Melissa A Rolfes1, Brendan Flannery1, Jessie R Chung1, Alissa O'Halloran1, Shikha Garg1, Edward A Belongia2, Manjusha Gaglani3, Richard K Zimmerman4, Michael L Jackson5, Arnold S Monto6, Nisha B Alden7, Evan Anderson8, Nancy M Bennett9, Laurie Billing10, Seth Eckel11, Pam Daily Kirley12, Ruth Lynfield13, Maya L Monroe14, Melanie Spencer15, Nancy Spina16, H Keipp Talbot17, Ann Thomas18, Salina M Torres19, Kimberly Yousey-Hindes20, James A Singleton21, Manish Patel1, Carrie Reed1, Alicia M Fry1. 1. Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia. 2. Marshfield Clinic Research Institute, Wisconsin. 3. Baylor Scott and White Health, Texas A&M University Health Science Center College of Medicine, Temple. 4. University of Pittsburgh Schools of Health Sciences, Pennsylvania. 5. Kaiser Permanente Washington Health Research Institute, Seattle. 6. University of Michigan School of Public Health, Ann Arbor. 7. Colorado Department of Public Health and Environment, Denver. 8. Georgia Emerging Infections Program, Atlanta VA Medical Center, Emory University, New York. 9. University of Rochester School of Medicine and Dentistry, New York. 10. Ohio Department of Health, Columbus. 11. Michigan Department of Health and Human Services, Lansing. 12. California Emerging Infections Program, Oakland. 13. Minnesota Department of Health, St. Paul. 14. Maryland Department of Health, Baltimore. 15. Salt Lake County Health Department, Utah. 16. New York State Emerging Infections Program, New York State Department of Health, Albany. 17. Vanderbilt University, Nashville, Tennessee. 18. Oregon Public Health Division, Portland. 19. New Mexico Department of Health, Santa Fe. 20. Connecticut Emerging Infections Program, Yale School of Public Health, New Haven. 21. Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
BACKGROUND: The severity of the 2017-2018 influenza season in the United States was high, with influenza A(H3N2) viruses predominating. Here, we report influenza vaccine effectiveness (VE) and estimate the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the 2017-2018 influenza season. METHODS: We used national age-specific estimates of 2017-2018 influenza vaccine coverage and disease burden. We estimated VE against medically attended reverse-transcription polymerase chain reaction-confirmed influenza virus infection in the ambulatory setting using a test-negative design. We used a compartmental model to estimate numbers of influenza-associated outcomes prevented by vaccination. RESULTS: The VE against outpatient, medically attended, laboratory-confirmed influenza was 38% (95% confidence interval [CI], 31%-43%), including 22% (95% CI, 12%-31%) against influenza A(H3N2), 62% (95% CI, 50%-71%) against influenza A(H1N1)pdm09, and 50% (95% CI, 41%-57%) against influenza B. We estimated that influenza vaccination prevented 7.1 million (95% CrI, 5.4 million-9.3 million) illnesses, 3.7 million (95% CrI, 2.8 million-4.9 million) medical visits, 109 000 (95% CrI, 39 000-231 000) hospitalizations, and 8000 (95% credible interval [CrI], 1100-21 000) deaths. Vaccination prevented 10% of expected hospitalizations overall and 41% among young children (6 months-4 years). CONCLUSIONS: Despite 38% VE, influenza vaccination reduced a substantial burden of influenza-associated illness, medical visits, hospitalizations, and deaths in the United States during the 2017-2018 season. Our results demonstrate the benefit of current influenza vaccination and the need for improved vaccines. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
BACKGROUND: The severity of the 2017-2018 influenza season in the United States was high, with influenza A(H3N2) viruses predominating. Here, we report influenza vaccine effectiveness (VE) and estimate the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the 2017-2018 influenza season. METHODS: We used national age-specific estimates of 2017-2018 influenza vaccine coverage and disease burden. We estimated VE against medically attended reverse-transcription polymerase chain reaction-confirmed influenza virus infection in the ambulatory setting using a test-negative design. We used a compartmental model to estimate numbers of influenza-associated outcomes prevented by vaccination. RESULTS: The VE against outpatient, medically attended, laboratory-confirmed influenza was 38% (95% confidence interval [CI], 31%-43%), including 22% (95% CI, 12%-31%) against influenza A(H3N2), 62% (95% CI, 50%-71%) against influenza A(H1N1)pdm09, and 50% (95% CI, 41%-57%) against influenza B. We estimated that influenza vaccination prevented 7.1 million (95% CrI, 5.4 million-9.3 million) illnesses, 3.7 million (95% CrI, 2.8 million-4.9 million) medical visits, 109 000 (95% CrI, 39 000-231 000) hospitalizations, and 8000 (95% credible interval [CrI], 1100-21 000) deaths. Vaccination prevented 10% of expected hospitalizations overall and 41% among young children (6 months-4 years). CONCLUSIONS: Despite 38% VE, influenza vaccination reduced a substantial burden of influenza-associated illness, medical visits, hospitalizations, and deaths in the United States during the 2017-2018 season. Our results demonstrate the benefit of current influenza vaccination and the need for improved vaccines. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
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