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Contact
WHO Collaborating Centre for Reference and Research on Influenza (VIDRL)
Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street
Melbourne VIC 3000 Australia

T +61 3 9342 9300
F +61 3 9342 9329
whoflu@influenzacentre.org


Epidemiology

A/Prof Sheena Sullivan
Senior Epidemiologist
Adjunct Assistant Professor, Department of Epidemiology, University of California, Los Angeles
Adjunct Associate Professor, Centre for Epidemiology and Biostatistics, The University of Melbourne
Visiting Research Fellow, School of Population Health, The University of Adelaide


Email: sheena.sullivan@influenzacentre.org


Research Interests
Influenza viruses undergo frequent antigenic changes and thus influenza vaccination in one season may no longer confer protection in a subsequent season. Moreover, the severity, timing and strains circulating may differ across seasons. Thus, there is a need to estimate influenza vaccine effectiveness on an annual basis to better understand the protection conferred by the vaccine. In recent years, there has been a dramatic increase in the number of countries reporting annual influenza vaccine effectiveness estimates using routine surveillance data. In these studies, patients presenting with influenza-like illness are recruited into the surveillance programme, swabbed and tested for influenza. Vaccination status is recorded and those testing positive are compared with those testing negative to obtain an influenza vaccine effectiveness estimate. There are three such surveillance systems operating in Australia, and the epidemiology group has been working with all three of these to make estimates of vaccine effectiveness and understand methodological issues in the study design used. We have also been exploring the validity of pooling data from these three systems to increase precision and generate estimates for sub-populations. Finally, we are exploring the roles played by antigenic and genetic drift in annual estimates of vaccine effectiveness.

The group is also interested in understanding vaccination uptake in certain populations and is working with VIDRL to use a novel type of questionnaire that explores the trade-offs made by people when choosing whether or not to get vaccinated. Initially, this questionnaire is being trialled among health care workers, where vaccination tends to be high, and will later be used in populations with low vaccination uptake, including cancer patients.

Research projects
  1. Understanding the validity of the test-negative design for studies of influenza vaccine effectiveness (with School of Public Health, University of Hong Kong).
  2. Pooling influenza vaccine effectiveness surveillance data across Australia (with Sentinel Practices Network of Western Australia, Australian Sentinel Practices Research Network, and General Practice Sentinel Surveillance of Victoria).
  3. Understanding the role of vaccination in genetic drift.
  4. Use of a discrete choice experiment to determine the factors considered, and the trade-offs made, by health care workers when deciding whether to receive the seasonal influenza vaccine (with Epidemiology Unit, VIDRL).
  5. Understanding influenza vaccination uptake among cancer patients (with Peter MacCallum Cancer Centre).

Related publications
Kelly HA, Sullivan SG, Grant KA, Fielding JE. Moderate influenza vaccine effectiveness with variable effectiveness by match between circulating and vaccine strains in Australian adults aged 20-64 years, 2007-2011. Influenza Other Respi Viruses. 2013; 7:729-37. doi: 10.1111/irv.12018. PubMed link

Sullivan SG, Kelly H. Stratified estimates of influenza vaccine effectiveness by prior vaccination: caution required. Clin Infect Dis. 2013; 57:474-6. doi: 10.1093/cid/cit255. PubMed link

Sullivan SG, Tay EL, Kelly H. Variable definitions of the influenza season and their impact on vaccine effectiveness estimates. Vaccine. 2013; 31:4280-3. doi: 10.1016/j.vaccine.2013.06.103. PubMed link

Fielding J, Grant K, Franklin L, Sullivan S, Papadakis G, Kelly H, Cheng A. Epidemiology of the 2012 influenza season in Victoria, Australia. Western Pacific Surveillance and Response Journal. 2013, 4(3). doi:10.5365/wpsar.2013.4.2.007. PubMed link

Sullivan SG, Kelly H. Late season interim estimates of influenza vaccine effectiveness reliably predict end of season estimates in Victoria, Australia. Euro Surveillance. 2013; 18(41):20605. PubMed link

Sullivan SG, Komadina K, Grant K, Jelley L, Papadakis G, Kelly H. Influenza vaccine effectiveness during the 2012 influenza season in Victoria, Australia: influences of waning immunity and vaccine match. J Med Virol. 2014; 86:1017-25. PubMed link.

Sullivan SG, Barr IG. Communicating the imperfect protection of today's influenza vaccines. Australas Epidemiol. 2014; 21(1): p. 40-43.

Sullivan SG, Chilver MB, Higgins G, Cheng AC, Stocks NP. Influenza vaccine effectiveness in Australia: results from the Australian Sentinel Practices Research Network. Med J Aust. 2014;201(2):109-11. PubMed link

Levy A, Sullivan SG, Tempone S, Wong K, Regan A, Dowse G, Effler P, Smith D. Pooled influenza vaccine effectiveness estimates for Western Australia, 2010 to 2012. Vaccine. doi: 10.1016/j.vaccine.2014.08.066.(Epub ahead of print) PubMed link.

Sullivan SG, Feng S, Cowling BJ. Influenza vaccine effectiveness: potential of the test-negative design. A systematic review. Expert Review of Vaccines (in press).

All relevant publications (PubMed listing)
All publications from the Centre

Antivirals and animal influenzas group
Early immune response group

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