End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18

Richard Pebody*, Abdelmajid Djennad, Joanna Ellis, Nicholas Andrews, Diogo F.P. Marques, Simon Cottrell, Arlene J. Reynolds, Rory Gunson, Monica Galiano, Katja Hoschler, Angie Lackenby, Chris Robertson, Mark O'doherty, Mary Sinnathamby, Nikolaos Panagiotopoulos, Ivelina Yonova, Rebecca Webb, Catherine Moore, Matthew Donati, Muhammad SartajSamantha J. Shepherd, Jim McMenamin, Simon de Lusignan, Maria Zambon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


Background: In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV). Aim: To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue. Methods: This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples. Results: Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15% (95% confidence interval (CI): −6.3 to 32) against all influenza; −16.4% (95% CI: −59.3 to 14.9) against A(H3N2); 24.7% (95% CI: 1.1 to 42.7) against B and 66.3% (95% CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9% (95% CI: −32.6 to 59.7) against all influenza; −75.5% (95% CI: −289.6 to 21) against A(H3N2); 60.8% (95% CI: 8.2 to 83.3) against B and 90.3% (95% CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9% (95% CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds. Conclusions: Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.

Original languageEnglish
Article number1800488
Issue number31
Publication statusPublished - 1 Aug 2019

Bibliographical note

Funding Information:
The study is partly funded from the European Union's Horizon 2020 research and innovation programme under grant agreement No 634446.

Publisher Copyright:
© 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.


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