One dose of the pandemic flu vaccines used in seven European countries conferred good protection against pandemic H1N1 influenza in the 2009-10 season, especially in people aged less than 65 years and in those without any chronic diseases. These findings from a study funded by the European Centre for Disease Prevention and Control (ECDC) and coordinated by EpiConcept, Paris, France, published in this week's PLoS Medicine, give an indication of the vaccine effectiveness for the influenza A (H1N1) 2009 strain included in the 2010-11 seasonal vaccines.
The authors conducted a multi-centre case-control study based on practitioner surveillance networks from seven countries--France, Hungary, Ireland, Italy, Romania, Portugal and Spain. Patients consulting a participating practitioner for influenza-like-illness had a nasal or throat swab taken within eight days of symptom onset. Individuals were considered vaccinated if they had received a dose of the vaccine more than 14 days before the date of onset of influenza like illness and unvaccinated if they were not vaccinated at all or if the vaccine was given less than 15 days before the onset of symptoms.
The authors analysed pandemic influenza vaccination effectiveness in those vaccinated less than 8 days, those vaccinated between, and including, 8 and 14 days and those vaccinated more than 14 days before onset of symptoms compared to those who had never been vaccinated. The authors then used statistical models to measure the effectiveness of pandemic influenza vaccine according to three age groups (< 15, 15-64, and 65+ years of age) and the presence of chronic diseases. These results obtained during the late phase of the pandemic suggest good protection with the pandemic H1N1 vaccine (vaccine effectiveness estimates between 65% and 100%). The findings also suggest that the 2009-10 seasonal influenza vaccine (as opposed to the pandemic H1N1 vaccine) did not protect against pandemic H1N1 influenza illness.
The authors said: "The late availability of the pandemic vaccine and subsequent limited coverage with this vaccine hampered our ability to study vaccine benefits during the outbreak period." They added: "Future studies should include estimation of effectiveness of the new trivalent vaccine in the 2010-2011 season, when vaccination will occur before the influenza season starts."
Bruno C. Ciancio, senior influenza expert from ECDC - who conceived the idea of a European network to measure influenza vaccine effectiveness and collaborated to design the study- stressed: "This study showed the added value of collaboration at European level as concerns vaccine evaluation. In addition, the results obtained are especially important for European countries this season, considering that the predominant influenza strain currently circulating across Europe is influenza A (H1N1).''
Funding: This project received funding from the European Centre for Disease Prevention and Control (ECDC, http://www.ecdc.europa.eu) through the call for tender FWC ECDC/07/015. ECDC uses only public money and P. Kramarz and B. C. Cianco (coauthors of the article and working for ECDC) have no conflicts of interest to declare. P. Kramarz and B. C. Ciancio collaborated with EpiConcept in setting up the system, deciding on study design, and writing the article.
Competing Interests: J-M Cohen is a direct advisor for the French Minister of Health (MOH). His salary as Head of re´seau des GROG is financed by the French MOH (76%) and Institut Pasteur (24%). The Institut Pasteur contribution is funded by a pool of five pharmaceutical firms (Roche, Glaxo SmithKline [GSK], Sanofi Pasteur, Solvay, Arge`ne). As Head of Open Rome, he is involved in several epidemiological studies that are partially or fully funded by pharmaceutical companies (Sanofi-Pasteur, GSK, Roche), nonprofit organizations (Mutuelles, Re´saeu DES France) or public institutions (ECDC, CU Strasbourg). He is a member of Association Mieux Prescrire and the advisory boards of Novartis, Roche, and Wyeth (free participation, no compensation). During the past five years, he has received travel grants from Sanofi-Pasteur and Roche. A. Mosnier is a member of the French MOH advisory board on influenza, and adviser for influenza to the French Health Insurance organization. As coordinator of the Re´seau des GROG (French Influenza Sentinel network), her salary is funded by MOH (76%) and Institut Pasteur (24%). Institut Pasteur contribution is funded by a pool of five pharmaceutical firms (GSK, Roche, Sanofi-Pasteur, Solvay, Argene). She is involved, through the other institution with which she is affiliated and salaried (Open Rome research department), in the coordination or analysis of epidemiological studies partially or fully funded by Roche and GSK. She is member of the Groupe d'Expertise et d'Information sur la Grippe (GEIG) Scientific Board. During the last five years, she has received travel grants from Roche for speaking, or participation, at scientific meetings. All other authors have declared that no competing interests exist.
Citation: Valenciano M, Kissling E, Cohen J-M, Oroszi B, Barret A-S, et al. (2011) Estimates of Pandemic Influenza Vaccine Effectiveness in Europe, 2009�: Results of Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE) Multicentre Case-Control Study. PLoS Med 8(1): e1000388. doi:10.1371/journal.pmed.1000388
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