Prospective hospital-based case-control study to assess the effectiveness of pandemic influenza A(H1N1)pdm09 vaccination and risk factors for hospitalization in 2009-2010 using matched hospital and test-negative controls.
Identifieur interne : 000239 ( Main/Exploration ); précédent : 000238; suivant : 000240Prospective hospital-based case-control study to assess the effectiveness of pandemic influenza A(H1N1)pdm09 vaccination and risk factors for hospitalization in 2009-2010 using matched hospital and test-negative controls.
Auteurs : Wiebke Hellenbrand [Allemagne] ; Pernille Jorgensen ; Brunhilde Schweiger ; Gerhard Falkenhorst ; Matthias Nachtnebel ; Benedikt Greutélaers ; Christian Traeder ; Ole WichmannSource :
- BMC infectious diseases [ 1471-2334 ] ; 2012.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Berlin (épidémiologie), Facteurs de risque (MeSH), Femelle (MeSH), Grippe humaine (anatomopathologie), Grippe humaine (prévention et contrôle), Grippe humaine (virologie), Grippe humaine (épidémiologie), Grossesse (MeSH), Hospitalisation (statistiques et données numériques), Humains (MeSH), Jeune adulte (MeSH), Mâle (MeSH), Nez (virologie), Pharynx (virologie), Réaction de polymérisation en chaîne (MeSH), Sous-type H1N1 du virus de la grippe A (immunologie), Sous-type H1N1 du virus de la grippe A (isolement et purification), Sujet âgé (MeSH), Tests sérologiques (MeSH), Vaccination (méthodes), Vaccins antigrippaux (administration et posologie), Vaccins antigrippaux (immunologie), Études cas-témoins (MeSH), Études prospectives (MeSH).
- MESH :
- administration et posologie : Vaccins antigrippaux.
- anatomopathologie : Grippe humaine.
- immunologie : Sous-type H1N1 du virus de la grippe A, Vaccins antigrippaux.
- isolement et purification : Sous-type H1N1 du virus de la grippe A.
- méthodes : Vaccination.
- prévention et contrôle : Grippe humaine.
- statistiques et données numériques : Hospitalisation.
- virologie : Grippe humaine, Nez, Pharynx.
- épidémiologie : Berlin, Grippe humaine.
- Adolescent, Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Grossesse, Humains, Jeune adulte, Mâle, Réaction de polymérisation en chaîne, Sujet âgé, Tests sérologiques, Études cas-témoins, Études prospectives.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Berlin (epidemiology), Case-Control Studies (MeSH), Female (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Influenza A Virus, H1N1 Subtype (immunology), Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza Vaccines (administration & dosage), Influenza Vaccines (immunology), Influenza, Human (epidemiology), Influenza, Human (pathology), Influenza, Human (prevention & control), Influenza, Human (virology), Male (MeSH), Middle Aged (MeSH), Nose (virology), Pharynx (virology), Polymerase Chain Reaction (MeSH), Pregnancy (MeSH), Prospective Studies (MeSH), Risk Factors (MeSH), Serologic Tests (MeSH), Vaccination (methods), Young Adult (MeSH).
- MESH :
- chemical , administration & dosage : Influenza Vaccines.
- geographic , epidemiology : Berlin.
- epidemiology : Influenza, Human.
- immunology : Influenza A Virus, H1N1 Subtype, Influenza Vaccines.
- isolation & purification : Influenza A Virus, H1N1 Subtype.
- methods : Vaccination.
- pathology : Influenza, Human.
- prevention & control : Influenza, Human.
- statistics & numerical data : Hospitalization.
- virology : Influenza, Human, Nose, Pharynx.
- Adolescent, Adult, Aged, Case-Control Studies, Female, Humans, Male, Middle Aged, Polymerase Chain Reaction, Pregnancy, Prospective Studies, Risk Factors, Serologic Tests, Young Adult.
Abstract
BACKGROUND
We performed a case-control study to estimate vaccine effectiveness (VE) for prevention of hospitalization due to pandemic influenza A(H1N1)pdm09 (pH1N1) and to identify risk factors for pH1N1 and acute respiratory infection (ARI) in 10 hospitals in Berlin from December 2009 to April 2010.
METHODS
Cases were patients aged 18-65 years with onset of ARI ≤10 days before admission testing positive for pH1N1 by PCR performed on nasal and throat swabs or by serological testing. Cases were compared to (1) matched hospital controls with acute surgical, traumatological or other diagnoses matched on age, sex and vaccination probability, and (2) ARI patients testing negative for pH1N1. Additionally, ARI cases were compared to matched hospital controls. A standardized interview and chart review elicited demographic and clinical data as well as potential risk factors for pH1N1/ARI. VE was estimated by 1-(Odds ratio) for pH1N1-vaccination ≥10 days before symptom onset using exact logistic regression analysis.
RESULTS
Of 177 ARI cases recruited, 27 tested pH1N1 positive. A monovalent AS03-adjuvanted pH1N1 vaccine was the only pandemic vaccine type identified among cases and controls (vaccination coverage in control group 1 and 2: 15% and 5.9%). The only breakthrough infections were observed in 2 of 3 vaccinated HIV positive pH1N1 patients. After exclusion of HIV positive participants, VE was 96% (95%CI: 26-100%) in the matched multivariate analysis and 46% (95%CI: -376-100%) in the test-negative analysis. Exposure to children in the household was independently associated with hospitalization for pH1N1 and ARI.
CONCLUSIONS
Though limited by low vaccination coverage and number of pH1N1 cases, our results suggest a protective effect of the AS03-adjuvanted pH1N1 vaccine for the prevention of pH1N1 hospitalization. The use of hospital but not test-negative controls showed a statistically protective effect of pH1N1-vaccination and permitted the integrated assessment of risk factors for pH1N1-infection. To increase statistical power and to permit stratified analyses (e.g. VE for specific risk groups), the authors suggest pooling of future studies assessing effectiveness of influenza vaccines for prevention of severe disease from different centres.
DOI: 10.1186/1471-2334-12-127
PubMed: 22650369
PubMed Central: PMC3464893
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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sortKey="Jorgensen, Pernille" sort="Jorgensen, Pernille" uniqKey="Jorgensen P" first="Pernille" last="Jorgensen">Pernille Jorgensen</name></author><author><name sortKey="Schweiger, Brunhilde" sort="Schweiger, Brunhilde" uniqKey="Schweiger B" first="Brunhilde" last="Schweiger">Brunhilde Schweiger</name></author><author><name sortKey="Falkenhorst, Gerhard" sort="Falkenhorst, Gerhard" uniqKey="Falkenhorst G" first="Gerhard" last="Falkenhorst">Gerhard Falkenhorst</name></author><author><name sortKey="Nachtnebel, Matthias" sort="Nachtnebel, Matthias" uniqKey="Nachtnebel M" first="Matthias" last="Nachtnebel">Matthias Nachtnebel</name></author><author><name sortKey="Greutelaers, Benedikt" sort="Greutelaers, Benedikt" uniqKey="Greutelaers B" first="Benedikt" last="Greutélaers">Benedikt Greutélaers</name></author><author><name sortKey="Traeder, Christian" sort="Traeder, Christian" uniqKey="Traeder C" first="Christian" last="Traeder">Christian Traeder</name></author><author><name 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controls.</title><author><name sortKey="Hellenbrand, Wiebke" sort="Hellenbrand, Wiebke" uniqKey="Hellenbrand W" first="Wiebke" last="Hellenbrand">Wiebke Hellenbrand</name><affiliation wicri:level="3"><nlm:affiliation>Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, 13086 Berlin, Germany. hellenbrandw@rki.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, 13086 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Jorgensen, Pernille" sort="Jorgensen, Pernille" uniqKey="Jorgensen P" first="Pernille" last="Jorgensen">Pernille Jorgensen</name></author><author><name sortKey="Schweiger, Brunhilde" sort="Schweiger, Brunhilde" uniqKey="Schweiger B" first="Brunhilde" last="Schweiger">Brunhilde Schweiger</name></author><author><name sortKey="Falkenhorst, Gerhard" sort="Falkenhorst, Gerhard" uniqKey="Falkenhorst G" first="Gerhard" last="Falkenhorst">Gerhard Falkenhorst</name></author><author><name sortKey="Nachtnebel, Matthias" sort="Nachtnebel, Matthias" uniqKey="Nachtnebel M" first="Matthias" last="Nachtnebel">Matthias Nachtnebel</name></author><author><name sortKey="Greutelaers, Benedikt" sort="Greutelaers, Benedikt" uniqKey="Greutelaers B" first="Benedikt" last="Greutélaers">Benedikt Greutélaers</name></author><author><name sortKey="Traeder, Christian" sort="Traeder, Christian" uniqKey="Traeder C" first="Christian" last="Traeder">Christian Traeder</name></author><author><name sortKey="Wichmann, Ole" sort="Wichmann, Ole" uniqKey="Wichmann O" first="Ole" last="Wichmann">Ole Wichmann</name></author></analytic><series><title level="j">BMC infectious diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Berlin (epidemiology)</term><term>Case-Control Studies (MeSH)</term><term>Female (MeSH)</term><term>Hospitalization (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Influenza A Virus, H1N1 Subtype (immunology)</term><term>Influenza A Virus, H1N1 Subtype (isolation & purification)</term><term>Influenza Vaccines (administration & dosage)</term><term>Influenza Vaccines (immunology)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (pathology)</term><term>Influenza, Human (prevention & control)</term><term>Influenza, Human (virology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Nose (virology)</term><term>Pharynx (virology)</term><term>Polymerase Chain Reaction (MeSH)</term><term>Pregnancy (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Risk Factors (MeSH)</term><term>Serologic Tests (MeSH)</term><term>Vaccination (methods)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Berlin (épidémiologie)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (anatomopathologie)</term><term>Grippe humaine (prévention et contrôle)</term><term>Grippe humaine (virologie)</term><term>Grippe humaine (épidémiologie)</term><term>Grossesse (MeSH)</term><term>Hospitalisation (statistiques et données numériques)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Mâle (MeSH)</term><term>Nez (virologie)</term><term>Pharynx (virologie)</term><term>Réaction de polymérisation en chaîne (MeSH)</term><term>Sous-type H1N1 du virus de la grippe A (immunologie)</term><term>Sous-type H1N1 du virus de la grippe A (isolement et purification)</term><term>Sujet âgé (MeSH)</term><term>Tests sérologiques (MeSH)</term><term>Vaccination (méthodes)</term><term>Vaccins antigrippaux (administration et posologie)</term><term>Vaccins antigrippaux (immunologie)</term><term>Études cas-témoins (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Berlin</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Sous-type H1N1 du virus de la grippe A</term><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Sous-type H1N1 du virus de la grippe A</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Hospitalisation</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Grippe humaine</term><term>Nez</term><term>Pharynx</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Influenza, Human</term><term>Nose</term><term>Pharynx</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Berlin</term><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Case-Control Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Polymerase Chain Reaction</term><term>Pregnancy</term><term>Prospective Studies</term><term>Risk Factors</term><term>Serologic Tests</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs de risque</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Réaction de polymérisation en chaîne</term><term>Sujet âgé</term><term>Tests sérologiques</term><term>Études cas-témoins</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>We performed a case-control study to estimate vaccine effectiveness (VE) for prevention of hospitalization due to pandemic influenza A(H1N1)pdm09 (pH1N1) and to identify risk factors for pH1N1 and acute respiratory infection (ARI) in 10 hospitals in Berlin from December 2009 to April 2010.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Cases were patients aged 18-65 years with onset of ARI ≤10 days before admission testing positive for pH1N1 by PCR performed on nasal and throat swabs or by serological testing. Cases were compared to (1) matched hospital controls with acute surgical, traumatological or other diagnoses matched on age, sex and vaccination probability, and (2) ARI patients testing negative for pH1N1. Additionally, ARI cases were compared to matched hospital controls. A standardized interview and chart review elicited demographic and clinical data as well as potential risk factors for pH1N1/ARI. VE was estimated by 1-(Odds ratio) for pH1N1-vaccination ≥10 days before symptom onset using exact logistic regression analysis.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Of 177 ARI cases recruited, 27 tested pH1N1 positive. A monovalent AS03-adjuvanted pH1N1 vaccine was the only pandemic vaccine type identified among cases and controls (vaccination coverage in control group 1 and 2: 15% and 5.9%). The only breakthrough infections were observed in 2 of 3 vaccinated HIV positive pH1N1 patients. After exclusion of HIV positive participants, VE was 96% (95%CI: 26-100%) in the matched multivariate analysis and 46% (95%CI: -376-100%) in the test-negative analysis. Exposure to children in the household was independently associated with hospitalization for pH1N1 and ARI.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Though limited by low vaccination coverage and number of pH1N1 cases, our results suggest a protective effect of the AS03-adjuvanted pH1N1 vaccine for the prevention of pH1N1 hospitalization. The use of hospital but not test-negative controls showed a statistically protective effect of pH1N1-vaccination and permitted the integrated assessment of risk factors for pH1N1-infection. To increase statistical power and to permit stratified analyses (e.g. VE for specific risk groups), the authors suggest pooling of future studies assessing effectiveness of influenza vaccines for prevention of severe disease from different centres.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22650369</PMID><DateCompleted><Year>2013</Year><Month>01</Month><Day>18</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><PubDate><Year>2012</Year><Month>May</Month><Day>31</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Prospective hospital-based case-control study to assess the effectiveness of pandemic influenza A(H1N1)pdm09 vaccination and risk factors for hospitalization in 2009-2010 using matched hospital and test-negative controls.</ArticleTitle><Pagination><MedlinePgn>127</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2334-12-127</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">We performed a case-control study to estimate vaccine effectiveness (VE) for prevention of hospitalization due to pandemic influenza A(H1N1)pdm09 (pH1N1) and to identify risk factors for pH1N1 and acute respiratory infection (ARI) in 10 hospitals in Berlin from December 2009 to April 2010.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Cases were patients aged 18-65 years with onset of ARI ≤10 days before admission testing positive for pH1N1 by PCR performed on nasal and throat swabs or by serological testing. Cases were compared to (1) matched hospital controls with acute surgical, traumatological or other diagnoses matched on age, sex and vaccination probability, and (2) ARI patients testing negative for pH1N1. Additionally, ARI cases were compared to matched hospital controls. A standardized interview and chart review elicited demographic and clinical data as well as potential risk factors for pH1N1/ARI. VE was estimated by 1-(Odds ratio) for pH1N1-vaccination ≥10 days before symptom onset using exact logistic regression analysis.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Of 177 ARI cases recruited, 27 tested pH1N1 positive. A monovalent AS03-adjuvanted pH1N1 vaccine was the only pandemic vaccine type identified among cases and controls (vaccination coverage in control group 1 and 2: 15% and 5.9%). The only breakthrough infections were observed in 2 of 3 vaccinated HIV positive pH1N1 patients. After exclusion of HIV positive participants, VE was 96% (95%CI: 26-100%) in the matched multivariate analysis and 46% (95%CI: -376-100%) in the test-negative analysis. Exposure to children in the household was independently associated with hospitalization for pH1N1 and ARI.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Though limited by low vaccination coverage and number of pH1N1 cases, our results suggest a protective effect of the AS03-adjuvanted pH1N1 vaccine for the prevention of pH1N1 hospitalization. The use of hospital but not test-negative controls showed a statistically protective effect of pH1N1-vaccination and permitted the integrated assessment of risk factors for pH1N1-infection. To increase statistical power and to permit stratified analyses (e.g. VE for specific risk groups), the authors suggest pooling of future studies assessing effectiveness of influenza vaccines for prevention of severe disease from different centres.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hellenbrand</LastName><ForeName>Wiebke</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, 13086 Berlin, Germany. hellenbrandw@rki.de</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jorgensen</LastName><ForeName>Pernille</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Schweiger</LastName><ForeName>Brunhilde</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Falkenhorst</LastName><ForeName>Gerhard</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Nachtnebel</LastName><ForeName>Matthias</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Greutélaers</LastName><ForeName>Benedikt</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Traeder</LastName><ForeName>Christian</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Wichmann</LastName><ForeName>Ole</ForeName><Initials>O</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>05</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Infect Dis</MedlineTA><NlmUniqueID>100968551</NlmUniqueID><ISSNLinking>1471-2334</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001604" MajorTopicYN="N" Type="Geographic">Berlin</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName 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