Publication Date
4-10-2024
Journal
Clinical Infectious Diseases
DOI
10.1093/cid/ciad677
PMID
38051664
PMCID
PMC11487098
PubMedCentral® Posted Date
4-10-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Adult, Humans, United States, Adolescent, Young Adult, Middle Aged, Influenza, Human, Influenza Vaccines, Influenza A Virus, H1N1 Subtype, Influenza A Virus, H3N2 Subtype, Vaccine Efficacy, Influenza B virus, Hospitalization, Influenza A virus, Vaccination, Seasons, : influenza, vaccine effectiveness, attenuation, organ failure, acute respiratory illness
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.
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Clinical Epidemiology Commons, Community Health and Preventive Medicine Commons, COVID-19 Commons, Critical Care Commons, Influenza Humans Commons, Influenza Virus Vaccines Commons, Medical Sciences Commons, Respiratory Tract Diseases Commons