Relative Effectiveness of the Cell-Cultured Quadrivalent Influenza Vaccine Compared to Standard, Egg-derived Quadrivalent Influenza Vaccines in Preventing Influenza-like Illness in 2017-2018
Open Access
- 15 November 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 71 (10), E665-E671
- https://doi.org/10.1093/cid/ciaa371
Abstract
Background. Influenza antigens may undergo adaptive mutations during egg-based vaccine production. In the 2017-2018 influenza season, quadrivalent, inactivated cell-derived influenza vaccine (ccIIV4) vaccine was produced using A(H3N2) seed virus propagated exclusively in cell culture, thus lacking egg adaptive changes. This United States study estimated relative vaccine effectiveness (rVE) of ccIIV4 vs egg-derived quadrivalent vaccines (egg-derived IIV4) for that season. Methods. Vaccination, outcome, and covariate data were ascertained retrospectively from a electronic medical record (EMR) dataset and analyzed. The study cohort included patients >= 4 years of age. rVE was estimated against influenza-like illness (ILI) using diagnostic International Classification of Diseases, Ninth or Tenth Revision codes. The adjusted odds ratios used to derive rVE estimates were estimated from multivariable logistic regression models adjusted for age, sex, race/ethnicity, geographic region, and health status. Results. Overall, 92 187 individuals had a primary care EMR record of ccIIV4 and 1 261 675 had a record of egg-derived IIV4. In the ccIIV4 group, 1705 narrowly defined ILI events occurred, and 25 645 occurred in the standard egg-derived IIV4 group. Crude rVE was 9.2% (95% confidence interval [CI], 4.6%-13.6%). When adjusted for age, sex, health status, comorbidities, and geographic region, the estimated rVE changed to 36.2% (95% CI, 26.1%-44.9%). Conclusions. ccIIV4, derived from A(H3N2) seed virus propagated exclusively in cell culture, was more effective than egg-derived IIV4 in preventing ILI during the 2017-2018 influenza season. This result suggests that cell-derived influenza vaccines may have greater effectiveness than standard egg-derived vaccines.Funding Information
- Seqirus Inc
This publication has 34 references indexed in Scilit:
- Clinical prediction rules combining signs, symptoms and epidemiological context to distinguish influenza from influenza-like illnesses in primary care: a cross sectional studyBMC Family Practice, 2011
- Safety of MDCK cell culture-based influenza vaccinesFuture Microbiology, 2011
- Validation of the safety of MDCK cells as a substrate for the production of a cell-derived influenza vaccineBiologicals, 2010
- Burden of Influenza‐Like Illness and Effectiveness of Influenza Vaccination among Working Adults Aged 50–64 YearsClinical Infectious Diseases, 2009
- Functional status is a confounder of the association of influenza vaccine and risk of all cause mortality in seniorsInternational Journal of Epidemiology, 2005
- Performance Characteristics of Clinical Diagnosis, a Clinical Decision Rule, and a Rapid Influenza Test in the Detection of Influenza Infection in a Community Sample of AdultsAnnals of Emergency Medicine, 2005
- Colds and Influenza-Like Illnesses in University Students: Impact on Health, Academic and Work Performance, and Health Care UseClinical Infectious Diseases, 2005
- Cost benefit of influenza vaccination in healthy, working adults: an economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccineVaccine, 2003
- Adapting a clinical comorbidity index for use with ICD-9-CM administrative databasesJournal of Clinical Epidemiology, 1992
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987