Vaccine. 2020 Jan 10;38(2):350-354. doi: 10.1016/j.vaccine.2019.10.005. Epub 2019 Oct 10.
Influenza vaccination and respiratory
virus interference among Department
of Defense personnel during the 2017
-2018 influenza season.
Wolff GG1.
Abstract
PURPOSE:
Receiving influenza vaccination may increase
the risk of other respiratory viruses, a phenomenon
known as virus interference. Test-negative study designs
are often utilized to calculate influenza vaccine
effectiveness. The virus interference phenomenon goes
against the basic assumption of the test-negative vaccine
effectiveness study that vaccination does not change the
risk of infection with other respiratory illness, thus
potentially biasing vaccine effectiveness results in the
positive direction. This study aimed to investigate virus
interference by comparing respiratory virus status among
Department of Defense personnel based on their influenza
vaccination status. Furthermore, individual respiratory
viruses and their association with influenza vaccination
were examined.
the risk of other respiratory viruses, a phenomenon
known as virus interference. Test-negative study designs
are often utilized to calculate influenza vaccine
effectiveness. The virus interference phenomenon goes
against the basic assumption of the test-negative vaccine
effectiveness study that vaccination does not change the
risk of infection with other respiratory illness, thus
potentially biasing vaccine effectiveness results in the
positive direction. This study aimed to investigate virus
interference by comparing respiratory virus status among
Department of Defense personnel based on their influenza
vaccination status. Furthermore, individual respiratory
viruses and their association with influenza vaccination
were examined.
RESULTS:
We compared vaccination status of 2880 people with non-influenza respiratory viruses to 3240 people with pan-negative results. Comparing vaccinated to non-vaccinated patients, the adjusted odds ratio for non-flu viruses was 0.97 (95% confidence interval (CI): 0.86, 1.09; p = 0.60). Additionally, the vaccination status of 3349 cases of influenza were compared to three different control groups: all controls (N = 6120), non-influenza positive controls (N = 2880), and pan-negative controls (N = 3240). The adjusted ORs for the comparisons among the three control groups did not vary much (range: 0.46-0.51).
CONCLUSIONS:
Receipt of influenza vaccination was not associated with virus interference among our population. Examining virus interference by specific respiratory viruses showed mixed results. Vaccine derived virus interference was significantly associated with coronavirus and human metapneumovirus; however, significant protection with vaccination was associated not only with most influenza viruses, but also parainfluenza, RSV, and non-influenza virus coinfections.
Published by Elsevier Ltd.
KEYWORDS:
Department of Defense; Influenza vaccine; Respiratory illness; Virus interference
- PMID:
- 31607599
- PMCID:
- PMC7126676
- DOI:
- 10.1016/j.vaccine.2019.10.005
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