Appendix
to the manuscript entitled “Application of the screening method to monitor influenza vaccine
effectiveness among the elderly in Germany” by Cornelius Remschmidt et al.
Appendix 1
Table A1. Sensitivity analysis in which people were excluded who were vaccinated <14 days prior to
symptom onset compared to the analysis presented in the paper.
Original analysis*1
Sensitivity analysis*2
Age-group
(VE in %)
(VE in %)
2010/11 Influenza A
60-79
75 (69-80)
75 (69-80)
Influenza B
60-79
83 (74-89)
82 (73-89)
2011/12 Influenza B
60-79
73 (49-86)
72 (49-86)
2012/13 Influenza A
60-79
62 (58-66)
62 (58-66)
Season
Influenza-type
*1 cases who were vaccinated <14 days prior symptom onset were considered as non-vaccinated
*2 cases who were vaccinated <14 days prior symptom onset were excluded
1
Appendix 2
Table A2. Baseline characteristics of excluded vs. included cases, Germany, 2010/11-2012/13.
Season 2010/11
Sex
Male
Age group
60-69
70-70
≥ 80
Influenza strain A(H1N1)pdm
A(H3N2)
B
not subtyped
Hospitalized
Yes
Season 11/12
Sex
Age group
Influenza strain
Hospitalized
Season 12/13
Sex
Age group
Male
60-69
70-70
≥ 80
A(H1N1)pdm
A(H3N2)
B
not subtyped
Yes
Male
60-69
70-70
≥ 80
Influenza strain A(H1N1)pdm
A(H3N2)
B
not subtyped
Hospitalized
Yes
* p-values for the chi-squared test
Included cases
N=1,174
n(%)
589 (59)
797 (68)
307 (26)
70 (6)
582 (60)
1 (<1)
251 (26)
137 (14)
455 (39)
N=767
n(%)
306 (40)
263 (34)
268 (35)
237 (31)
12 (4)
118 (37)
97 (31)
89 (28)
317 (41)
N=5,217
n(%)
2,440 (47)
2,485 (48)
1,736 (33)
996 (19)
859 (28)
168 (5)
1,267 (41)
806 (26)
2,060 (40)
Excluded cases
N=197
n(%)
111 (56)
135 (69)
51 (26)
11 (6)
106 (64)
1 (1)
44 (27)
15 (9)
81 (41)
N=266
n(%)
101 (38)
71 (27)
73 (27)
122 (46)
4 (6)
35 (49)
18 (25)
15 (21)
115 (43)
N=1,586
n(%)
778 (49)
648 (41)
518 (33)
420 (26)
252 (30)
36 (4)
332 (39)
231 (27)
679 (44)
p-value*
0.11
0.97
0.16
0.59
p-value*
0.6
<0.01
0.25
0.59
p-value*
0.11
p<0.01
0.31
0.01
2
Appendix 3
Table A3 (online supplement). Sensitivity analysis assuming that vaccine coverage among excluded
cases was 50% and 200% of vaccine coverage among included cases, respectively, compared to the
analysis presented in the paper (“original analysis).
Age-group (years)
Season 2010/11
≥ 60
Season 11/12
≥ 60
Season 12/13
≥ 60
VC among excluded cases
VC among excluded cases
considered 50% of VC of
considered 200% of VC of
Original analysis
included cases
included cases
VE (%)
VE (%)
VE (%)
162/1,074 vacc.
176/1,371 vacc.
216/1,371 vacc.
80 (76-83)
81 (78-84)
76 (72-79)
208/767 vacc.
244/765 vacc.
353/767 vacc.
49 (39-57)
57 (51-63)
28 (19-37)
921/5,217 vacc.
1,061/6,803 vacc.
1,479/6,803 vacc.
64 (63-67)
69 (67-71)
54 (51-56)
VE, vaccine effectiveness; VC, vaccination coverage; vacc., vaccinated
3
Appendix 4
Table A4. Sensitivity analysis comparing baseline characteristics of cases with exact date of
vaccination vs. those without this information; Germany, 2010/11-2012/13.
Season 2010/11
Sex
Male
Age group
60-69
70-70
≥ 80
Influenza strain A(H1N1)pdm
A(H3N2)
B
not subtyped
Hospitalized
Yes
Season 11/12
Sex
Age group
Influenza strain
Hospitalized
Season 12/13
Sex
Age group
Male
60-69
70-70
≥ 80
A(H1N1)pdm
A(H3N2)
B
not subtyped
Yes
Male
60-69
70-70
≥ 80
Influenza strain A(H1N1)pdm
A(H3N2)
B
not subtyped
Hospitalized
Yes
* p-values for the chi-squared test
Cases with
information on
vaccination date
n/N=122
(%)
56 (46)
83 (68)
32 (26)
7 (6)
69 (70)
1 (1)
16 (16)
12 (13)
36 (30)
n/N=137
(%)
64 (47)
34 (24)
43 (32)
60 (44)
1 (2)
31 (54)
10 (18)
15 (26)
49 (36)
n/N=612
(%)
274 (45)
204 (33)
241 (39)
167 (27)
73 (26)
17 (6)
112 (40)
80 (28)
219 (36)
Cases without
information on
vaccination date
n/N=40
(%)
19 (48)
26 (65)
12 (30)
2 (5)
23 (62)
0
12 (32)
2 (5)
17 (43)
n/N=70
(%)
20 (29)
10 (14)
30 (43)
30 (43)
0
21 (64)
5 (15)
7 (21)
18 (28)
n/N=305
(%)
124 (41)
93 (30)
129 (43)
83 (27)
41 (23)
28 (16)
66 (37)
42 (24)
120 (40)
p-value*
0.86
0.89
0.14
0.13
p-value*
0.01
0.13
0.76
0.14
p-value*
0.24
0.63
0.01
0.27
4
Appendix 5
Table A5. Sensitivity analysis, assuming that 50% of cases without information on exact date of
vaccination are considered as non-vaccinated. Vaccine effectiveness (%) against all influenza types.
Age-group (years)
Season 2010/11
All age-groups ≥ 60
Season 11/12
All age-groups ≥ 60
Season 12/13
All age-groups ≥ 60
Original analysis assuming
Sensitivity analysis assuming
cases without information on exact
50% of cases without information
date of vaccination considered
on exact date of vaccination
vaccinated
considered non-vaccinated
VE (%)
VE (%)
162 vacc./ 1,022 non-vacc.
142 vacc./ 1,042 non-vacc.
80 (76-83)
83 (65-73)
208 vacc./ 559 non-vacc.
173 vacc./ 594 non-vacc.
49 (39-57)
60 (53-66)
921 vacc./4,296 non-vacc.
769 vacc./ 4,448 non-vacc.
64 (63-67)
71 (69-73)
VE, vaccine effectiveness; vacc., vaccinated
5