636. Risk Factors of Influenza Vaccine Failure in 2012-13, 2013-14 and 2014-15 at Baylor Scott & White Health (BSWH) in Central Texas.
Session: Poster Abstract Session: Oh, Those Pesky Viruses!
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Vaccine Failure - IDWeek 2016 vs1.0.pdf (206.2 kB)
  • Background: Risk factors for vaccine failure against medically-attended influenza are largely unknown. We examined these risk factors at BSWH for 3 seasons.

    Methods: BSWH has been a CDC US Flu VE network site since 2011. We enrolled patients ages ≥6 months seeking outpatient care for acute respiratory illness (ARI) with cough; onset ≤7 days. Nasal-throat swabs were tested for influenza A&B by PCR. Subjects with vaccine failure and vaccinated controls were identified by influenza PCR results and EMR-verified vaccination ≥14 days prior to illness onset or first medically-attended ARI (MAARI). Subjects whose influenza status could not be ascertained were excluded. Multivariable logistic regression models were built using covariates with a p-value <0.2 in the univariate analysis. Odds ratios (OR) with 95% confidence intervals (CI) were computed.

    Results: Out of 1445, 1035 and 1783 enrolled subjects during 2012-13, 2013-14 and 2014-15 seasons, we had 130, 53 and 153 PCR-confirmed vaccine failure cases, respectively. During 2012-13, age-group, health today, and inpatient stay during prior year were found to be significantly associated with vaccine failure. During 2013-14 and 2014-15, days from vaccination to illness onset, days from illness onset to enrollment, and prior season vaccination were significantly associated with vaccine failure.

    Tables: Significant Risk factors for Vaccine Failure Against Medically-Attended Influenza for 3 seasons.

    2012-13

    OR

    OR 95% CI

    Age Group

    6m-8y

    9-17y

    18-49y

    50-64y

    >65y

    1.21

    1.50

    Reference

    1.12

    3.91

    0.56-2.56

    0.68-3.26

    0.50-2.47

    1.69-9.06

    Health today

    0.98

    0.97-0.99

    Prior year Inpatient stay

    Yes

    No

    0.29

    Reference

    0.09-0.99

    2013-14

    2014-15

    OR

    OR 95% CI

    OR

    OR 95% CI

    Days from Vaccination to illness onset

    0.99

    0.98-1.00

    0.98

    0.98-0.99

    Days from illness onset to enrollment

    0.76

    0.61-0.96

    0.67

    0.56-0.79

    Prior season vaccination

    Yes

    No

    2.69

    Reference

    1.01-7.21

    2.23

    Reference

    1.19-4.18

    Conclusion: The risk factors for vaccine failure against medically-attended influenza are age-group ≥65 years and prior season vaccination. Prior year inpatient stay, days from vaccination to illness onset and days from illness onset to enrollment had protective effects. Better and longer lasting vaccines are needed to prevent influenza.

    Manjusha Gaglani, MBBS1, Kempapura Murthy, MBBS, MPH2, Jessica Pruszynski, Ph. D3, Anne Robertson, AA4, Archana Nangrani, MBBS4 and Lydia Clipper, RN3, (1)Pediatrics, Baylor Scott & White Health, Texas A&M HSC COM, Temple, TX, (2)Academic Operations Research Development, Baylor Scott & White Health, Temple, TX, (3)Academic Operations, Baylor Scott & White Health, Temple, TX, (4)Baylor Scott & White Health, Temple, TX

    Disclosures:

    M. Gaglani, None

    K. Murthy, None

    J. Pruszynski, None

    A. Robertson, None

    A. Nangrani, None

    L. Clipper, None

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