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

Abstract : OBJECTIVES: We discussed which method between the test-negative design (TND) and the screening method (SM) could provide more robust real-time and end-of-season vaccine effectiveness (VE) 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. Using the SM, we estimated end-of-season VE in preventing medically attended influenza-like illness and laboratory-confirmed influenza among the population at risk. Using the TND, we estimated end-of-season VE in preventing influenza among both the general and the at-risk population. We estimated real-time VE using both methods. RESULTS: For the SM, the overall adjusted end-of-season VE 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 influenza-like illness and laboratory-confirmed influenza, respectively. For the TND, the overall adjusted end-of-season VE 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 VE estimates obtained through the TND showed more variability across each season and lower precision than those estimated with the SM. CONCLUSIONS: Although the worldwide use of the TND allows for comparison of overall VE estimates among countries, the SM performs better in providing robust real-time VE estimates among the population at risk.
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https://hal.archives-ouvertes.fr/hal-01911031
Contributor : Laure-Hélène Davoine <>
Submitted on : Friday, November 2, 2018 - 11:47:01 AM
Last modification on : Thursday, April 11, 2019 - 11:42:04 AM

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A. M. Vilcu, C. Souty, V. Enouf, L. Capai, C. Turbelin, et al.. Estimation of seasonal influenza vaccine effectiveness using data collected in primary care in France: comparison of the test-negative design and the screening method. Clinical Microbiology and Infection, Elsevier for the European Society of Clinical Microbiology and Infectious Diseases, 2018, 24 (4), pp.431.e5-431.e12. ⟨10.1016/j.cmi.2017.09.003⟩. ⟨hal-01911031⟩

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