Influenza Vaccine Effectiveness During the 2023/2024 Season: A Test‐Negative Case–Control Study Among Emergency Hospital Admissions With Respiratory Conditions in Northern Ireland

Background
We evaluated the effectiveness of the influenza vaccine programme against infection among emergency hospital admissions with respiratory conditions in Northern Ireland during the 2023/2024 influenza season.

Methods
Using a test-negative design, we compared the odds of vaccination between patients who tested positive (cases) and negative (controls) for laboratory-confirmed influenza, adjusting for confounders. VE was stratified by age group, sex and time since vaccination.

Results
We included 2368 hospitalised patients, of whom 1740 (73.5%) were influenza positive. Among these, 1703 (97.9%) were influenza A and 37 (2.1%) were influenza B. Of the influenza A-positive specimens, 84 were A(H1), 268 A(H3) and 1351 were untyped influenza A. VE against all laboratory-confirmed influenza was 47.5% (95% CI: 31.3%–60.1%), including 65.2% (95% CI: 44.2%–78.6%) in children aged 2–17, 46% (95% CI: 7.8%–68.2%) in adults 18–64 and 39.5% (95% CI: 4.8%–62.1%) in adults aged 65 and over. VE against infection for influenza A was 45.8% (95% CI: 25.1%–61%) in all age groups, but 64.7% (95% CI: 42.6%–78.6%) among children aged 2–17, 43.9% (95% CI: 3.7%–67.1%) among adults aged 18–64 years old and 39.6% (95% CI: 5%–62.1%) in adults aged ≥ 65 years. Being vaccinated was associated with 44.2% (95% CI: −13.3%-73.1%) and 37.9% (95% CI: 5.5%–59.5%) reduced odds of influenza A(H1) and A(H3)-associated community-acquired emergency admissions. VE against infection for influenza B was 87.2% (95% CI: 43.1%–98.3%). VE was highest within 2–8 weeks of vaccination at 67.5% (95% CI: 42.7%–81.7%) and declined to 41.2% (95% CI: 14.8%–59.5%) at 9–16 weeks.

Conclusions
Influenza vaccines provided protection against influenza-associated illness across age groups during the 2023/2024 influenza season.