3 years ago

Estimation of seasonal influenza vaccine effectiveness using data collected in primary care in France: comparison of the test-negative design and the screening method

In this study we discuss which method between the test-negative design and the screening method could provide more robust real-time and end-of-season vaccine effectiveness estimates, using data collected from routine influenza surveillance in primary care. Methods We used data collected during two influenza seasons (2014/15 and 2015/16). Screening method we estimated end-of-season vaccine effectiveness in preventing medically attended influenza-like illness and laboratory-confirmed influenza among the population at risk. Test-negative design: we estimated end-of-season vaccine effectiveness in preventing influenza among both the general and the at risk population. We estimated real-time vaccine effectiveness using both methods. Results Screening method: the overall adjusted end-of-season vaccine effectiveness was 24% (95% Confidence Interval (CI): 16 to 32) and 12% (95%CI: -16 to 33) during season 2014/15, and 53% (95%CI: 44 to 60) and 47% (95%CI: 23 to 64) during season 2015/16, in preventing ILI and laboratory-confirmed influenza respectively. Test-negative design: the overall adjusted end-of-season vaccine effectiveness was -17% (95%CI: -79 to 24) and -38% (95%CI: -199 to 13) in 2014/15, and 10% (95%CI: -31 to 39) and 18% (95%CI: -33 to 50) in 2015/16, among the general and at risk population respectively. Real-time vaccine effectiveness estimates obtained through the test-negative design showed more variability across each season and lower precision than those estimated with the screening method. Conclusions Although the worldwide use of the test-negative design allows for comparison of overall vaccine effectiveness estimates between countries, the screening method performs better in providing robust real-time vaccine effectiveness estimates among the population at risk.

Publisher URL: www.sciencedirect.com/science

DOI: S1198743X17305013

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