Factors associated with influenza vaccination failure and severe disease in a French region in 2015

PLoS One. 2018 Apr 17;13(4):e0195611. doi: 10.1371/journal.pone.0195611. eCollection 2018.

Abstract

Current influenza vaccination strategy is based on limited analyses of circulating strains and has some drawbacks, as illustrated during the 2014-2015 season with the circulation of A(H3N2) viruses belonging to divergent genetic subgroups. We reasoned that these strains, poorly neutralized in vitro, may have been associated with vaccination failure and more severe diseases. We conducted a study on a continuous series of 249 confirmed influenza infections. Incidence was three fold greater than in the previous three years. Most isolates were A(H3N2) viruses (78%) and clustered in subgroups 3C.2a (57%) and 3C.3b (43%). We identified 23 non-synonymous mutations that had already been identified during previous seasons at low frequencies, except mutation Q197H, present in 26% of 3C.3b isolates. We identified lung disorder, tobacco smoking and A(H1N1)pdm09 infection as risk factor of severe influenza disease. In contrast, young age (< 5 years), A(H3N2) infection and initial admission to an emergency department were associated with a better outcome of influenza infection.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Child
  • Child, Preschool
  • Female
  • France / epidemiology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Influenza A Virus, H1N1 Subtype / genetics
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza A Virus, H3N2 Subtype / genetics
  • Influenza A Virus, H3N2 Subtype / isolation & purification*
  • Influenza Vaccines / adverse effects*
  • Influenza, Human / drug therapy*
  • Influenza, Human / epidemiology
  • Influenza, Human / virology
  • Lung Diseases / complications
  • Male
  • Middle Aged
  • Phylogeny
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index*
  • Tobacco Smoking / adverse effects
  • Treatment Failure
  • Vaccination
  • Young Adult

Substances

  • Influenza Vaccines

Grants and funding

The authors received no specific funding for this work.