Takeaway
- Waning protection with time since influenza vaccination most pronounced among patients with prior season vaccination.
Why this matters
- Careful consideration of risks and benefits of delayed vaccination needed before changes to current vaccine recommendations.
Study design
- US Influenza Vaccine Effectiveness Network.
- Pooled data from 2011-12 through 2014-15 seasons.
- Patients ≥9 y old with laboratory-confirmed influenza.
- Considered vaccinated if dosed at least 14 d before illness onset.
- Funding: US Centers for Disease Control and Prevention.
Key results
- Vaccine effectiveness (VE) against influenza A(H3N2) (n=11,200), influenza A(H1N1)pdm09 (n=4100), and influenza B (n=5525).
- Adjusted VE decreased with increasing time since vaccination for influenza A(H3N2) (P=.004), influenza A(H1N1)pdm09 (P=.01), and influenza B viruses (P=.04).
- Maximum VE observed shortly after vaccination, declining about 7% per month for influenza A(H3N2) and influenza B and 6%-11% per month for influenza A(H1N1)pdm09.
- Decline in VE was more pronounced among patients with prior season influenza vaccination.
Limitations
- Possibility of a drifted variant less well-matched to the vaccine strain; confounding factors associated with vaccine timing and influenza risk; heterogeneity of the at-risk population and the leaky vaccine effect.
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