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Clin Infect Dis. 2019 Feb 2. doi: 10.1093/cid/ciz075. [Epub ahead of print]

Effects of Influenza Vaccination in the United States during the 2017-2018 Influenza Season.

Author information

1
Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
2
Marshfield Clinical Research Institute, Marshfield, WI.
3
Baylor Scott and White Health, Texas A&M College of Medicine, Temple, TX.
4
University of Pittsburgh Schools of Health Sciences, Pittsburgh, PA.
5
Kaiser Permanente Washington Health Research Institute, Seattle, WA.
6
University of Michigan School of Public Health, Ann Arbor, MI.
7
Colorado Department of Public Health and Environment, Denver, CO.
8
Georgia Emerging Infections Program, Atlanta VA Medical Center, Emory University, Atlanta, GA.
9
University of Rochester School of Medicine and Dentistry, Rochester, NY.
10
Ohio Department of Health, Columbus, OH.
11
Michigan Department of Health and Human Services, Lansing, MI.
12
California Emerging Infections Program, Oakland, CA.
13
Minnesota Department of Health, St. Paul, MN.
14
Maryland Department of Health and Mental Hygiene, Baltimore, MD.
15
Salt Lake County Health Department, Salt Lake City, UT.
16
New York State Emerging Infections Program, New York State Department of Health, Albany, NY.
17
Vanderbilt University, Nashville, TN.
18
Oregon Department of Public Health, Portland, OR.
19
New Mexico Department of Health, Sante Fe, NM.
20
Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT.
21
Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, GA.

Abstract

Background:

The severity of the 2017-2018 influenza season in the U.S. was high with influenza A(H3N2) viruses predominating. 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, and 95% confidence intervals (CI), against medically-attended RT-PCR confirmed influenza virus infection, in the ambulatory setting, using a test-negative design. We estimated influenza type/subtype-specific burden using multipliers applied to population-based rates of influenza-associated hospitalizations. We used a compartmental model to estimate numbers, with 95% credible intervals (CrI), of influenza-associated outcomes prevented by vaccination.

Results:

The VE against outpatient medically-attended, laboratory-confirmed influenza was 38% (95% 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 8,000 (95% CrI: 1,100-21,000) 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 U.S. during the 2017-2018 season. Our results demonstrate the benefit of current influenza vaccination and the need for improved vaccines.

PMID:
30715278
DOI:
10.1093/cid/ciz075

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