Effectiveness of vaccine against pandemic influenza A/H1N1 among people with underlying chronic diseases: Cohort study, Denmark, 2009-10

Abstract

Objective: To determine the effectiveness of an adjuvanted monovalent vaccine against pandemic influenza A/H1N1 among people with underlying chronic diseases. Design: Historical cohort study. Setting: Mandatory national reporting systems, 2 November 2009 to 31 January 2010, Denmark. Participants: 388 069 people under 65 years of age with a diagnosis in the past five years of at least one underlying disease expected to increase the risk of severe illness after influenza. Main outcome measures: Laboratory confirmed H1N1 infection and influenza related hospital admission with laboratory confirmed H1N1 infection. Estimates of vaccine effectiveness were adjusted for age and underlying disease. Results: The effectiveness of pandemic vaccine against confirmed H1N1 infection 14 days after one dose of vaccine was 49% (95% confidence interval 10% to 71%). The effectiveness of vaccine against admission to hospital for confirmed H1N1 infection was 44% (-19% to 73%). Conclusions: The adjuvanted monovalent vaccine against pandemic influenza A/H1N1 was offered late in the 2009-10 influenza season. Among chronically ill people, this vaccine offered protection against laboratory confirmed H1N1 infection but only offered non-significant protection against influenza related hospital admissions confirmed as H1N1 infection. This finding is of public health relevance because the population of chronically ill people is a major target group for pandemic vaccinations and because of the delayed availability of pandemic vaccines in a forthcoming pandemic.