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Using population-wide administrative and laboratory data to estimate type- and subtype-specific influenza vaccine effectiveness: a surveillance protocol
  1. Allison Nicole Scott1,2,
  2. Sarah A Buchan3,4,5,
  3. Jeffrey C Kwong3,4,5,6,
  4. Steven J Drews7,
  5. Kimberley A Simmonds1,8,
  6. Lawrence W Svenson1,8,9,10
  1. 1 Ministry of Health, Government of Alberta, Edmonton, Alberta, Canada
  2. 2 Department of Public Health, Concordia University of Edmonton, Edmonton, Alberta, Canada
  3. 3 Populations and Public Health Research Program, ICES, Toronto, Ontario, Canada
  4. 4 Public Health Sciences, Public Health Ontario, Toronto, Ontario, Canada
  5. 5 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  6. 6 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  7. 7 Canadian Blood Services, Edmonton, Alberta, Canada
  8. 8 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  9. 9 Division of Preventive Medicine, University of Alberta, Edmonton, Alberta, Canada
  10. 10 School of Public Health, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Allison Nicole Scott; AScott{at}


Introduction The appropriateness of using routinely collected laboratory data combined with administrative data for estimating influenza vaccine effectiveness (VE) is still being explored. This paper outlines a protocol to estimate influenza VE using linked laboratory and administrative data which could act as a companion to estimates derived from other methods.

Methods and analysis We will use the test-negative design to estimate VE for each influenza type/subtype and season. Province-wide individual-level records of positive and negative influenza tests at the Provincial Laboratory for Public Health in Alberta will be linked, by unique personal health numbers, to administrative databases and vaccination records held at the Ministry of Health in Alberta to determine covariates and influenza vaccination status, respectively. Covariates of interests include age, sex, immunocompromising chronic conditions and healthcare setting. Cases will be defined based on an individual’s first positive influenza test during the season, and potential controls will be defined based on an individual’s first negative influenza test during the season. One control for each case will be randomly selected based on the week the specimen was collected. We will estimate VE using multivariable logistic regression.

Ethics and dissemination Ethics approval was obtained from the University of Alberta’s Health Research Ethics Board—Health Panel under study ID Pro00075997. Results will be disseminated by public health officials in Alberta.

  • influenza
  • vaccine effectiveness
  • test-negative
  • administrative data
  • population-level
  • laboratory data
  • vaccination database

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors ANS and SJD conceived of and designed the protocol and drafted and revised the manuscript. KAS and LWS planned the original approach, providing guidance on available administrative database resources. SAB and JCK made substantial contributions to the design and critically revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval and consent to participate Ethics approval was obtained from the University of Alberta’s Health Research Ethics Board—Health Panel under study ID Pro00075997.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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