Rationale for two influenza B lineages in seasonal vaccines: A meta-regression study on immunogenicity and controlled field trials.
Vaccine
; 35(33): 4167-4176, 2017 07 24.
Article
en En
| MEDLINE
| ID: mdl-28655451
ABSTRACT
B lineage mismatch prompted introduction of quadri-valent influenza vaccines (QIV) with two influenza B viruses representing distinct antigenic lineages. To explore the impact on antibody induction and vaccine effectiveness predicted from antibody (VEab), we performed a systematic literature search on immunogenicity studies conducted to assess antibody superiority of QIV over trivalent influenza vaccine (TIV). Thirteen relevant articles described 31 trials from 2007 and 2013. Log-transformed GMT trial estimates and their variances were converted to clinical protection rates predicted from antibody (PRab). VEab estimates were calculated from pre- and post-vaccination PRab. Without specific pre-vaccination immunity, average VEab was 69% for match, and -4% for lineage mismatch. With increasing pre-vaccination seropositivity, mismatch impact declined to 2%. We also performed an umbrella literature search for randomised controlled trials and test-negative case-control trials with TIV, and estimated vaccine effectiveness against laboratory-confirmed influenza B (VEf). Sixty-eight eligible clinical articles described 110 season-trials from 1965 to 2012, covering seasons with B lineage match (n=52), lineage drift (n=15) and lineage mismatch (n=43). With no pre-vaccination antibody levels determined, we used chance of previous exposure to influenza B (Ppe) as pre-seasonal immunity measure. When Ppe was 0%, average VEf for matched seasons was 67%, and for mismatched seasons 35%, indicating a moderate, yet significant mismatch impact on VEf. With increasing Ppe, mismatch impact declined to 3%. Thus serological and field trials indicate that B lineage mismatch impact is negatively related to pre-seasonal immunity and that the gain of QIV over TIV most benefits infants and children not yet exposed to influenza B.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Virus de la Influenza B
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Vacunas contra la Influenza
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Gripe Humana
Tipo de estudio:
Clinical_trials
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Prognostic_studies
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Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Vaccine
Año:
2017
Tipo del documento:
Article
País de afiliación:
Países Bajos