Paradoxical clade- and age-specific vaccine effectiveness during the 2018/19 influenza A(H3N2) epidemic in Canada: potential imprint-regulated effect of vaccine (I-REV)
Identifieur interne : 000059 ( Main/Exploration ); précédent : 000058; suivant : 000060Paradoxical clade- and age-specific vaccine effectiveness during the 2018/19 influenza A(H3N2) epidemic in Canada: potential imprint-regulated effect of vaccine (I-REV)
Auteurs : Danuta M. Skowronski [Canada] ; Suzana Sabaiduc [Canada] ; Siobhan Leir [Canada] ; Caren Rose [Canada] ; Macy Zou [Canada] ; Michelle Murti [Canada] ; James A. Dickinson [Canada] ; Romy Olsha [Canada] ; Jonathan B. Gubbay [Canada] ; Matthew A. Croxen [Canada] ; Hugues Charest [Canada] ; Nathalie Bastien [Canada] ; Yan Li [Canada] ; Agatha Jassem [Canada] ; Mel Krajden [Canada] ; Gaston De Serres [Canada]Source :
- Eurosurveillance [ 1025-496X ] ; 2019.
Abstract
The Canadian Sentinel Practitioner Surveillance Network reports vaccine effectiveness (VE) for the 2018/19 influenza A(H3N2) epidemic.
To explain a paradoxical signal of increased clade 3C.3a risk among 35–54-year-old vaccinees, we hypothesise childhood immunological imprinting and a cohort effect following the 1968 influenza A(H3N2) pandemic.
We assessed VE by test-negative design for influenza A(H3N2) overall and for co-circulating clades 3C.2a1b and 3C.3a. VE variation by age in 2018/19 was compared with amino acid variation in the haemagglutinin glycoprotein by year since 1968.
Influenza A(H3N2) VE was 17% (95% CI: −13 to 39) overall: 27% (95% CI: −7 to 50) for 3C.2a1b and −32% (95% CI: −119 to 21) for 3C.3a. Among 20–64-year-olds, VE was −7% (95% CI: −56 to 26): 6% (95% CI: −49 to 41) for 3C.2a1b and −96% (95% CI: −277 to −2) for 3C.3a. Clade 3C.3a VE showed a pronounced negative dip among 35–54-year-olds in whom the odds of medically attended illness were > 4-fold increased for vaccinated vs unvaccinated participants (p < 0.005). This age group was primed in childhood to influenza A(H3N2) viruses that for two decades following the 1968 pandemic bore a serine at haemagglutinin position 159, in common with contemporary 3C.3a viruses but mismatched to 3C.2a vaccine strains instead bearing tyrosine.
Imprinting by the first childhood influenza infection is known to confer long-lasting immunity focused toward priming epitopes. Our findings suggest vaccine mismatch may negatively interact with imprinted immunity. The immunological mechanisms for imprint-regulated effect of vaccine (I-REV) warrant investigation.
Url:
DOI: 10.2807/1560-7917.ES.2019.24.46.1900585
PubMed: 31771709
PubMed Central: 6864978
Affiliations:
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Skowronski</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Sabaiduc, Suzana" sort="Sabaiduc, Suzana" uniqKey="Sabaiduc S" first="Suzana" last="Sabaiduc">Suzana Sabaiduc</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Leir, Siobhan" sort="Leir, Siobhan" uniqKey="Leir S" first="Siobhan" last="Leir">Siobhan Leir</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Rose, Caren" sort="Rose, Caren" uniqKey="Rose C" first="Caren" last="Rose">Caren Rose</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Zou, Macy" sort="Zou, Macy" uniqKey="Zou M" first="Macy" last="Zou">Macy Zou</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Murti, Michelle" sort="Murti, Michelle" uniqKey="Murti M" first="Michelle" last="Murti">Michelle Murti</name><affiliation wicri:level="1"><nlm:aff id="aff3">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff4">University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Dickinson, James A" sort="Dickinson, James A" uniqKey="Dickinson J" first="James A" last="Dickinson">James A. Dickinson</name><affiliation wicri:level="4"><nlm:aff id="aff5">University of Calgary, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Calgary, Calgary</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Olsha, Romy" sort="Olsha, Romy" uniqKey="Olsha R" first="Romy" last="Olsha">Romy Olsha</name><affiliation wicri:level="1"><nlm:aff id="aff3">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><affiliation wicri:level="1"><nlm:aff id="aff3">Public Health Ontario, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Public Health Ontario, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff4">University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Croxen, Matthew A" sort="Croxen, Matthew A" uniqKey="Croxen M" first="Matthew A" last="Croxen">Matthew A. Croxen</name><affiliation><nlm:aff id="aff6">Alberta Precision Laboratories, Edmonton, Alberta</nlm:aff><wicri:noCountry code="subfield">Alberta</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="aff7">University of Alberta, Edmonton, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Alberta, Edmonton</wicri:regionArea><wicri:noRegion>Edmonton</wicri:noRegion></affiliation></author><author><name sortKey="Charest, Hugues" sort="Charest, Hugues" uniqKey="Charest H" first="Hugues" last="Charest">Hugues Charest</name><affiliation wicri:level="1"><nlm:aff id="aff8">Institut National de Santé Publique du Québec, Québec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Québec</wicri:regionArea><wicri:noRegion>Québec</wicri:noRegion></affiliation></author><author><name sortKey="Bastien, Nathalie" sort="Bastien, Nathalie" uniqKey="Bastien N" first="Nathalie" last="Bastien">Nathalie Bastien</name><affiliation wicri:level="1"><nlm:aff id="aff9">National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg</wicri:regionArea><wicri:noRegion>Winnipeg</wicri:noRegion></affiliation></author><author><name sortKey="Li, Yan" sort="Li, Yan" uniqKey="Li Y" first="Yan" last="Li">Yan Li</name><affiliation wicri:level="1"><nlm:aff id="aff9">National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg</wicri:regionArea><wicri:noRegion>Winnipeg</wicri:noRegion></affiliation></author><author><name sortKey="Jassem, Agatha" sort="Jassem, Agatha" uniqKey="Jassem A" first="Agatha" last="Jassem">Agatha Jassem</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><affiliation wicri:level="1"><nlm:aff id="aff1">British Columbia Centre for Disease Control, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>British Columbia Centre for Disease Control, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">University of British Columbia, Vancouver, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver</wicri:regionArea><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><affiliation wicri:level="1"><nlm:aff id="aff8">Institut National de Santé Publique du Québec, Québec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Institut National de Santé Publique du Québec, Québec</wicri:regionArea><wicri:noRegion>Québec</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10">Laval University, Quebec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Laval University, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff11">Centre Hospitalier Universitaire de Québec, Québec, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre Hospitalier Universitaire de Québec, Québec</wicri:regionArea><wicri:noRegion>Québec</wicri:noRegion></affiliation></author></analytic><series><title level="j">Eurosurveillance</title><idno type="ISSN">1025-496X</idno><idno type="eISSN">1560-7917</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>The Canadian Sentinel Practitioner Surveillance Network reports vaccine effectiveness (VE) for the 2018/19 influenza A(H3N2) epidemic.</p></sec><sec><title>Aim</title><p>To explain a paradoxical signal of increased clade 3C.3a risk among 35–54-year-old vaccinees, we hypothesise childhood immunological imprinting and a cohort effect following the 1968 influenza A(H3N2) pandemic.</p></sec><sec><title>Methods</title><p>We assessed VE by test-negative design for influenza A(H3N2) overall and for co-circulating clades 3C.2a1b and 3C.3a. VE variation by age in 2018/19 was compared with amino acid variation in the haemagglutinin glycoprotein by year since 1968.</p></sec><sec><title>Results</title><p>Influenza A(H3N2) VE was 17% (95% CI: −13 to 39) overall: 27% (95% CI: −7 to 50) for 3C.2a1b and −32% (95% CI: −119 to 21) for 3C.3a. Among 20–64-year-olds, VE was −7% (95% CI: −56 to 26): 6% (95% CI: −49 to 41) for 3C.2a1b and −96% (95% CI: −277 to −2) for 3C.3a. Clade 3C.3a VE showed a pronounced negative dip among 35–54-year-olds in whom the odds of medically attended illness were > 4-fold increased for vaccinated vs unvaccinated participants (p < 0.005). This age group was primed in childhood to influenza A(H3N2) viruses that for two decades following the 1968 pandemic bore a serine at haemagglutinin position 159, in common with contemporary 3C.3a viruses but mismatched to 3C.2a vaccine strains instead bearing tyrosine.</p></sec><sec><title>Discussion</title><p>Imprinting by the first childhood influenza infection is known to confer long-lasting immunity focused toward priming epitopes. Our findings suggest vaccine mismatch may negatively interact with imprinted immunity. 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Skowronski</name></noRegion><name sortKey="Bastien, Nathalie" sort="Bastien, Nathalie" uniqKey="Bastien N" first="Nathalie" last="Bastien">Nathalie Bastien</name><name sortKey="Charest, Hugues" sort="Charest, Hugues" uniqKey="Charest H" first="Hugues" last="Charest">Hugues Charest</name><name sortKey="Croxen, Matthew A" sort="Croxen, Matthew A" uniqKey="Croxen M" first="Matthew A" last="Croxen">Matthew A. Croxen</name><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><name sortKey="Dickinson, James A" sort="Dickinson, James A" uniqKey="Dickinson J" first="James A" last="Dickinson">James A. Dickinson</name><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><name sortKey="Gubbay, Jonathan B" sort="Gubbay, Jonathan B" uniqKey="Gubbay J" first="Jonathan B" last="Gubbay">Jonathan B. Gubbay</name><name sortKey="Jassem, Agatha" sort="Jassem, Agatha" uniqKey="Jassem A" first="Agatha" last="Jassem">Agatha Jassem</name><name sortKey="Jassem, Agatha" sort="Jassem, Agatha" uniqKey="Jassem A" first="Agatha" last="Jassem">Agatha Jassem</name><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><name sortKey="Krajden, Mel" sort="Krajden, Mel" uniqKey="Krajden M" first="Mel" last="Krajden">Mel Krajden</name><name sortKey="Leir, Siobhan" sort="Leir, Siobhan" uniqKey="Leir S" first="Siobhan" last="Leir">Siobhan Leir</name><name sortKey="Li, Yan" sort="Li, Yan" uniqKey="Li Y" first="Yan" last="Li">Yan Li</name><name sortKey="Murti, Michelle" sort="Murti, Michelle" uniqKey="Murti M" first="Michelle" last="Murti">Michelle Murti</name><name sortKey="Murti, Michelle" sort="Murti, Michelle" uniqKey="Murti M" first="Michelle" last="Murti">Michelle Murti</name><name sortKey="Olsha, Romy" sort="Olsha, Romy" uniqKey="Olsha R" first="Romy" last="Olsha">Romy Olsha</name><name sortKey="Rose, Caren" sort="Rose, Caren" uniqKey="Rose C" first="Caren" last="Rose">Caren Rose</name><name sortKey="Rose, Caren" sort="Rose, Caren" uniqKey="Rose C" first="Caren" last="Rose">Caren Rose</name><name sortKey="Sabaiduc, Suzana" sort="Sabaiduc, Suzana" uniqKey="Sabaiduc S" first="Suzana" last="Sabaiduc">Suzana Sabaiduc</name><name sortKey="Skowronski, Danuta M" sort="Skowronski, Danuta M" uniqKey="Skowronski D" first="Danuta M" last="Skowronski">Danuta M. Skowronski</name><name sortKey="Zou, Macy" sort="Zou, Macy" uniqKey="Zou M" first="Macy" last="Zou">Macy Zou</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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