Assessment of VE with regards to disease severity showed there to be a higher association with protection against more severe outcomes (e.g., for those hospitalized). Our results should be interpreted in the context of relatively small sample size and low incidence of A(H1N1)pdm09 infection, especially among the older children in our study. The study was reviewed and approved by the University of Michigan Medical School Institutional Review Board. Gaglani CDC has already released updated recommendations for vaccine distribution, urging health care workers to concentrate on providing a single vaccine dose to at-risk groups and not to hold back vaccine supplies in order to provide a second dose to each individual. Respiratory specimens were tested by real-time reverse-transcription polymerase chain reaction (RT-PCR) for identification of influenza virus, using primers and probes developed and provided by the Influenza Division at the Centers for Disease Control and Prevention. Dark Bars = Hospitalized Cases. Affiliation Full or Associate Professor, Head of the Division of Geriatrics, New Faculty Positions - Molecular Epidemiology, Endowed Chair and Head, Division of Infectious Diseases & Co-Director, Center for Infectious Diseases, Copyright © 2020 Infectious Diseases Society of America. There is animal, laboratory-based [44] and human epidemiologic-based evidence [45] which strongly suggests smoking as an important factor in predisposing to influenza infection and/or pneumonia. Controls were more likely to have a history of an underlying medical condition compared to cases (46% versus 24%, respectively). We speculate that vaccine responses could be improved by including a contemporary A(H1N1)pdm09 strain in future formulations. Characteristics of urinary tract infections in older patients in a tertiary hospital in Greece. Data interpretation caveatsThe authors included several caveats about the findings. They also pointed out that the low incidence of medical visits for H1N1 infections and low vaccine uptake could limit the statistical power of the analyses. Data collection begins at the time of entry into service and continues through the military career. https://doi.org/10.1371/journal.pone.0010722.t001. Published by Elsevier Ltd. All rights reserved. "That's why we did these studies originally, to help inform the public health response." In contrast, Europe and Eastern Asia had an outbreak of H3N2 during the season that H1N1 skipped. . The analysis using multivariate imputation, based on 2,902 cases, found an overall pandemic vaccine effectiveness of 71.9% (95% confidence interval [CI], 45.6% to 85.5%). Discover a faster, simpler path to publishing in a high-quality journal. a All had HAI titers of <40 against both VS and VS-K166Q viruses. Diarrhea in the pediatric solid organ transplantation recipient: A multidisciplinary approach to diagnosis and management. Management guideline for Werner syndrome 2020. Or view hourly updated newsfeeds in your RSS reader: Keep up to date with the latest news from ScienceDaily via social networks: Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Dr. The "skip and resurgence" pattern was observed throughout Europe and Eastern Asia, including United Kingdom and China. Family connection [24] . Similar findings have also been observed in US military populations where the influenza vaccine increased the effectiveness of preventing pneumonia and influenza morbidity among vaccine-naïve service members compared to service members routinely immunized [7]. Influenza vaccination was documented in electronic medical records and the Michigan Care Improvement Registry. Like the US CDC's recently published US serologic data [22]–[24] our findings also strongly suggest an age-related association with protection. A(H1N1)pdm09 circulated minimally during the 2012–2013 season but predominated during the 2013–2014 season [4]. This association with protection was greater among hospitalized cases (62%) compared to non-hospitalized cases (42%) (Table 6). VE was defined as (1 – OR *100) as previously published [12] the adjusted odds ratios for LAIV and TIV in the vaccine stratified analysis were tested for homogeneity using a conditional logistic regression model. Potential conflicts of interest. 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A P value of <.05 indicated statistical significance. The H1N1 component of the vaccine has not been updated in several years, and it is likely that many of the individuals in our study had prior A(H1N1)pdm09 infection and/or vaccination. Besides the rapid loss of immunity, the transmission rate and the total number of infected population can be estimated with the mathematical model framework developed by Dr He. www.sciencedaily.com/releases/2015/11/151102084629.htm (accessed November 6, 2020). Earlier this summer, estimates of this year's death toll from the H1N1 strain reached into the tens of thousands. Recent clinical trials, [8], [9] as well as DoD-based analyses of influenza, influenza-like illnesses and pneumonia-related healthcare encounters, [6], [7] suggest that TIV is more efficacious against laboratory-confirmed influenza among civilians as well as among highly-immunized military service members. Critical review and assistance in final drafting of the manuscript: RJL KGV JLS. There are several limitations with this study. However, if this misclassification did occur we expect it would be non-differential in nature and, again, bias our results toward the null. Vaccination was a time-dependent variable that increased over time. Yes The immune responses to a whole virus pandemic H1N1 … A novel A/H1N1 virus is the cause of the present influenza pandemic; vaccination is a key countermeasure, however, few data assessing prior seasonal vaccine effectiveness (VE) against the pandemic strain of H1N1 (pH1N1) virus are available. For more information about PLOS Subject Areas, click . S. E. O. has received grant support from Sanofi Pasteur for work unrelated to this report. In addition to these specific epitopes, other studies have suggested that neutralizing capability depends also on the affinity and avidity of the antibodies such that quality may be more of a factor than quantity alone [36]–[39]. The genealogy of the H1N1 virus family would explain why exposure to a swine lineage via the 1976 vaccine or to older human lineages offers cross-protection against the new strain. "Since it was generally believed that all developed countries are highly connected by international flights, such a distinct pattern between Europe and Northern America is very surprising," said Dr He. Analyzed the data: MCJ AAE SEL RJL JLS. HAI assays were performed using vaccine strain and VS-K166Q viruses as previously described [8]. We fit multivariable logistic regression models to examine HAI titers against vaccine strain and VS-K166Q viruses as correlates of protection against A(H1N1)pdm09 infection. For univariate analyses, subjects were categorized into 4 groups on the basis of measured HAI titers against vaccine strain and VS-K166Q viruses. Researchers stratified the pandemic and seasonal vaccine groups by three age-groups and split the study period into early and late phases. The study found that the serum from 52 (63 percent) of the adult subjects produced antibody levels of 160 or more when exposed to the novel H1N1 virus. The protective efficacy of the H1N1 vaccine was also confirmed using a severe combined immunodeficient (SCID) mouse model. A new pandemic influenza A(H1N1) virus (A[H1N1]pdm09) began circulating in humans in 2009 [1]. Meanwhile, a U.K. trial of a pandemic vaccine containing MF59, an immunity-boosting vaccine additive that is approved in Europe, produced protective responses with half the usual amount of virus antigen in three quarters of trial subjects. Copyright © 2010 Elsevier Ltd. Ongoing, systematic evaluations of seasonal and pH1N1-specific vaccination programs are critical to assess the overall public health impact of these interventions. Senior scientific oversight: RJL KLR. It is generally believed that individuals who get the H1N1 flu vaccine lose their immunity to the H1N1 flu virus in about 10 years, but according to an analysis led by The Hong Kong Polytechnic University (PolyU), immunity lasts for two years. Our data supports the importance of continued immunization coverage for all populations as recently recommended by the CDC's Advisory Committee on Immunization Practices [52]. Disclaimer: The opinions and assertions contained herein are solely those of the authors and do not reflect the official policy or position of the US Department of Defense (DoD) or of its subordinate services (Army, Navy or Air Force) medical authorities. https://doi.org/10.1371/journal.pone.0010722.t005. Yes . Nearly all A(H1N1)pdm09 viruses that circulated during the 2013–2014 season possessed a mutation, K166Q, in this important HA epitope [8]. These data indicate that contemporary A(H1N1)pdm09 strains are antigenically distinct from the current A(H1N1)pdm09 vaccine strain. Safety measures for COVID-19. Wrote the paper: MCJ JLS. We have previously shown that many adults possess antibodies that recognize a A(H1N1)pdm09 HA epitope involving residue 166 [8]. We will assess the data further and make critical distribution decisions.” PLoS ONE 5(5): Murphy supplied most of the 1976 serum samples used in Katz's study. Relationship between hemagglutination-inhibition (HAI) titer and 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) infection risk. Cross-protective immunity, as a result of natural influenza infections or prior influenza immunization in the military setting, may play a role in conferring a certain degree of enhanced host immunity as exposure takes place with each subsequent influenza season strain(s). Immunization with prior season's TIV (VE = 44%, 95% CI, 32 to 54%) as well as LAIV (VE = 24%, 95% CI, 6 to 38%) were both found to be associated with protection. Among vaccinated subjects, only specimens collected ≥14 days after vaccination were assayed. Cases were distributed over a wide geographic range with most (74%) reported in six states (Texas, n = 511; California, n = 128; South Carolina, n = 73; Florida, n = 68; North Carolina, n = 58; and, Missouri, n = 49) and the remaining 318 cases distributed among 26 additional states (AK, AR, AZ, CO, DC, GA, HI, IL, KS, KY, LA, MA, MD, ME, MS, ND, NE, NJ, NM, NY, OH, OK, SD, VA, WA and WY). Yes Inherent biases in case ascertainment and access to care may have taken place, however, we feel these potential biases were minimized due to our study population. During the period April 20, 2009 to October 15, 2009, a total of 1,205 clinically-apparent, laboratory-confirmed pH1N1-associated illnesses were reported. In addition, prior vaccination in 2004–08 timeframe (VE = 41%, 95% CI, 29 to 51%) was also significantly associated with protection (Table 4). Our finding of a greater association with protection against severe illness (e.g., hospitalization) suggests that the northern hemisphere 2008–09 influenza vaccine may have a more significant impact against overt pH1N1-associated illness compared to subclinical infection. Senior scientific leadership and institutional guidance: RFD. 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Many of the lab workers showed a "tremendously vigorous" antibody response to the 1976 vaccine at the time, Murphy recalls. , Pruszynski J, Murthy Ket al. Reports of confirmed influenza from Army, Air Force and Navy (including Marine Corps and US Coast Guard) reporting systems were included as part of the DMSS data. The parent of all H1N1 flu viruses, the virus that caused the pandemic of 1918–1919, jumped into the human population from some as yet unknown source and wrought worldwide havoc for two years, then settled down with considerably less virulence to become the circulating human seasonal flu strain for nearly 40 years. We performed HAI assays with the vaccine strain and an A/California/7/2009 vaccine strain engineered to possess the K166Q HA mutation (hereafter, “VS-K166Q”) and determined whether HAI titers were associated with protection against A(H1N1)pdm09 infection. These results provide support for the use of recombinant influenza VLP vaccine as an effective strategy against pandemic H1N1 virus. Editing of manuscript: DLB KGV. Only 1% of individuals in our study had HAI titers of <40 against the vaccine strain but ≥40 against VS-K166Q virus (group 4). AS , Bedford T. Oxford University Press is a department of the University of Oxford. Individuals who volunteered for blood specimen collection were significantly older, less likely to be vaccinated, and more likely to have had A(H1N1)pdm09 infection than those who did not volunteer. Prior vaccination in the 2004–08 timeframe was also independently associated with protection. Conversely, previously published AFHSC data also suggest that LAIV may be just as effective as TIV among vaccine-naïve personnel [7]. Influenza H1N1 VLPs with a diameter of approximately 120 nm were released into the culture medium from Sf9 insect cells infected with recombinant baculovirus coexpressing HA, NA, and M1 proteins. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Expanded assessment of vaccine effectiveness among high-risk recruit populations who are immunologically-naïve and who traditionally sustain higher rates of acute respiratory infections, [27] as well as, among young children and high-risk adults, are indicated and may further refine understanding of biological diversity based on age, sex and background disease states. , Petrie JG, Cross RTet al. The findings may help to explain why the virus sickens children and young adults more than older people, the authors wrote. 1 hour ago — Jeffery DelViscio and Timothy Weaver, 2 hours ago — Martin N. Ross and Leonard David | Opinion, 20 hours ago — Chelsea Harvey and E&E News, 21 hours ago — Matthew W. Johnson and David B. Yaden | Opinion. The number of subjects with each measured HAI titer who were infected with A(H1N1)pdm09 is reported above the line denoting the proportion infected. All studies that measure 2009 H1N1 vaccine effectiveness face the same challenge, that the vaccine was launched about the time the disease was peaking or later, he said. Ohmit Expert lauds study design, notes challengesEdward Belongia, MD, director of the Epidemiology Research Center at the Marshfield Clinic Research Foundation in Marshfield, Wis., told CIDRAP News that the study is well designed and that the approach using cases and test-negative controlss accounts for any differences in healthcare-seeking behavior between vaccinated and unvaccinated groups. However, since having history of an underlying medical condition was highly correlated with age and receipt of prior influenza vaccine during 2004–08 (two variables already included in the adjusted model), this variable had no effect on the VE estimate when added to the model and was therefore not include in the final adjusted model. Neher Armed Forces Health Surveillance Center, Silver Spring, Maryland, United States of America. , Petrie JG, Malosh REet al. No, Is the Subject Area "Armed forces" applicable to this article? Although antibody to HA is considered to be the major correlate of protection, antibody to neuraminidase has also been shown to independently correlate with protection against influenza virus infection [12]. Our findings further complement recent reports among civilian populations in Mexico [13], [14] and among health care professional in Ontario, Canada [15] that demonstrate moderate to high (35 to 73%) vaccine effectiveness against pH1N1-associated illness from seasonal influenza vaccination. "They accounted for that in this analysis," Belongia added. c All had HAI titers of ≥40 against VS and <40 against VS-K166Q viruses. "Basically, it's a 1931-like swine virus," says Brian Murphy, co-chief of the respiratory viruses laboratory at NIAID. The researchers first conducted a complete case analysis and excluded all individuals with missing values. PLOS ONE promises fair, rigorous peer review, Since the new H1N1 virus emerged earlier this year, health officials have noted how it has disproportionately struck children and young adults and conspicuously spared older people worldwide. Immunization data from DMSS were used to determine whether cases and controls received any influenza vaccination during the influenza season of August 1, 2008 through July 31, 2009. The preexisting immunity may also prime 1976 vaccinees to respond vigorously to the new pandemic vaccine. Vaccine status was also confirmed in many instances through medical records. The CDC group also started over the summer to test 83 samples of serum drawn in 1976 from adults who received a single dose of the swine flu vaccine as well as a handful of samples from children who got the 1976 vaccine. Purified recombinant H1N1 VLPs morphologically resembled influenza virions and exhibited biological characteristics of influenza virus, including HA and NA activities. The widespread H1N1 virus infection further emphasizes the need for vaccine strategies that are effective against emerging pandemic viruses and are not dependent on the limitations of traditional egg-based technology. Subject characteristics (eg, age and sex) were reported at enrollment, and electronic medical records were reviewed to document the presence of high-risk health conditions associated with an increased risk for complications of influenza. As the official flu season begins in the Northern Hemisphere, health officials are looking for ways to stretch limited supplies of vaccine against the novel H1N1 flu virus that leapt from swine to humans earlier this year. Influenza A (H1N1) 2009 Monovalent Vaccine is formulated to contain 15 mcg hemagglutinin (HA) per 0.5-mL dose of the following virus strain: A/California/7/2009 (H1N1)v-like virus. He said the study's limitations are that the group wasn't able to provide separate estimates for adjuvanted and nonadjuvanted vaccines. Data on children are expected in another two weeks, said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases (NIAID) in a press conference today. It seems likely that, in addition to induced hemagglutinin (HA) strain-specific antibody responses, that cross-reactive epitopes on the HA and neuraminidase (NA) external proteins, as well as, immune responses to epitopes on internal proteins can contribute to protection against influenza [30]–[35]. The first country in the group that started immunizing against the 2009 H1N1 virus was Hungary, and the last was Romania, which began its campaign 8 weeks later. , Blanton L, Kniss Ket al. The killed vaccine was injected, while the … The results of this assessment suggest there is an association with protection from the northern hemisphere 2008–09 seasonal influenza vaccine against clinically-apparent, laboratory-confirmed pH1N1-associated illness among active component US military service members. Moreover, one recently published study out of Canada documented an increased risk for medically-attended, laboratory-confirmed pH1N1 after receipt of seasonal vaccine (VE = −68%, 95% CI, −174 to 3%) [21]. Since laboratory testing requirements for pH1N1 confirmation have changed over the time period of this study (starting with universal testing to only testing severe cases), and since physicians may not have requested confirmatory testing for all suspected cases, the possibility exists that a control subject may have been infected with pH1N1 but did not get recorded as a laboratory-confirmed case.
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