Influenza vaccine effectiveness against influenza-related hospitalization during a season with mixed outbreaks of four influenza viruses: a test-negative case-control study in adults in Canada.
Identifieur interne : 000071 ( Main/Corpus ); précédent : 000070; suivant : 000072Influenza vaccine effectiveness against influenza-related hospitalization during a season with mixed outbreaks of four influenza viruses: a test-negative case-control study in adults in Canada.
Auteurs : Melissa K. Andrew ; Vivek Shinde ; Todd Hatchette ; Ardith Ambrose ; Guy Boivin ; William Bowie ; Ayman Chit ; Gael Dos Santos ; May Elsherif ; Karen Green ; François Haguinet ; Scott A. Halperin ; Barbara Ibarguchi ; Jennie Johnstone ; Kevin Katz ; Joanne M. Langley ; Jason Leblanc ; Mark Loeb ; Donna Mackinnon-Cameron ; Anne Mccarthy ; Janet Mcelhaney ; Allison Mcgeer ; Michaela K. Nichols ; Jeff Powis ; David Richardson ; Makeda Semret ; Grant Stiver ; Sylvie Trottier ; Louis Valiquette ; Duncan Webster ; Lingyun Ye ; Shelly A. McneilSource :
- BMC infectious diseases [ 1471-2334 ] ; 2017.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Canada (epidemiology), Case-Control Studies (MeSH), Disease Outbreaks (MeSH), Female (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Influenza A Virus, H1N1 Subtype (immunology), Influenza A Virus, H1N1 Subtype (pathogenicity), Influenza A Virus, H3N2 Subtype (immunology), Influenza A Virus, H3N2 Subtype (pathogenicity), Influenza B virus (immunology), Influenza B virus (pathogenicity), Influenza Vaccines (immunology), Influenza Vaccines (therapeutic use), Influenza, Human (epidemiology), Influenza, Human (prevention & control), Influenza, Human (virology), Male (MeSH), Middle Aged (MeSH), Odds Ratio (MeSH), Prospective Studies (MeSH), Seasons (MeSH), Vaccination (MeSH), Young Adult (MeSH).
- MESH :
- chemical , immunology : Influenza Vaccines.
- epidemiology : Canada, Influenza, Human.
- immunology : Influenza A Virus, H1N1 Subtype, Influenza A Virus, H3N2 Subtype, Influenza B virus.
- pathogenicity : Influenza A Virus, H1N1 Subtype, Influenza A Virus, H3N2 Subtype, Influenza B virus.
- prevention & control : Influenza, Human.
- statistics & numerical data : Hospitalization.
- chemical , therapeutic use : Influenza Vaccines.
- virology : Influenza, Human.
- Adolescent, Adult, Aged, Case-Control Studies, Disease Outbreaks, Female, Humans, Male, Middle Aged, Odds Ratio, Prospective Studies, Seasons, Vaccination, Young Adult.
Abstract
BACKGROUND
The Serious Outcomes Surveillance (SOS) Network was established to monitor seasonal influenza complications among hospitalized Canadian adults and to assess the effectiveness of influenza vaccination against severe outcomes. Here we report age- and strain-specific vaccine effectiveness (VE) in preventing severe outcomes during a season characterized by mixed outbreaks of four different influenza strains.
METHODS
This prospective, multicentre, test-negative case-control study evaluated the VE of trivalent influenza vaccine (TIV) in the prevention of laboratory-confirmed influenza-hospitalization in adults aged ≥16 years (all adults) and adults aged 16-64 years (younger adults). The SOS Network identified hospitalized patients with diagnoses potentially attributable to influenza during the 2011/12 influenza season. Swabs collected at admission were tested by reverse transcriptase polymerase chain reaction (RT PCR) or viral culture to discriminate influenza cases (positive) from controls (negative). VE was calculated as 1-odds ratio (OR) of vaccination in cases versus controls × 100.
RESULTS
Overall, in all adults, the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 41.8% (95% Confidence Interval [CI]: 26.0, 54.3), and 42.8% (95% CI: 23.8, 57.0), respectively. In younger adults (16-64 years), the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 35.8% (95% CI: 4.5, 56.8) and 33.2% (95% CI: -6.7, 58.2), respectively. In the all adults group, adjusted VE against influenza A/H1N1 was 72.5% (95% CI: 30.5, 89.1), against A/H3N2 was 86.1% (95% CI: 40.1, 96.8), against B/Victoria was 40.5% (95% CI: -28.9, 72.6), and against B/Yamagata was 32.3% (95% CI: -8.3, 57.7). The adjusted estimate of early season VE (from November 1 to March 11) was 54.4% (95% CI: 29.7-70.4), which was higher than late season (from March 11 to May 25) VE estimate (VE: 29.7%, 95% CI: -5.3, 53.1).
CONCLUSIONS
These results suggest that TIV was highly effective against A viruses and moderately effective against B viruses during a mild season characterised by co-circulation of four influenza strains in Canada. Findings underscore the need to provide VE assessment by subtype/lineage as well as the timing of vaccination (early season vs late season) to accurately evaluate vaccine performance and thus guide public health decision-making.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT01517191. Registration was retrospective and the date of registration was January 17, 2012.
DOI: 10.1186/s12879-017-2905-8
PubMed: 29284435
PubMed Central: PMC5747268
Links to Exploration step
pubmed:29284435Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Influenza vaccine effectiveness against influenza-related hospitalization during a season with mixed outbreaks of four influenza viruses: a test-negative case-control study in adults in Canada.</title><author><name sortKey="Andrew, Melissa K" sort="Andrew, Melissa K" uniqKey="Andrew M" first="Melissa K" last="Andrew">Melissa K. Andrew</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Shinde, Vivek" sort="Shinde, Vivek" uniqKey="Shinde V" first="Vivek" last="Shinde">Vivek Shinde</name><affiliation><nlm:affiliation>GSK, King of Prussia, Current affiliation: Novavax Vaccines, Washington, DC, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Hatchette, Todd" sort="Hatchette, Todd" uniqKey="Hatchette T" first="Todd" last="Hatchette">Todd Hatchette</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ambrose, Ardith" sort="Ambrose, Ardith" uniqKey="Ambrose A" first="Ardith" last="Ambrose">Ardith Ambrose</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Boivin, Guy" sort="Boivin, Guy" uniqKey="Boivin G" first="Guy" last="Boivin">Guy Boivin</name><affiliation><nlm:affiliation>Centre Hospitalier Universitaire de Québec, 2705 Boulevard Laurier, RC-709, Québec, Québec, G1V 4G2, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Bowie, William" sort="Bowie, William" uniqKey="Bowie W" first="William" last="Bowie">William Bowie</name><affiliation><nlm:affiliation>University of British Columbia, 452D, Heather Pavilion East, VGH, 2733 Heather Street, Vancouver, British Columbia, V5Z 3J5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Chit, Ayman" sort="Chit, Ayman" uniqKey="Chit A" first="Ayman" last="Chit">Ayman Chit</name><affiliation><nlm:affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Current affiliation: Sanofi Pasteur, Swiftwater, Pennsylvania, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Dos Santos, Gael" sort="Dos Santos, Gael" uniqKey="Dos Santos G" first="Gael" last="Dos Santos">Gael Dos Santos</name><affiliation><nlm:affiliation>Business & Decision Life Sciences, Bruxelles, Belgium, on behalf of GSK (Wavre, Belgium), Current affiliation: GSK, Wavre, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Elsherif, May" sort="Elsherif, May" uniqKey="Elsherif M" first="May" last="Elsherif">May Elsherif</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><affiliation><nlm:affiliation>Mount Sinai Hospital, 600 University Ave, Room 210, Toronto, Ontario, M5G 1X5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Haguinet, Francois" sort="Haguinet, Francois" uniqKey="Haguinet F" first="François" last="Haguinet">François Haguinet</name><affiliation><nlm:affiliation>GSK, Wavre, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Halperin, Scott A" sort="Halperin, Scott A" uniqKey="Halperin S" first="Scott A" last="Halperin">Scott A. Halperin</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ibarguchi, Barbara" sort="Ibarguchi, Barbara" uniqKey="Ibarguchi B" first="Barbara" last="Ibarguchi">Barbara Ibarguchi</name><affiliation><nlm:affiliation>GSK, Mississauga, Ontario, Canada, Current affiliation: Bayer Inc, Mississauga, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Johnstone, Jennie" sort="Johnstone, Jennie" uniqKey="Johnstone J" first="Jennie" last="Johnstone">Jennie Johnstone</name><affiliation><nlm:affiliation>McMaster University, Michael G. DeGroote Centre for Learning, 1200 Main Street West, Room 3208, Hamilton, Ontario, L8S 4K1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Katz, Kevin" sort="Katz, Kevin" uniqKey="Katz K" first="Kevin" last="Katz">Kevin Katz</name><affiliation><nlm:affiliation>North York General Hospital, 4001 Leslie St, Toronto, Ontario, M2K 1E1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Langley, Joanne M" sort="Langley, Joanne M" uniqKey="Langley J" first="Joanne M" last="Langley">Joanne M. Langley</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Leblanc, Jason" sort="Leblanc, Jason" uniqKey="Leblanc J" first="Jason" last="Leblanc">Jason Leblanc</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Loeb, Mark" sort="Loeb, Mark" uniqKey="Loeb M" first="Mark" last="Loeb">Mark Loeb</name><affiliation><nlm:affiliation>McMaster University, Michael G. DeGroote Centre for Learning, 1200 Main Street West, Room 3208, Hamilton, Ontario, L8S 4K1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mackinnon Cameron, Donna" sort="Mackinnon Cameron, Donna" uniqKey="Mackinnon Cameron D" first="Donna" last="Mackinnon-Cameron">Donna Mackinnon-Cameron</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mccarthy, Anne" sort="Mccarthy, Anne" uniqKey="Mccarthy A" first="Anne" last="Mccarthy">Anne Mccarthy</name><affiliation><nlm:affiliation>The Ottawa Hospital, Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, Ontario, K1Y 4E9, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcelhaney, Janet" sort="Mcelhaney, Janet" uniqKey="Mcelhaney J" first="Janet" last="Mcelhaney">Janet Mcelhaney</name><affiliation><nlm:affiliation>Health Sciences North Research Institute, 41 Ramsey Lake Rd, Sudbury, Ontario, P3E 5J1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><affiliation><nlm:affiliation>Mount Sinai Hospital, 600 University Ave, Room 210, Toronto, Ontario, M5G 1X5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Nichols, Michaela K" sort="Nichols, Michaela K" uniqKey="Nichols M" first="Michaela K" last="Nichols">Michaela K. Nichols</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><affiliation><nlm:affiliation>Michael Garron Hospital, 825 Coxwell Ave, Toronto, Ontario, M4C 3E7, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Richardson, David" sort="Richardson, David" uniqKey="Richardson D" first="David" last="Richardson">David Richardson</name><affiliation><nlm:affiliation>William Osler Health System, Department of Infectious Diseases and Medical Microbiology, 2100 Bovaird Dr East, Brampton, Ontario, L6R 3J7, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Semret, Makeda" sort="Semret, Makeda" uniqKey="Semret M" first="Makeda" last="Semret">Makeda Semret</name><affiliation><nlm:affiliation>McGill University, McGill University Health Centre, Glen Site, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Stiver, Grant" sort="Stiver, Grant" uniqKey="Stiver G" first="Grant" last="Stiver">Grant Stiver</name><affiliation><nlm:affiliation>University of British Columbia, 452D, Heather Pavilion East, VGH, 2733 Heather Street, Vancouver, British Columbia, V5Z 3J5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Trottier, Sylvie" sort="Trottier, Sylvie" uniqKey="Trottier S" first="Sylvie" last="Trottier">Sylvie Trottier</name><affiliation><nlm:affiliation>Centre Hospitalier Universitaire de Québec, 2705 Boulevard Laurier, RC-709, Québec, Québec, G1V 4G2, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Valiquette, Louis" sort="Valiquette, Louis" uniqKey="Valiquette L" first="Louis" last="Valiquette">Louis Valiquette</name><affiliation><nlm:affiliation>Université de Sherbrooke, 3001 12th Ave North, Sherbrooke, Quebec, J1H 5N4, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Webster, Duncan" sort="Webster, Duncan" uniqKey="Webster D" first="Duncan" last="Webster">Duncan Webster</name><affiliation><nlm:affiliation>Saint John Regional Hospital, Dalhousie University, 400 University Ave, Saint John, New Brunswick, E2L 4L2, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ye, Lingyun" sort="Ye, Lingyun" uniqKey="Ye L" first="Lingyun" last="Ye">Lingyun Ye</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcneil, Shelly A" sort="Mcneil, Shelly A" uniqKey="Mcneil S" first="Shelly A" last="Mcneil">Shelly A. Mcneil</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada. Shelly.McNeil@nshealth.ca.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:29284435</idno><idno type="pmid">29284435</idno><idno type="doi">10.1186/s12879-017-2905-8</idno><idno type="pmc">PMC5747268</idno><idno type="wicri:Area/Main/Corpus">000071</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000071</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Influenza vaccine effectiveness against influenza-related hospitalization during a season with mixed outbreaks of four influenza viruses: a test-negative case-control study in adults in Canada.</title><author><name sortKey="Andrew, Melissa K" sort="Andrew, Melissa K" uniqKey="Andrew M" first="Melissa K" last="Andrew">Melissa K. Andrew</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Shinde, Vivek" sort="Shinde, Vivek" uniqKey="Shinde V" first="Vivek" last="Shinde">Vivek Shinde</name><affiliation><nlm:affiliation>GSK, King of Prussia, Current affiliation: Novavax Vaccines, Washington, DC, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Hatchette, Todd" sort="Hatchette, Todd" uniqKey="Hatchette T" first="Todd" last="Hatchette">Todd Hatchette</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ambrose, Ardith" sort="Ambrose, Ardith" uniqKey="Ambrose A" first="Ardith" last="Ambrose">Ardith Ambrose</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Boivin, Guy" sort="Boivin, Guy" uniqKey="Boivin G" first="Guy" last="Boivin">Guy Boivin</name><affiliation><nlm:affiliation>Centre Hospitalier Universitaire de Québec, 2705 Boulevard Laurier, RC-709, Québec, Québec, G1V 4G2, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Bowie, William" sort="Bowie, William" uniqKey="Bowie W" first="William" last="Bowie">William Bowie</name><affiliation><nlm:affiliation>University of British Columbia, 452D, Heather Pavilion East, VGH, 2733 Heather Street, Vancouver, British Columbia, V5Z 3J5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Chit, Ayman" sort="Chit, Ayman" uniqKey="Chit A" first="Ayman" last="Chit">Ayman Chit</name><affiliation><nlm:affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Current affiliation: Sanofi Pasteur, Swiftwater, Pennsylvania, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Dos Santos, Gael" sort="Dos Santos, Gael" uniqKey="Dos Santos G" first="Gael" last="Dos Santos">Gael Dos Santos</name><affiliation><nlm:affiliation>Business & Decision Life Sciences, Bruxelles, Belgium, on behalf of GSK (Wavre, Belgium), Current affiliation: GSK, Wavre, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Elsherif, May" sort="Elsherif, May" uniqKey="Elsherif M" first="May" last="Elsherif">May Elsherif</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><affiliation><nlm:affiliation>Mount Sinai Hospital, 600 University Ave, Room 210, Toronto, Ontario, M5G 1X5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Haguinet, Francois" sort="Haguinet, Francois" uniqKey="Haguinet F" first="François" last="Haguinet">François Haguinet</name><affiliation><nlm:affiliation>GSK, Wavre, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Halperin, Scott A" sort="Halperin, Scott A" uniqKey="Halperin S" first="Scott A" last="Halperin">Scott A. Halperin</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ibarguchi, Barbara" sort="Ibarguchi, Barbara" uniqKey="Ibarguchi B" first="Barbara" last="Ibarguchi">Barbara Ibarguchi</name><affiliation><nlm:affiliation>GSK, Mississauga, Ontario, Canada, Current affiliation: Bayer Inc, Mississauga, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Johnstone, Jennie" sort="Johnstone, Jennie" uniqKey="Johnstone J" first="Jennie" last="Johnstone">Jennie Johnstone</name><affiliation><nlm:affiliation>McMaster University, Michael G. DeGroote Centre for Learning, 1200 Main Street West, Room 3208, Hamilton, Ontario, L8S 4K1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Katz, Kevin" sort="Katz, Kevin" uniqKey="Katz K" first="Kevin" last="Katz">Kevin Katz</name><affiliation><nlm:affiliation>North York General Hospital, 4001 Leslie St, Toronto, Ontario, M2K 1E1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Langley, Joanne M" sort="Langley, Joanne M" uniqKey="Langley J" first="Joanne M" last="Langley">Joanne M. Langley</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Leblanc, Jason" sort="Leblanc, Jason" uniqKey="Leblanc J" first="Jason" last="Leblanc">Jason Leblanc</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Loeb, Mark" sort="Loeb, Mark" uniqKey="Loeb M" first="Mark" last="Loeb">Mark Loeb</name><affiliation><nlm:affiliation>McMaster University, Michael G. DeGroote Centre for Learning, 1200 Main Street West, Room 3208, Hamilton, Ontario, L8S 4K1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mackinnon Cameron, Donna" sort="Mackinnon Cameron, Donna" uniqKey="Mackinnon Cameron D" first="Donna" last="Mackinnon-Cameron">Donna Mackinnon-Cameron</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mccarthy, Anne" sort="Mccarthy, Anne" uniqKey="Mccarthy A" first="Anne" last="Mccarthy">Anne Mccarthy</name><affiliation><nlm:affiliation>The Ottawa Hospital, Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, Ontario, K1Y 4E9, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcelhaney, Janet" sort="Mcelhaney, Janet" uniqKey="Mcelhaney J" first="Janet" last="Mcelhaney">Janet Mcelhaney</name><affiliation><nlm:affiliation>Health Sciences North Research Institute, 41 Ramsey Lake Rd, Sudbury, Ontario, P3E 5J1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><affiliation><nlm:affiliation>Mount Sinai Hospital, 600 University Ave, Room 210, Toronto, Ontario, M5G 1X5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Nichols, Michaela K" sort="Nichols, Michaela K" uniqKey="Nichols M" first="Michaela K" last="Nichols">Michaela K. Nichols</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><affiliation><nlm:affiliation>Michael Garron Hospital, 825 Coxwell Ave, Toronto, Ontario, M4C 3E7, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Richardson, David" sort="Richardson, David" uniqKey="Richardson D" first="David" last="Richardson">David Richardson</name><affiliation><nlm:affiliation>William Osler Health System, Department of Infectious Diseases and Medical Microbiology, 2100 Bovaird Dr East, Brampton, Ontario, L6R 3J7, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Semret, Makeda" sort="Semret, Makeda" uniqKey="Semret M" first="Makeda" last="Semret">Makeda Semret</name><affiliation><nlm:affiliation>McGill University, McGill University Health Centre, Glen Site, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Stiver, Grant" sort="Stiver, Grant" uniqKey="Stiver G" first="Grant" last="Stiver">Grant Stiver</name><affiliation><nlm:affiliation>University of British Columbia, 452D, Heather Pavilion East, VGH, 2733 Heather Street, Vancouver, British Columbia, V5Z 3J5, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Trottier, Sylvie" sort="Trottier, Sylvie" uniqKey="Trottier S" first="Sylvie" last="Trottier">Sylvie Trottier</name><affiliation><nlm:affiliation>Centre Hospitalier Universitaire de Québec, 2705 Boulevard Laurier, RC-709, Québec, Québec, G1V 4G2, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Valiquette, Louis" sort="Valiquette, Louis" uniqKey="Valiquette L" first="Louis" last="Valiquette">Louis Valiquette</name><affiliation><nlm:affiliation>Université de Sherbrooke, 3001 12th Ave North, Sherbrooke, Quebec, J1H 5N4, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Webster, Duncan" sort="Webster, Duncan" uniqKey="Webster D" first="Duncan" last="Webster">Duncan Webster</name><affiliation><nlm:affiliation>Saint John Regional Hospital, Dalhousie University, 400 University Ave, Saint John, New Brunswick, E2L 4L2, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ye, Lingyun" sort="Ye, Lingyun" uniqKey="Ye L" first="Lingyun" last="Ye">Lingyun Ye</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mcneil, Shelly A" sort="Mcneil, Shelly A" uniqKey="Mcneil S" first="Shelly A" last="Mcneil">Shelly A. Mcneil</name><affiliation><nlm:affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada. Shelly.McNeil@nshealth.ca.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMC infectious diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2017" type="published">2017</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>Canada (epidemiology)</term><term>Case-Control Studies (MeSH)</term><term>Disease Outbreaks (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 (pathogenicity)</term><term>Influenza A Virus, H3N2 Subtype (immunology)</term><term>Influenza A Virus, H3N2 Subtype (pathogenicity)</term><term>Influenza B virus (immunology)</term><term>Influenza B virus (pathogenicity)</term><term>Influenza Vaccines (immunology)</term><term>Influenza Vaccines (therapeutic use)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (prevention & control)</term><term>Influenza, Human (virology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Odds Ratio (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Seasons (MeSH)</term><term>Vaccination (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Canada</term><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza A Virus, H3N2 Subtype</term><term>Influenza B virus</term></keywords><keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza A Virus, H3N2 Subtype</term><term>Influenza B virus</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Case-Control Studies</term><term>Disease Outbreaks</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Odds Ratio</term><term>Prospective Studies</term><term>Seasons</term><term>Vaccination</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The Serious Outcomes Surveillance (SOS) Network was established to monitor seasonal influenza complications among hospitalized Canadian adults and to assess the effectiveness of influenza vaccination against severe outcomes. Here we report age- and strain-specific vaccine effectiveness (VE) in preventing severe outcomes during a season characterized by mixed outbreaks of four different influenza strains.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This prospective, multicentre, test-negative case-control study evaluated the VE of trivalent influenza vaccine (TIV) in the prevention of laboratory-confirmed influenza-hospitalization in adults aged ≥16 years (all adults) and adults aged 16-64 years (younger adults). The SOS Network identified hospitalized patients with diagnoses potentially attributable to influenza during the 2011/12 influenza season. Swabs collected at admission were tested by reverse transcriptase polymerase chain reaction (RT PCR) or viral culture to discriminate influenza cases (positive) from controls (negative). VE was calculated as 1-odds ratio (OR) of vaccination in cases versus controls × 100.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Overall, in all adults, the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 41.8% (95% Confidence Interval [CI]: 26.0, 54.3), and 42.8% (95% CI: 23.8, 57.0), respectively. In younger adults (16-64 years), the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 35.8% (95% CI: 4.5, 56.8) and 33.2% (95% CI: -6.7, 58.2), respectively. In the all adults group, adjusted VE against influenza A/H1N1 was 72.5% (95% CI: 30.5, 89.1), against A/H3N2 was 86.1% (95% CI: 40.1, 96.8), against B/Victoria was 40.5% (95% CI: -28.9, 72.6), and against B/Yamagata was 32.3% (95% CI: -8.3, 57.7). The adjusted estimate of early season VE (from November 1 to March 11) was 54.4% (95% CI: 29.7-70.4), which was higher than late season (from March 11 to May 25) VE estimate (VE: 29.7%, 95% CI: -5.3, 53.1).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>These results suggest that TIV was highly effective against A viruses and moderately effective against B viruses during a mild season characterised by co-circulation of four influenza strains in Canada. Findings underscore the need to provide VE assessment by subtype/lineage as well as the timing of vaccination (early season vs late season) to accurately evaluate vaccine performance and thus guide public health decision-making.</p></div><div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION</b></p><p>ClinicalTrials.gov Identifier: NCT01517191. Registration was retrospective and the date of registration was January 17, 2012.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">29284435</PMID><DateCompleted><Year>2018</Year><Month>05</Month><Day>21</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>02</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>17</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>12</Month><Day>29</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Influenza vaccine effectiveness against influenza-related hospitalization during a season with mixed outbreaks of four influenza viruses: a test-negative case-control study in adults in Canada.</ArticleTitle><Pagination><MedlinePgn>805</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12879-017-2905-8</ELocationID><Abstract><AbstractText Label="BACKGROUND">The Serious Outcomes Surveillance (SOS) Network was established to monitor seasonal influenza complications among hospitalized Canadian adults and to assess the effectiveness of influenza vaccination against severe outcomes. Here we report age- and strain-specific vaccine effectiveness (VE) in preventing severe outcomes during a season characterized by mixed outbreaks of four different influenza strains.</AbstractText><AbstractText Label="METHODS">This prospective, multicentre, test-negative case-control study evaluated the VE of trivalent influenza vaccine (TIV) in the prevention of laboratory-confirmed influenza-hospitalization in adults aged ≥16 years (all adults) and adults aged 16-64 years (younger adults). The SOS Network identified hospitalized patients with diagnoses potentially attributable to influenza during the 2011/12 influenza season. Swabs collected at admission were tested by reverse transcriptase polymerase chain reaction (RT PCR) or viral culture to discriminate influenza cases (positive) from controls (negative). VE was calculated as 1-odds ratio (OR) of vaccination in cases versus controls × 100.</AbstractText><AbstractText Label="RESULTS">Overall, in all adults, the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 41.8% (95% Confidence Interval [CI]: 26.0, 54.3), and 42.8% (95% CI: 23.8, 57.0), respectively. In younger adults (16-64 years), the unadjusted and adjusted VEs of TIV against influenza-hospitalization were 35.8% (95% CI: 4.5, 56.8) and 33.2% (95% CI: -6.7, 58.2), respectively. In the all adults group, adjusted VE against influenza A/H1N1 was 72.5% (95% CI: 30.5, 89.1), against A/H3N2 was 86.1% (95% CI: 40.1, 96.8), against B/Victoria was 40.5% (95% CI: -28.9, 72.6), and against B/Yamagata was 32.3% (95% CI: -8.3, 57.7). The adjusted estimate of early season VE (from November 1 to March 11) was 54.4% (95% CI: 29.7-70.4), which was higher than late season (from March 11 to May 25) VE estimate (VE: 29.7%, 95% CI: -5.3, 53.1).</AbstractText><AbstractText Label="CONCLUSIONS">These results suggest that TIV was highly effective against A viruses and moderately effective against B viruses during a mild season characterised by co-circulation of four influenza strains in Canada. Findings underscore the need to provide VE assessment by subtype/lineage as well as the timing of vaccination (early season vs late season) to accurately evaluate vaccine performance and thus guide public health decision-making.</AbstractText><AbstractText Label="TRIAL REGISTRATION">ClinicalTrials.gov Identifier: NCT01517191. Registration was retrospective and the date of registration was January 17, 2012.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Andrew</LastName><ForeName>Melissa K</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shinde</LastName><ForeName>Vivek</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>GSK, King of Prussia, Current affiliation: Novavax Vaccines, Washington, DC, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hatchette</LastName><ForeName>Todd</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ambrose</LastName><ForeName>Ardith</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boivin</LastName><ForeName>Guy</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Centre Hospitalier Universitaire de Québec, 2705 Boulevard Laurier, RC-709, Québec, Québec, G1V 4G2, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bowie</LastName><ForeName>William</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>University of British Columbia, 452D, Heather Pavilion East, VGH, 2733 Heather Street, Vancouver, British Columbia, V5Z 3J5, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chit</LastName><ForeName>Ayman</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Current affiliation: Sanofi Pasteur, Swiftwater, Pennsylvania, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dos Santos</LastName><ForeName>Gael</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Business & Decision Life Sciences, Bruxelles, Belgium, on behalf of GSK (Wavre, Belgium), Current affiliation: GSK, Wavre, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>ElSherif</LastName><ForeName>May</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Green</LastName><ForeName>Karen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Mount Sinai Hospital, 600 University Ave, Room 210, Toronto, Ontario, M5G 1X5, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Haguinet</LastName><ForeName>François</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>GSK, Wavre, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Halperin</LastName><ForeName>Scott A</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ibarguchi</LastName><ForeName>Barbara</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>GSK, Mississauga, Ontario, Canada, Current affiliation: Bayer Inc, Mississauga, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Johnstone</LastName><ForeName>Jennie</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>McMaster University, Michael G. DeGroote Centre for Learning, 1200 Main Street West, Room 3208, Hamilton, Ontario, L8S 4K1, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Katz</LastName><ForeName>Kevin</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>North York General Hospital, 4001 Leslie St, Toronto, Ontario, M2K 1E1, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Langley</LastName><ForeName>Joanne M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>LeBlanc</LastName><ForeName>Jason</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loeb</LastName><ForeName>Mark</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>McMaster University, Michael G. DeGroote Centre for Learning, 1200 Main Street West, Room 3208, Hamilton, Ontario, L8S 4K1, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>MacKinnon-Cameron</LastName><ForeName>Donna</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McCarthy</LastName><ForeName>Anne</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>The Ottawa Hospital, Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, Ontario, K1Y 4E9, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McElhaney</LastName><ForeName>Janet</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Health Sciences North Research Institute, 41 Ramsey Lake Rd, Sudbury, Ontario, P3E 5J1, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McGeer</LastName><ForeName>Allison</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Mount Sinai Hospital, 600 University Ave, Room 210, Toronto, Ontario, M5G 1X5, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nichols</LastName><ForeName>Michaela K</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Powis</LastName><ForeName>Jeff</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Michael Garron Hospital, 825 Coxwell Ave, Toronto, Ontario, M4C 3E7, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Richardson</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>William Osler Health System, Department of Infectious Diseases and Medical Microbiology, 2100 Bovaird Dr East, Brampton, Ontario, L6R 3J7, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Semret</LastName><ForeName>Makeda</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>McGill University, McGill University Health Centre, Glen Site, 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stiver</LastName><ForeName>Grant</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>University of British Columbia, 452D, Heather Pavilion East, VGH, 2733 Heather Street, Vancouver, British Columbia, V5Z 3J5, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trottier</LastName><ForeName>Sylvie</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Centre Hospitalier Universitaire de Québec, 2705 Boulevard Laurier, RC-709, Québec, Québec, G1V 4G2, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Valiquette</LastName><ForeName>Louis</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Université de Sherbrooke, 3001 12th Ave North, Sherbrooke, Quebec, J1H 5N4, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Webster</LastName><ForeName>Duncan</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Saint John Regional Hospital, Dalhousie University, 400 University Ave, Saint John, New Brunswick, E2L 4L2, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ye</LastName><ForeName>Lingyun</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McNeil</LastName><ForeName>Shelly A</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, 5850/5980 University Ave, Halifax, Nova Scotia, B3K 6R8, Canada. Shelly.McNeil@nshealth.ca.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) Serious Outcomes Surveillance Network and the Toronto Invasive Bacterial Diseases Network (TIBDN)</CollectiveName></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT01517191</AccessionNumber><AccessionNumber>NCT01517191</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>12</Month><Day>29</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="D002170" MajorTopicYN="N">Canada</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004196" MajorTopicYN="N">Disease Outbreaks</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">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="N">immunology</QualifierName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D053122" MajorTopicYN="N">Influenza A Virus, H3N2 Subtype</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009981" MajorTopicYN="N">Influenza B virus</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="Y">Influenza Vaccines</DescriptorName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012621" MajorTopicYN="N">Seasons</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Adults</Keyword><Keyword MajorTopicYN="Y">Effectiveness</Keyword><Keyword MajorTopicYN="Y">Hospitalization</Keyword><Keyword MajorTopicYN="Y">Influenza</Keyword><Keyword 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