Abstract

BackgroundThe SARS-CoV-2 pandemic has spotlighted respiratory infections and the value of effective vaccines. The SARS-CoV-2 vaccine has been remarkably effective; however, influenza vaccine effectiveness has been reported to be lower among active duty military populations than in the general public (18% vs 36%). The Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED) study compares 3 FDA-licensed influenza vaccine types (egg-based, cell-based, and recombinant) to assess differences in immunogenicity and effectiveness in adults. MethodsParticipants in the 3rd year of PAIVED (2020/21 influenza season) were enrolled from October 2020 through January 2021. Participants received weekly surveys about influenza-like-illnesses (ILI) experienced in the past week; if they reported an ILI, they were queried about symptom duration and severity, and asked to self-collect a nasal swab and dried blood sample. Four weeks later, more information about symptom duration and illness burden was obtained via telephone interview, and the participant collected a second blood sample. ResultsPAIVED year 3 enrolled 3,269 participants (Table 1). 278 participants reported 1 ILI , while 60 reported 2 ILIs, and 18 reported 3 ILIs. No pathogen was identified for most processed ILI samples (78%); the most common viruses were SARS-CoV-2 (25, 12%), rhinovirus (24, 12%), and seasonal coronaviruses (4, 2%). No influenza has been identified thus far. Among those participants who had convalescent ILI visits (275), the median duration of the reported ILIs was 9 days (IQR 5, 15), with a median of 4 days (IQR 2, 7) of limited activity, and 2 days (IQR 0, 3) with fever. Three individuals were hospitalized. ConclusionThere have been relatively low rates of ILI identified in this study during this season, with only 11% of the participants reporting an ILI so far, consistent with low rates of non-COVID-19 ILI reported elsewhere during the current pandemic. We anticipate some influenza cases may be identified as more samples are processed. Planned analyses include calculating comparative influenza vaccine effectiveness to inform future vaccine purchasing decisions, as well as comparing serological response to the different vaccines. Disclosures Ryan C. Maves, MD, EMD Serono (Advisor or Review Panel member)Heron Therapeutics (Advisor or Review Panel member) Jitu Modi, MD, GSK (Speaker’s Bureau)

Highlights

  • Respiratory Syncytial Virus (RSV) is one of the most common causes of childhood lower respiratory tract infection (LRTI) worldwide

  • Accurate data are critical to inform the rationale for RSV vaccine and immunoprophylaxis development

  • Our data support the need for RSV vaccines and immunoprophylaxis to prevent RSV hospitalization

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Summary

Conclusion

Hospitalized RSV LRTI among children < 5 years remains significant, and is associated with substantial HCRU, antibiotic use and morbidity. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, Tacoma, Washington; 5Infectious Disease Clinical Research Program and the Henry M. Darnall Army Medical Center, San Antonio, Texas; 8Infectious Disease Clinical Research Program, Bethesda, MD, The Henry M. Jackson Foundation, Bethesda, MD, and Brooke Army Medical Center, Fort Sam Houston, TX, San Antonio, TX; 13NHC Annapolis, Annapolis, Maryland; 14Defense Health Agency, Vienna, Virginia; 15Madigan Army Medical Center, Tacoma, WA, Tacoma, Washington; 16Immunization Health Branch, Defense Health Agency, Falls Church, VA; 17Lackland Air Force Base, San Antonio, Texas; 18Naval Medical Center San Diego, Infectious Disease Clinical Research Program, Bethesda, MD, and Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, San Diego, California; 19Naval Medical Center Portsmouth, Portsmouth, VA, Portsmouth, VA; 20Infectious Disease Clinical Research Program, Bethesda, MD, The Henry M.

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