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KMID : 1143420200130181207
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Public Health Weekly Report
2020 Volume.13 No. 18 p.1207 ~ p.1216
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Establishment of surveillance system and network for the evaluation of influenza vaccine effectiveness and estimation of influenza vaccine effectiveness in preventing influenza
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Park Sun-Young
Kim Jong-Hee
Cho En-Hi
Kim Woo-Joo
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Abstract
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Since the beginning of the Korean National Immunization Program (NIP) of influenza for the elderly in 1997, the NIP of the
influenza vaccine has been operated with the inclusion of children and a high vaccine coverage rate. However, there is a lack of a system of evaluation to estimate influenza vaccine effectiveness (IVE). Evaluation of IVE for preventing laboratoryconfirmed influenza (LCI), hospitalization, and death and the estimation of averted disease burden of influenza by influenza vaccine are required for the introduction of a newer vaccine and establishment of a policy for the prevention and control of influenza. Thus, a well-constructed system for estimation of IVE is urgently needed.
In this study, a network for the surveillance of influenza and a system for the evaluation of IVE were established. IVE in
preventing LCI was estimated during the 2018-2019 flu season. The study population comprised of 2,409 adults over 19
years of age and 6,026 children over 6 months of age. Among the adults, 377 subjects in the prospective study who were
enrolled in hospitals joined a network for the surveillance and 2,032 subjects in the retrospective study were collected from
the immunization registry (IR) and the health insurance review and assessment service data. Furthermore, of the 6,026
children over the age of 6 months, 62 children were in the prospective study and 5,964 children were in the retrospective
study. Prospective studies (for adults: October 14, 2018-May 9, 2019 and for children: December 27, 2018-April 30, 2019)
with test-negative case-control design (TND) and a retrospective study with case-control design in the 2018-2019
influenza season were performed.
Through the prospective test-negative case-control study, adjusted VE in preventing all influenza and A/H1N1 were
estimated as 55.9% (95% CI, 1.6-80.3) and 66.4% (95% CI, 6.7-87.9), respectively in adults aged 19-49 years of age. In
pediatrics (≤18 years), adjusted VE for prevention of all influenza was 48.5% (95% CI, -141.5-89.0). In the retrospective case-control study, adjusted VE in preventing all influenza and A/H1N1 were estimated as 41.4% (95% CI, 11.0-61.4) and 39.9% (95% CI, 2.2-63.0), respectively, in adults aged 19-49 years. In pediatrics (≤18 years), adjusted VE for prevention of all influenza, influenza A and influenza B were estimated as 43.2% (95% CI, 33.3-51.6), 47.7% (95% CI, 36.9-56.7) and 28.3% (95% CI, 6.9-44.8), respectively.
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KEYWORD
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Influenza, the influenza-like illness (ILI), Influenza vaccine, National Immunization Program (NIP), Effectiveness evaluation, Prospective study designed with test-negative, case-control design (TND), Retrospective case-control study, laboratory-confirmed influenza (LCI)
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