Alternative Title前シーズンのインフルエンザ感染者と非感染者において前シーズンのインフルエンザワクチン接種が現シーズンのイ ンフルエンザワクチン効果へ及ぼすネガティブな影響について:日本での検査陰性症例対照研究
Degree grantor/typeNagasaki University (長崎大学)
Note (General)Background: Accumulating evidences indicate that repeated influenza vaccination has negative impact on the vaccine effectiveness (VE). However no published studies considered past influenza infection when assessing the VE of repeated vaccination. Methods: Prospective surveillance was conducted from 2009 to 2012 at a community hospital on a small island in Japan. The study included all outpatients with an influenza-like illness (ILI) who attended the hospital, and a rapid diagnostic test (RDT) was used to diagnose influenza A/B infection. The VE of trivalent inactivated influenza vaccine (TIV) against medically attended influenza A (MA-fluA) was estimatedusing a test-negative case-control study design. The influence of TIV in the prior season on VE in the current season was investigated in the context of MA-fluA during the prior season. Results: During the three influenza seasons, 5838 ILI episodes (4127 subjects) were analysed. Subjects who had an episode of MA-fluA in the prior season were at a significantly lower risk of MA-fluA in thecurrent season (adjusted odds ratio: 0.38, 95% CI: 0.30?0.50). The overall adjusted VE was 28% (95% CI, 14?40). VE was substantially lower in subjects vaccinated in the prior season compared to those who had not been vaccinated in prior season (19%; 95% CI: 0?35 vs 46%; 95% CI: 26?60, test for interaction,P value <0.05). In subjects who did not have MA-fluA in the prior season showed the attenuation of VE due to repeated vaccination (13%; 95% CI: -7 to 30 vs 44%; 95% CI: 24?59, test for interaction, P < 0.05). However this effect was not detected in subjects who had contracted MA-fluA in the prior season. Conclusions: Negative effects of repeated vaccination were significant among those without history of MA-fluA in the prior season.
長崎大学学位論文 学位記番号:博(医歯薬)甲第980号 学位授与年月日:平成29年6月7日
Author: Nobuo Saito, Kazuhiro Komori, Motoi Suzuki, Kounosuke Morimoto, Takayuki Kishikawa, Takahiro Yasaka, Koya Ariyoshi
Citation: Vaccine, 35(4), pp.687-693; 2017
Nagasaki University (長崎大学), 博士(医学) (2017-06-07)
DOIinfo:doi/10.1016/j.vaccine.2016.11.024
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2017-07-03T04:10:06+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション