Influenza epidemiology and vaccine effectiveness during the 2023/2024 season in Italy: A test-negative case-control study

Int J Infect Dis. 2024 Oct:147:107202. doi: 10.1016/j.ijid.2024.107202. Epub 2024 Aug 8.

Abstract

Objectives: In order to support policymakers in allocating resources, we aimed to assess vaccine effectiveness (VE) of inactivated influenza vaccines (IIVs) available for Italian adults in the 2023/2024 season.

Methods: A hospital-based test-negative case-control study was conducted in Genoa between mid-October 2023 and mid-April 2024. Adult (≥18 years) inpatients with prescription of a polymerase chain reaction test for influenza were eligible.

Results: Of 1,664 adults analyzed, most (82%) of which were ≥65 years, 114 (6.9%) tested positive for influenza A. Most (92%) cases were caused by subclades 6B.1A.5a.2a and 6B.1A.5a.2a.1 of the A(H1N1)pdm09 subtype. In older adults aged ≥65 years vaccination was effective at 51% (95% CI: 8%, 74%) against any influenza A and 49% (95% CI: 2%, 73%) against A(H1N1)pdm09. Compared with non-vaccinated older adults, VE point estimates for the adjuvanted and, especially, high-dose IIVs were higher than those for the standard-dose non-adjuvanted IIV.

Conclusion: The 2023/2024 seasonal influenza vaccination proved moderately effective in preventing hospitalization for laboratory-confirmed influenza. Being more appropriate for older adults, local policymakers and vaccinating physicians should maximize adoption of the enhanced IIVs.

Keywords: Adjuvanted influenza vaccine; Adults; High-dose influenza vaccine; Influenza; Influenza vaccine; Vaccine effectiveness.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype / immunology
  • Influenza Vaccines* / administration & dosage
  • Influenza Vaccines* / immunology
  • Influenza, Human* / epidemiology
  • Influenza, Human* / prevention & control
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Seasons*
  • Vaccination / statistics & numerical data
  • Vaccine Efficacy*
  • Vaccines, Inactivated / administration & dosage
  • Vaccines, Inactivated / immunology
  • Young Adult

Substances

  • Influenza Vaccines
  • Vaccines, Inactivated