Using Point of Care Testing to estimate influenza vaccine effectiveness in the English primary care sentinel surveillance network
Using Point of Care Testing to estimate influenza vaccine effectiveness in the English primary care sentinel surveillance network
INTRODUCTION: Rapid Point of Care Testing (POCT) for influenza could be used to provide information on influenza vaccine effectiveness (IVE) as well as influencing clinical decision-making in primary care.
METHODS: We undertook a test negative case control study to estimate the overall and age-specific (6 months-17 years, 18-64 years, ≥65 years old) IVE against medically attended POCT-confirmed influenza. The study took place over the winter of 2019-2020 and was nested within twelve general practices that are part of the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), the English sentinel surveillance network.
RESULTS: 648 POCT were conducted. 193 (29.7%) of those who were swabbed had received the seasonal influenza vaccine. The crude unadjusted overall IVE was 46.1% (95% CI: 13.9-66.3). After adjusting for confounders the overall IVE was 26.0% (95% CI: 0-65.5). In total 211 patients were prescribed an antimicrobial after swab testing. Given a positive influenza POCT result, the odds ratio (OR) of receiving an antiviral was 21.1 (95%CI: 2.4-182.2, p = <0.01) and the OR of being prescribed an antibiotic was 0.6 (95%CI: 0.4-0.9, p = <0.01).
DISCUSSION: Using influenza POCT in a primary care sentinel surveillance network to estimate IVE is feasible and provides comparable results to published IVE estimates. A further advantage is that near patient testing of influenza is associated with improvements in appropriate antiviral and antibiotic use. Larger, randomised studies are needed in primary care to see if these trends are still present and to explore their impact on outcomes.
1-11
Clark, Tristan
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de Lusignan, Simon
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Hoang, Uy
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Liyanage, Harshana
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Tripathy, Manasa
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Sherlock, Julian
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Joy, Mark
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Ferreira, Filipa
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Diez-Domingo, Javier
b2051128-4695-4720-b78a-8c4953baefd1
11 March 2021
Clark, Tristan
712ec18e-613c-45df-a013-c8a22834e14f
de Lusignan, Simon
ff8f6923-47a6-4c8e-8f12-c0517e6e3724
Hoang, Uy
45488204-2aa6-4f90-a48c-c75106e8fdaf
Liyanage, Harshana
28a7ebc4-00c8-4623-bb1b-99f004776cfc
Tripathy, Manasa
2c168494-e31f-42c3-8197-2e929f6ebe12
Sherlock, Julian
cbddbd48-9a70-4a6e-a1e7-000cecbd5102
Joy, Mark
4f3aea70-fa22-40a5-ae01-542f8b80cbec
Ferreira, Filipa
1c49ad65-579e-4863-a9c6-ede4de1d922f
Diez-Domingo, Javier
b2051128-4695-4720-b78a-8c4953baefd1
Clark, Tristan, de Lusignan, Simon, Hoang, Uy, Liyanage, Harshana, Tripathy, Manasa, Sherlock, Julian, Joy, Mark, Ferreira, Filipa and Diez-Domingo, Javier
(2021)
Using Point of Care Testing to estimate influenza vaccine effectiveness in the English primary care sentinel surveillance network.
PLoS ONE, 16, , [e0248123].
(doi:10.1371/journal.pone.0248123).
Abstract
INTRODUCTION: Rapid Point of Care Testing (POCT) for influenza could be used to provide information on influenza vaccine effectiveness (IVE) as well as influencing clinical decision-making in primary care.
METHODS: We undertook a test negative case control study to estimate the overall and age-specific (6 months-17 years, 18-64 years, ≥65 years old) IVE against medically attended POCT-confirmed influenza. The study took place over the winter of 2019-2020 and was nested within twelve general practices that are part of the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), the English sentinel surveillance network.
RESULTS: 648 POCT were conducted. 193 (29.7%) of those who were swabbed had received the seasonal influenza vaccine. The crude unadjusted overall IVE was 46.1% (95% CI: 13.9-66.3). After adjusting for confounders the overall IVE was 26.0% (95% CI: 0-65.5). In total 211 patients were prescribed an antimicrobial after swab testing. Given a positive influenza POCT result, the odds ratio (OR) of receiving an antiviral was 21.1 (95%CI: 2.4-182.2, p = <0.01) and the OR of being prescribed an antibiotic was 0.6 (95%CI: 0.4-0.9, p = <0.01).
DISCUSSION: Using influenza POCT in a primary care sentinel surveillance network to estimate IVE is feasible and provides comparable results to published IVE estimates. A further advantage is that near patient testing of influenza is associated with improvements in appropriate antiviral and antibiotic use. Larger, randomised studies are needed in primary care to see if these trends are still present and to explore their impact on outcomes.
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PlosONE POCT 2021
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More information
Accepted/In Press date: 19 February 2021
e-pub ahead of print date: 11 March 2021
Published date: 11 March 2021
Additional Information:
Publisher Copyright:
Copyright: © 2021 de Lusignan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Local EPrints ID: 448002
URI: http://eprints.soton.ac.uk/id/eprint/448002
ISSN: 1932-6203
PURE UUID: caed1b63-797d-4b20-8ac4-aa6ebd172d22
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Date deposited: 30 Mar 2021 16:30
Last modified: 06 Jun 2024 01:52
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Contributors
Author:
Simon de Lusignan
Author:
Uy Hoang
Author:
Harshana Liyanage
Author:
Manasa Tripathy
Author:
Julian Sherlock
Author:
Mark Joy
Author:
Filipa Ferreira
Author:
Javier Diez-Domingo
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