TY - JOUR
T1 - Influence of Preseason Antibodies Against Influenza Virus on Risk of Influenza Infection among Healthcare Personnel
AU - Gorse, Geoffrey J.
AU - Rattigan, Susan M.
AU - Kirpich, Alexander
AU - Simberkoff, Michael S.
AU - Bessesen, Mary T.
AU - Gibert, Cynthia
AU - Nyquist, Ann Christine
AU - Price, Connie Savor
AU - Gaydos, Charlotte A.
AU - Radonovich, Lewis J.
AU - Perl, Trish M.
AU - Rodriguez-Barradas, Maria C.
AU - Cummings, Derek A.T.
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background: The association of hemagglutination inhibition (HAI) antibodies with protection from influenza among healthcare personnel (HCP) with occupational exposure to influenza viruses has not been well-described. Methods: The Respiratory Protection Effectiveness Clinical Trial was a cluster-randomized, multisite study that compared medical masks to N95 respirators in preventing viral respiratory infections among HCP in outpatient healthcare settings for 5180 participant-seasons. Serum HAI antibody titers before each influenza season and influenza virus infection confirmed by polymerase chain reaction were studied over 4 study years. Results: In univariate models, the risk of influenza A(H3N2) and B virus infections was associated with HAI titers to each virus, study year, and site. HAI titers were strongly associated with vaccination. Within multivariate models, each log base 2 increase in titer was associated with 15%, 26% and 33%-35% reductions in the hazard of influenza A(H3N2), A(H1N1), and B infections, respectively. Best models included preseason antibody titers and study year, but not other variables. Conclusions: HAI titers were associated with protection from influenza among HCP with routine exposure to patients with respiratory illness and influenza season contributed to risk. HCP can be reassured about receiving influenza vaccination to stimulate immunity.
AB - Background: The association of hemagglutination inhibition (HAI) antibodies with protection from influenza among healthcare personnel (HCP) with occupational exposure to influenza viruses has not been well-described. Methods: The Respiratory Protection Effectiveness Clinical Trial was a cluster-randomized, multisite study that compared medical masks to N95 respirators in preventing viral respiratory infections among HCP in outpatient healthcare settings for 5180 participant-seasons. Serum HAI antibody titers before each influenza season and influenza virus infection confirmed by polymerase chain reaction were studied over 4 study years. Results: In univariate models, the risk of influenza A(H3N2) and B virus infections was associated with HAI titers to each virus, study year, and site. HAI titers were strongly associated with vaccination. Within multivariate models, each log base 2 increase in titer was associated with 15%, 26% and 33%-35% reductions in the hazard of influenza A(H3N2), A(H1N1), and B infections, respectively. Best models included preseason antibody titers and study year, but not other variables. Conclusions: HAI titers were associated with protection from influenza among HCP with routine exposure to patients with respiratory illness and influenza season contributed to risk. HCP can be reassured about receiving influenza vaccination to stimulate immunity.
KW - correlates of protection
KW - healthcare personnel
KW - hemagglutination inhibition antibodies
KW - influenza virus
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U2 - 10.1093/infdis/jiab468
DO - 10.1093/infdis/jiab468
M3 - Article
C2 - 34534319
AN - SCOPUS:85125552751
SN - 0022-1899
VL - 225
SP - 891
EP - 902
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 5
ER -