Effectiveness of trivalent influenza vaccines against hospitalizations due to laboratory-confirmed influenza a in the elderly: Comparison of test-negative design with register-based designs.

INTRODUCTION: Measuring influenza vaccine effectiveness (IVE) seasonally is important and has been conducted utilizing several observational study designs. The active test-negative design has been most widely used and the validity of passive register-based studies has been debated. We aimed to explore the potential differences, advantages, and weaknesses of different study designs in estimating influenza vaccine effectiveness. METHODS: We compared three study designs in estimating IVE against hospitalization in the elderly aged 65 years or more over three influenza seasons 2015/16, 2016/17 and 2017/18. Designs compared were active test-negative design (TND), register-based cohort design and register-based case-control design with different selection criteria for cases and controls. RESULTS: Adjusted IVE estimates for the three consecutive seasons 2015-18 in active test-negative design were 82% (95% confidence interval 26, 96), 21% (-179, 77), 15% (-113, 66). For case-control design, estimates from different analyses ranged in 2015/16 from 47% (-16, 76) to 52% (-48, 84), in 2016/17 from 10% (-42, 43) to 29% (-20, 58), and in 2017/18 from -27% (-91, 15) to 1% (-40, 30). In the cohort design, the adjusted IVE estimates were 48% (-9, 75), 29% (1, 49), 13% (-21, 37) for the three seasons. CONCLUSIONS: The register-based cohort design produced results more concordant with the active test-negative design than the case-control design. Furthermore, the register-based cohort design yielded most precise estimates with narrower confidence intervals. In Finland with the availability of near real-time nationwide register data, the register-based cohort design is the method of choice to continue the annual surveillance of influenza vaccine effectiveness.

The effects of laser welding on heterogeneous immunoassay performance in a microfluidic cartridge.

Sealing of a microfluidic cartridge is a challenge, because the cartridge commonly contains heat-sensitive biomolecules that must also be protected from contamination. In addition, the objective is usually to obtain a sealing method suitable for mass production. Laser welding is a rapid technique that can be accomplished with low unit costs. Even though the technique has been widely adopted in industry, the literature on its use in microfluidic applications is not large. This paper is the first to report the effects of laser welding on the performance of the heterogeneous immunoassay in a polystyrene microfluidic cartridge in which biomolecules are immobilized into the reaction surface of the cartridge before sealing. The paper compares the immunoassay performance of microfluidic cartridges that are sealed either with an adhesive tape or by use of laser transmission welding. The model analyte used is thyroid stimulating hormone (TSH). The results show that the concentration curves in the laser-welded cartridges are very close to the curves in the taped cartridges. This indicates, first, that laser welding does not cause any significant reduction in immunoassay performance, and second, that the polystyrene cover does not have significant effect on the signal levels. Interestingly, the coefficients of variance between parallel samples were lower in the laser-welded cartridges than in the taped cartridges.