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BackgroundInfluenza infection is a trigger of asthma attacks. Influenza vaccination can potentially reduce the incidence of influenza in people with asthma, but uptake remains persistently low, partially reflecting concerns about vaccine effectiveness (VE).MethodsWe conducted a test-negative designed case-control study to estimate the effectiveness of influenza vaccine in people with asthma in Scotland over 6 seasons (2010/2011 to 2015/2016). We used individual patient-level data from 223 practices, which yielded 1 830 772 patient-years of data that were linked with virological (n = 5910 swabs) data.ResultsVaccination was associated with an overall 55.0% (95% confidence interval [CI], 45.8-62.7) risk reduction of laboratory-confirmed influenza infections in people with asthma over 6 seasons. There were substantial variations in VE between seasons, influenza strains, and age groups. The highest VE (76.1%; 95% CI, 55.6-87.1) was found in the 2010/2011 season, when the A(H1N1) strain dominated and there was a good antigenic vaccine match. High protection was observed against the A(H1N1) (eg, 2010/2011; 70.7%; 95% CI, 32.5-87.3) and B strains (eg, 2010/2011; 83.2%; 95% CI, 44.3-94.9), but there was lower protection for the A(H3N2) strain (eg, 2014/2015; 26.4%; 95% CI, -12.0 to 51.6). The highest VE against all viral strains was observed in adults aged 18-54 years (57.0%; 95% CI, 42.3-68.0).ConclusionsInfluenza vaccination gave meaningful protection against laboratory-confirmed influenza in people with asthma across all seasons. Strategies to boost influenza vaccine uptake have the potential to substantially reduce influenza-triggered asthma attacks.

Original publication

DOI

10.1093/cid/ciz1086

Type

Journal article

Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Publication Date

10/2020

Volume

71

Pages

e94 - e104

Addresses

Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom.

Keywords

Humans, Influenza B virus, Asthma, Influenza Vaccines, Vaccination, Sentinel Surveillance, Case-Control Studies, Seasons, Adolescent, Adult, Middle Aged, Influenza, Human, Influenza A Virus, H3N2 Subtype, Influenza A Virus, H1N1 Subtype, Young Adult