VE against more severe influenza-associated outcomes included: 41% (29%–50%) against influenza with hypoxemia treated with supplemental oxygen; 65% (56%–72%) against influenza with respiratory, cardiovascular, or renal failure treated with organ support; and 66% (40%–81%) against influenza with respiratory failure treated with invasive mechanical ventilation.
Conclusions
During an early 2022–2023 influenza season with a well-matched influenza vaccine, vaccination was associated with reduced risk of influenza-associated hospitalization and organ failure.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
Cited by
8 articles.
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