Can the rolling cross-sectional survey design be used to estimate the effectiveness of influenza vaccines?

Abstract:

INTRODUCTION:Observational studies of influenza vaccine effectiveness often study persons seeking medical care for acute respiratory infection (ARI). We conducted a pilot study to determine if vaccine effectiveness could be estimated in the general population with a novel rolling cross-sectional survey sampling design and laboratory confirmation of influenza. METHODS:Cross-sectional samples were selected weekly from defined populations in Marshfield, Wisconsin and Monroe County, New York from January through April, 2011 (12 weeks). Persons were telephoned and asked about the occurrence of ARI in the past week. Nasal and throat swabs were obtained from consenting individuals with ARI and tested by real-time reverse transcription polymerase chain reaction (RT-PCR). Vaccine effectiveness (VE) was defined as (100×[1-OR]) for vaccination in a logistic regression model that adjusted for age, calendar week, and site. The comparison group included all study participants without RT-PCR confirmed influenza, including those who were not ill. RESULTS:Study personnel contacted 9537 (62%) of 15,303 persons sampled; the primary analysis included 5678 subjects. Of these, 193 (3%) reported an ARI and agreed to be tested for influenza; 13 (7%) were influenza positive. The adjusted effectiveness of the influenza vaccine was 1% (95% confidence limits -239-70%). CONCLUSIONS:The rolling cross-sectional design is methodologically feasible and may be useful as a complement to clinic-based VE studies. This pilot study did not have sufficient power to detect significant vaccine effectiveness during a mild influenza season, but this approach may facilitate rapid estimation of VE in a pandemic setting when normal patterns of health care utilization are disrupted.

journal_name

Vaccine

journal_title

Vaccine

authors

Donahue JG,Kieke BA,Szilagy PG,Blumkin AK,Hilgemann D,Flanders WD,Shay DK,Meece J,Gallivan S,Treanor J,Belongia EA

doi

10.1016/j.vaccine.2014.09.051

subject

Has Abstract

pub_date

2014-11-12 00:00:00

pages

6440-4

issue

48

eissn

0264-410X

issn

1873-2518

pii

S0264-410X(14)01319-X

journal_volume

32

pub_type

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