Association between the 2008–09 Seasonal Influenza Vaccine and Pandemic H1N1 Illness during Spring–Summer 2009: Four Observational Studies from Canada
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{"title"=>"Association between the 2008-09 seasonal influenza vaccine and pandemic H1N1 illness during spring-summer 2009: Four observational studies from Canada", "type"=>"journal", "authors"=>[{"first_name"=>"Danuta M.", "last_name"=>"Skowronski", "scopus_author_id"=>"7004017482"}, {"first_name"=>"Gaston", "last_name"=>"de Serres", "scopus_author_id"=>"7006630854"}, {"first_name"=>"Natasha S.", "last_name"=>"Crowcroft", "scopus_author_id"=>"8427406200"}, {"first_name"=>"Naveed Z.", "last_name"=>"Janjua", "scopus_author_id"=>"7003951222"}, {"first_name"=>"Nicole", "last_name"=>"Boulianne", "scopus_author_id"=>"7004066517"}, {"first_name"=>"Travis S.", "last_name"=>"Hottes", "scopus_author_id"=>"26028535100"}, {"first_name"=>"Laura C.", "last_name"=>"Rosella", "scopus_author_id"=>"23489789700"}, {"first_name"=>"James A.", "last_name"=>"Dickinson", "scopus_author_id"=>"7202899853"}, {"first_name"=>"Rodica", "last_name"=>"Gilca", "scopus_author_id"=>"16424523400"}, {"first_name"=>"Pam", "last_name"=>"Sethi", "scopus_author_id"=>"36070798500"}, {"first_name"=>"Najwa", "last_name"=>"Ouhoummane", "scopus_author_id"=>"12798918900"}, {"first_name"=>"Donald J.", "last_name"=>"Willison", "scopus_author_id"=>"7003725965"}, {"first_name"=>"Isabelle", "last_name"=>"Rouleau", "scopus_author_id"=>"7004164920"}, {"first_name"=>"Martin", "last_name"=>"Petric", "scopus_author_id"=>"55147762700"}, {"first_name"=>"Kevin", "last_name"=>"Fonseca", "scopus_author_id"=>"6701367954"}, {"first_name"=>"Steven J.", "last_name"=>"Drews", "scopus_author_id"=>"8699364100"}, {"first_name"=>"Anuradha", "last_name"=>"Rebbapragada", "scopus_author_id"=>"6506266667"}, {"first_name"=>"Subhugues", "last_name"=>"Charest", "scopus_author_id"=>"36070376000"}, {"first_name"=>"Marie ??ve", "last_name"=>"Hamelin", "scopus_author_id"=>"8547365700"}, {"first_name"=>"Guy", "last_name"=>"Boivin", "scopus_author_id"=>"24309591300"}, {"first_name"=>"Jennifer L.", "last_name"=>"Gardy", "scopus_author_id"=>"7801475389"}, {"first_name"=>"Yan", "last_name"=>"Li", "scopus_author_id"=>"35187394200"}, {"first_name"=>"Trijntje L.", "last_name"=>"Kwindt", "scopus_author_id"=>"16039811300"}, {"first_name"=>"David M.", "last_name"=>"Patrick", "scopus_author_id"=>"35549518300"}, {"first_name"=>"Robert C.", "last_name"=>"Brunham", "scopus_author_id"=>"7007047752"}], "year"=>2010, "source"=>"PLoS Medicine", "identifiers"=>{"sgr"=>"77951745708", "pui"=>"358744945", "doi"=>"10.1371/journal.pmed.1000258", "pmid"=>"20386731", "isbn"=>"1549-1676 (Electronic)\\r1549-1277 (Linking)", "scopus"=>"2-s2.0-77951745708", "issn"=>"15491277"}, "id"=>"990a3b1b-3e7f-3919-a1a5-256790de5e69", "abstract"=>"BACKGROUND: In late spring 2009, concern was raised in Canada that prior vaccination with the 2008-09 trivalent inactivated influenza vaccine (TIV) was associated with increased risk of pandemic influenza A (H1N1) (pH1N1) illness. Several epidemiologic investigations were conducted through the summer to assess this putative association. METHODS AND FINDINGS: STUDIES INCLUDED: (1) test-negative case-control design based on Canada's sentinel vaccine effectiveness monitoring system in British Columbia, Alberta, Ontario, and Quebec; (2) conventional case-control design using population controls in Quebec; (3) test-negative case-control design in Ontario; and (4) prospective household transmission (cohort) study in Quebec. Logistic regression was used to estimate odds ratios for TIV effect on community- or hospital-based laboratory-confirmed seasonal or pH1N1 influenza cases compared to controls with restriction, stratification, and adjustment for covariates including combinations of age, sex, comorbidity, timeliness of medical visit, prior physician visits, and/or health care worker (HCW) status. For the prospective study risk ratios were computed. Based on the sentinel study of 672 cases and 857 controls, 2008-09 TIV was associated with statistically significant protection against seasonal influenza (odds ratio 0.44, 95% CI 0.33-0.59). In contrast, estimates from the sentinel and three other observational studies, involving a total of 1,226 laboratory-confirmed pH1N1 cases and 1,505 controls, indicated that prior receipt of 2008-09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring-summer 2009, with estimated risk or odds ratios ranging from 1.4 to 2.5. Risk of pH1N1 hospitalization was not further increased among vaccinated people when comparing hospitalized to community cases. CONCLUSIONS: Prior receipt of 2008-09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring-summer 2009 in Canada. The occurrence of bias (selection, information) or confounding cannot be ruled out. Further experimental and epidemiological assessment is warranted. Possible biological mechanisms and immunoepidemiologic implications are considered.", "link"=>"http://www.mendeley.com/research/association-between-200809-seasonal-influenza-vaccine-pandemic-h1n1-illness-during-springsummer-2009", "reader_count"=>98, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>13, "Librarian"=>2, "Researcher"=>28, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>19, "Student > Postgraduate"=>5, "Other"=>7, "Student > Master"=>9, "Student > Bachelor"=>5, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>4}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>13, "Librarian"=>2, "Researcher"=>28, "Student > Doctoral Student"=>2, "Student > Ph. D. 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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/425274", "https://ndownloader.figshare.com/files/425360", "https://ndownloader.figshare.com/files/425438", "https://ndownloader.figshare.com/files/425494", "https://ndownloader.figshare.com/files/425564", "https://ndownloader.figshare.com/files/425633", "https://ndownloader.figshare.com/files/425711"], "description"=>"<div><h3>Background</h3><p>In late spring 2009, concern was raised in Canada that prior vaccination with the 2008–09 trivalent inactivated influenza vaccine (TIV) was associated with increased risk of pandemic influenza A (H1N1) (pH1N1) illness. Several epidemiologic investigations were conducted through the summer to assess this putative association.</p><h3>Methods and Findings</h3><p>Studies included: (1) test-negative case-control design based on Canada's sentinel vaccine effectiveness monitoring system in British Columbia, Alberta, Ontario, and Quebec; (2) conventional case-control design using population controls in Quebec; (3) test-negative case-control design in Ontario; and (4) prospective household transmission (cohort) study in Quebec. Logistic regression was used to estimate odds ratios for TIV effect on community- or hospital-based laboratory-confirmed seasonal or pH1N1 influenza cases compared to controls with restriction, stratification, and adjustment for covariates including combinations of age, sex, comorbidity, timeliness of medical visit, prior physician visits, and/or health care worker (HCW) status. For the prospective study risk ratios were computed. Based on the sentinel study of 672 cases and 857 controls, 2008–09 TIV was associated with statistically significant protection against seasonal influenza (odds ratio 0.44, 95% CI 0.33–0.59). In contrast, estimates from the sentinel and three other observational studies, involving a total of 1,226 laboratory-confirmed pH1N1 cases and 1,505 controls, indicated that prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009, with estimated risk or odds ratios ranging from 1.4 to 2.5. Risk of pH1N1 hospitalization was not further increased among vaccinated people when comparing hospitalized to community cases.</p><h3>Conclusions</h3><p>Prior receipt of 2008–09 TIV was associated with increased risk of medically attended pH1N1 illness during the spring–summer 2009 in Canada. The occurrence of bias (selection, information) or confounding cannot be ruled out. Further experimental and epidemiological assessment is warranted. Possible biological mechanisms and immunoepidemiologic implications are considered.</p><h3></h3><p><em>Please see later in the article for the Editors' Summary</em></p></div>", "links"=>[], "tags"=>["seasonal", "influenza", "pandemic", "h1n1", "observational", "studies", "canada"], "article_id"=>143943, "categories"=>["Cancer", "Medicine", "Biological Sciences", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.s001", "https://dx.doi.org/10.1371/journal.pmed.1000258.s002", "https://dx.doi.org/10.1371/journal.pmed.1000258.s003", "https://dx.doi.org/10.1371/journal.pmed.1000258.s004", "https://dx.doi.org/10.1371/journal.pmed.1000258.s005", "https://dx.doi.org/10.1371/journal.pmed.1000258.s006", "https://dx.doi.org/10.1371/journal.pmed.1000258.s007"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Association_between_the_2008_09_Seasonal_Influenza_Vaccine_and_Pandemic_H1N1_Illness_during_Spring_Summer_2009_Four_Observational_Studies_from_Canada/143943", "title"=>"Association between the 2008–09 Seasonal Influenza Vaccine and Pandemic H1N1 Illness during Spring–Summer 2009: Four Observational Studies from Canada", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2010-04-06 01:05:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/855657"], "description"=>"<p>Fully adjusted effect measures and 95% confidence intervals from four epidemiologic studies in Canada to assess the association between 2008–09 trivalent inactivated influenza vaccine (TIV) and risk of community-based seasonal influenza and pH1N1 illness. *Note: Boxes show point estimates for the OR for each study/subgroup except the Quebec prospective cohort study for which the effect measure displayed is the RR. See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000258#pmed-1000258-t001\" target=\"_blank\">Tables 1</a>, <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000258#pmed-1000258-t003\" target=\"_blank\">3</a>, and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000258#pmed-1000258-t005\" target=\"_blank\">5</a> for covariates included in adjusted analyses. RR for the Quebec prospective cohort study was age-stratified but not further adjusted (see <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000258#pmed-1000258-t001\" target=\"_blank\">tables 1</a> and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000258#pmed-1000258-t006\" target=\"_blank\">6</a>). LCL, lower confidence limit; UCL, upper confidence limit.</p>", "links"=>[], "tags"=>["Infectious diseases", "infectious diseases/epidemiology and control of infectious diseases", "infectious diseases/respiratory infections", "infectious diseases/viral infections", "public health and epidemiology", "public health and epidemiology/immunization", "public health and epidemiology/infectious diseases", "public health and epidemiology/preventive medicine", "respiratory medicine/respiratory infections"], "article_id"=>526077, "categories"=>["Computational Biology", "Infectious Diseases", "Medicine", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_main_findings_/526077", "title"=>"Summary of main findings.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2010-04-06 01:41:17"}
  • {"files"=>["https://ndownloader.figshare.com/files/855828"], "description"=>"<p>ILI is defined as fever + cough + one or more of sore throat, myalgia, arthralgia, headache, or prostration.</p>", "links"=>[], "tags"=>["ph1n1", "rates", "members", "tiv"], "article_id"=>526251, "categories"=>["Computational Biology", "Infectious Diseases", "Medicine", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.t006"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Quebec_household_transmission_study_Secondary_pH1N1_attack_rates_among_household_members_by_2008_8211_09_TIV_status_/526251", "title"=>"Quebec household transmission study: Secondary pH1N1 attack rates among household members by 2008–09 TIV status.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-06 01:44:11"}
  • {"files"=>["https://ndownloader.figshare.com/files/855899"], "description"=>"<p>NOTE: Where percentages do not sum 100%, this is due to missing data. ILI is defined as fever+cough+one or more of: sore throat, myalgia, arthralgia, headache, or prostration.</p>a<p>Comorbidity or chronic condition is defined as a vaccine-eligible underlying condition.</p>b<p>Smoker is defined as any current smoking.</p>c<p>For these variables, denominators are slightly different because of missing or not applicable values.</p>d<p>HCW is defined as any person working in the health care system with or without direct contact with patients.</p><p>N/A, not available.</p>", "links"=>[], "tags"=>["ontario", "ph1n1", "case-control"], "article_id"=>526317, "categories"=>["Computational Biology", "Infectious Diseases", "Medicine", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.t004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Quebec_and_Ontario_pH1N1_case_control_studies_Participant_profiles_/526317", "title"=>"Quebec and Ontario pH1N1 case-control studies: Participant profiles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-06 01:45:17"}
  • {"files"=>["https://ndownloader.figshare.com/files/855968"], "description"=>"<p>Ontario Study: Test date was included as a binary variable (before/after June 11, 2009) in all Ontario models (see text). <sup>a</sup>Physician visits = number of visits to family doctor/primary care physician in the 12 mo prior.</p>b<p>Adjusted for age (5–19, 20–34 [as reference], 35–49, 50–59, and 60+ y)+comorbidity+sex+HCW.</p>c<p>Adjusted for age+sex+HCW.</p>d<p>In Ontario adjustment for HCW not performed if not represented in all cells.</p>e<p>Adjusted for age (<10, 10–19 y, and 20–49 [as reference])+comorbidity+sex+HCW.</p>f<p>Adjusted for age (50–59 [as reference] and 60+ y)+comorbidity+sex+HCW.</p>g<p>Adjusted for chronic condition+sex+HCW.</p>h<p>Adjusted for comorbidity+sex.</p><p>N/A, not available.</p>", "links"=>[], "tags"=>["ontario", "case-control", "ors", "tiv"], "article_id"=>526387, "categories"=>["Computational Biology", "Infectious Diseases", "Medicine", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.t005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Quebec_and_Ontario_case_control_studies_ORs_95_CI_for_TIV_effect_on_pH1N1_/526387", "title"=>"Quebec and Ontario case-control studies: ORs (95% CI) for TIV effect on pH1N1.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-06 01:46:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/856039"], "description"=>"a<p>BC did not collect information on 2007–08 vaccine status. 2007–08 percentages derived based on participants for whom vaccine status known. Denominators do not include those with missing information (never exceeding four missing counts for any age category).</p>", "links"=>[], "tags"=>["test-negative", "case-control", "influenza"], "article_id"=>526459, "categories"=>["Computational Biology", "Infectious Diseases", "Medicine", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sentinel_test_negative_case_control_study_Participant_profile_by_analysis_period_seasonal_influenza_and_pH1N1_/526459", "title"=>"Sentinel test-negative case-control study: Participant profile by analysis period (seasonal influenza and pH1N1).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-06 01:47:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/856118"], "description"=>"a<p>Specimens positive for seasonal influenza (29) or of unknown subtype (2) were excluded as controls from pH1N1 analysis period.</p>b<p>Adjusted for age as 1–8, 9–19, 20–49, 50–64, and ≥65 y, where possible, and 1–8, 9–49, ≥50 y where zero cells preclude adjustment with finer age categories (indicated by †); not further age adjusted for 20–49 years. Referent age category was the last age group included in each analysis, e.g., for overall analyses it was the category ≥65 y, and for the analysis restricted to those <50 y, it was the category 20–49 y.</p>c<p>Fully adjusted includes chronic conditions (yes/no), age, province (as appropriate), and interval since ILI onset (≤4 d/>4 d);</p>d<p>Includes data only from Alberta, Ontario and Quebec; BC did not collect information on 2007–08 immunization status. Children <3 y excluded from these analyses.</p><p>NA, not applicable; NSS, insufficient sample size precluding reliable estimation.</p>", "links"=>[], "tags"=>["test-negative", "case-control", "ors", "tiv", "seasonal", "ph1n1", "stratified", "restrictions"], "article_id"=>526533, "categories"=>["Computational Biology", "Infectious Diseases", "Medicine", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.t003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sentinel_test_negative_case_control_study_ORs_95_CIs_for_2008_8211_09_TIV_effect_on_seasonal_and_pH1N1_illness_overall_and_stratified_by_age_with_adjustment_for_relevant_covariates_and_with_additional_restrictions_as_specified_/526533", "title"=>"Sentinel test-negative case-control study: ORs (95% CIs) for 2008–09 TIV effect on seasonal and pH1N1 illness overall and stratified by age, with adjustment for relevant covariates, and with additional restrictions as specified.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-06 01:48:53"}
  • {"files"=>["https://ndownloader.figshare.com/files/856196"], "description"=>"<p>Summary of study design, sample size and outcomes applied in evaluating the association between 2008–09 TIV receipt and pH1N1 risk.</p>", "links"=>[], "tags"=>["outcomes", "applied", "evaluating", "tiv", "receipt", "ph1n1"], "article_id"=>526607, "categories"=>["Computational Biology", "Infectious Diseases", "Medicine", "Biotechnology"], "users"=>["Danuta M. Skowronski", "Gaston De Serres", "Natasha S. Crowcroft", "Naveed Z. Janjua", "Nicole Boulianne", "Travis S. Hottes", "Laura C. Rosella", "James A. Dickinson", "Rodica Gilca", "Pam Sethi", "Najwa Ouhoummane", "Donald J. Willison", "Isabelle Rouleau", "Martin Petric", "Kevin Fonseca", "Steven J. Drews", "Anuradha Rebbapragada", "Hugues Charest", "Marie-Eve Hamelin", "Guy Boivin", "Jennifer L. Gardy", "Yan Li", "Trijntje L. Kwindt", "David M. Patrick", "Robert C. Brunham"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000258.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_study_design_sample_size_and_outcomes_applied_in_evaluating_the_association_between_2008_8211_09_TIV_receipt_and_pH1N1_risk_/526607", "title"=>"Summary of study design, sample size and outcomes applied in evaluating the association between 2008–09 TIV receipt and pH1N1 risk.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-04-06 01:50:07"}

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