Comparing influenza vaccine effectiveness between cell-derived and egg-derived vaccines, 2017–2018 influenza season

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The Department of Defense Global Respiratory Pathogen Surveillance Program conducted a study to compare the differences in vaccine effectiveness (VE) of the cell-derived and egg-derived vaccines. DoD healthcare beneficiaries, excluding service members, that presented with influenza-like illness for the period of 1 October 2017 through 28 April 2018 were included in a test-negative case-control study examining laboratory confirmed influenza infections. Three VE analyses were performed (1) influenza infection among those vaccinated with cell-derived vaccines (2) influenza infection among those vaccinated with egg-derived vaccines and a (3) relative VE which directly compared the odds of influenza infection with cell-derived vaccine against those with egg-derived vaccines. The cell-derived and egg-derived vaccines were moderately protective against all influenza types with significant VE estimates for all dependents at 46% (95% confidence interval, 33, 56) and 53% (45, 60), respectively. Of the subtype analyses, influenza A(H1N1)pdm09 performed the best. In the cell-derived vaccine, the adult age group was moderate to high at 71% (44, 85) and children moderate at 56% (15, 75). In the egg-derived vaccine, the children age group was at a high 88% (80, 93) effectiveness and adults at 81% (56, 92). When comparing cell-derived vaccine directly to the egg-derived vaccine, the relative VE found significant results only for influenza A(H1N1)pdm09 which favored the egg-derived vaccine with odds ratios of 2.0 (1.1, 3.6) for all dependents and 2.9 (1.3, 6.3) for children. In the influenza A(H3N2) analysis, statistical significance was not gained; however, the odds favored the cell-derived vaccine.