Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type during 2013-2014 in the United States

Manjusha Gaglani, Jessica Pruszynski, Kempapura Murthy, Lydia Clipper, Anne Robertson, Michael Reis, Jessie R. Chung, Pedro A. Piedra, Vasanthi Avadhanula, Mary Patricia Nowalk, Richard K. Zimmerman, Michael L. Jackson, Lisa A. Jackson, Joshua G. Petrie, Suzanne E. Ohmit, Arnold S. Monto, Huong Q. McLean, Edward A. Belongia, Alicia M. Fry, Brendan Flannery

Research output: Contribution to journalReview articlepeer-review

148 Scopus citations


Background. The predominant strain during the 2013-2014 influenza season was 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09). This vaccine-component has remained unchanged from 2009. Methods. The US Flu Vaccine Effectiveness Network enrolled subjects aged ≥6 months with medically attended acute respiratory illness (MAARI), including cough, with illness onset ≤7 days before enrollment. Influenza was confirmed by reverse-transcription polymerase chain reaction (RT-PCR). We determined the effectiveness of trivalent or quadrivalent inactivated influenza vaccine (IIV) among subjects ages ≥6 months and the effectiveness of quadrivalent live attenuated influenza vaccine (LAIV4) among children aged 2-17 years, using a test-negative design. The effect of prior receipt of any A(H1N1)pdm09-containing vaccine since 2009 on the effectiveness of current-season vaccine was assessed. Results. We enrolled 5999 subjects; 5637 (94%) were analyzed; 18% had RT-PCR-confirmed A(H1N1)pdm09-related MAARI. Overall, the effectiveness of vaccine against A(H1N1)pdm09-related MAARI was 54% (95% confidence interval [CI], 46%-61%). Among fully vaccinated children aged 2-17 years, the effectiveness of LAIV4 was 17% (95% CI, -39% to 51%) and the effectiveness of IIV was 60% (95% CI, 36%-74%). Subjects aged ≥9 years showed significant residual protection of any prior A(H1N1)pdm09-containing vaccine dose(s) received since 2009, as did children <9 years old considered fully vaccinated by prior season. Conclusions. During 2013-2014, IIV was significantly effective against A(H1N1)pdm09. Lack of LAIV4 effectiveness in children highlights the importance of continued annual monitoring of effectiveness of influenza vaccines in the United States.

Original languageEnglish (US)
Pages (from-to)1546-1556
Number of pages11
JournalJournal of Infectious Diseases
Issue number10
StatePublished - May 15 2016


  • Influenza
  • Influenza vaccine
  • Influenza vaccine effectiveness
  • Vaccine effectiveness

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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