Estimates of the effectiveness (VE) of the adjuvanted A(H1N1)pdm09 vaccine (when received ≥14 days before the index date) against hospitalization due to influenza or pneumonia by certain demographic and clinical characteristics.

<p>*Defined as diagnosis with one of following diseases: diabetes, chronic obstructive pulmonary disease, asthma, ischemic heart disease, chronic renal failure, or cancer (excluding non-melanoma skin cancer).</p><p>**Model A: Adjusted for age, gender, place of residence;</p><p>***Model B: Adjusted for Model A variables plus income, comorbidity, A(H1N1)pdm09 priority group, receiving the 2009/10 seasonal influenza vaccine, receiving a pneumococcal vaccine, immunosuppressed, pregnancy, ≥20 physician encounters in the last 5 years, ≥1 hospital admission in the last 5 years; use of antiviral prophylaxis and diagnosis of chronic renal failure.</p><p>Estimates of the effectiveness (VE) of the adjuvanted A(H1N1)pdm09 vaccine (when received ≥14 days before the index date) against hospitalization due to influenza or pneumonia by certain demographic and clinical characteristics.</p

Demographic and clinical characteristics of cases and controls.

<p>SD: standard deviation.</p><p>* Defined as diagnosis with one of following diseases: diabetes, chronic obstructive pulmonary disease, asthma, ischemic heart disease, chronic renal failure, or cancer (excluding non-melanoma skin cancer).</p><p>Demographic and clinical characteristics of cases and controls.</p

Number of tests and positivity rate at Cadham provincial laboratory.

Samples were analyzed by PCR analysis, and positive tests are tabulated using results from all samples analyzed per day. Data date range February 19, 2020 to July 28 2022.</p

Dorfman pooling schematic.

Samples are represented by tubes, and PCR tests are represented by green (negative) or red (positive) rounded rectangles. When a Dorfman pool is positive, deconvolution is required. When a positive pool is detected each sample is individually re-tested. Pool sizes of 4, for example would result in 7 total tests utilized for analysis of 12 samples. In addition, positivity rate, sensitivity, and efficiency gained need to be taken into consideration when choosing an appropriate pool size for large scale testing.</p

Test efficiency of Dorfman pooling.

The efficiency of utilizing Dorfman pooling at varying pool sizes adapted to positivity prevalence compared to individual testing. A positive value for tests saved represents a reduction in tests used compared to individual testing, and negative values represent an increase in the number of tests used.</p

Estimates of the effectiveness (VE) of pandemic, seasonal influenza and pneumococcal vaccine against hospitalization with laboratory-confirmed influenza^*.

<p>*In these analyses, individuals vaccinated before the identified time duration considered unvaccinated</p><p>**Model A: Adjusted for age, gender, place of residence;</p><p>***Model B: Adjusted for Model A variables plus income, comorbidity, A(H1N1)pdm09 priority group, receiving the 2009/10 seasonal influenza vaccine, receiving a pneumococcal vaccine, immunosuppressed, pregnancy, ≥20 physician encounters in the last 5 years, ≥1 hospital admission in the last 5 years; use of antiviral prophylaxis and diagnosis of chronic renal failure.</p><p>^† Exact numbers between 1–5 are not reported as required by the data custodian to protect patient confidentiality.</p><p>Estimates of the effectiveness (VE) of pandemic, seasonal influenza and pneumococcal vaccine against hospitalization with laboratory-confirmed influenza^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0142754#t004fn001" target="_blank">*</a>}.</p

Change in Dorfman Pooled Ct values for each pool size.

Individual unpooled Ct values are represented by solid lines, and pooled Ct values are graphed with dotted lines for each PCR target ORF1/a and E. Ct values are smoothed using an average of the nearest eight neighbours. A default Ct value of 40 was also instituted when pools had a result of “Target not detected” (Supplemental Material).</p

S1 Data -

PCR-based analysis is the gold standard for detection of SARS-CoV-2 and was used broadly throughout the pandemic. However, heightened demand for testing put strain on diagnostic resources and the adequate amount of PCR-based testing required exceeded existing testing capacity. Pooled testing strategies presented an effective method to increase testing capacity by decreasing the number of tests and resources required for laboratory PCR analysis of SARS-CoV-2. We sought to conduct an analysis of SARS-CoV-2 pooling schemes to determine the sensitivity of various sized Dorfman pooling strategies and evaluate the utility of using such pooling strategies in diagnostic laboratory settings. Overall, a trend of decreasing sensitivity with larger pool sizes was observed, with modest sensitivity losses in the largest pools tested, and high sensitivity in all other pools. Efficiency data was then calculated to determine the optimal Dorfman pool sizes based on test positivity rate. This was correlated with current presumptive test positivity to maximize the number of tests saved, thereby increasing testing capacity and resource efficiency in the community setting. Dorfman pooling methods were evaluated and found to offer a high-throughput solution to SARS-CoV-2 clinical testing that improve resource efficiency in low-resource environments.</div

Test sensitivity based on Dorfman pooling size.

True positive and false negative tests are determined against gold standard of individual testing.</p

Influenza vaccine effectiveness against hospitalization and all-cause mortality during influenza periods, 2000–01 to 2005–06 with and without adjustment for multiple and select covariates.

<p><b>Note.</b> IVE = influenza vaccine effectiveness; CI = confidence interval; Hosp = hospitalization with pneumonia, influenza, or acute respiratory disease listed as most responsible admission diagnosis; Death = all-cause mortality; SES = socioeconomic status.</p>a<p>Adjusted for all following covariates: age, sex, socio-economic status, urban residency, prior influenza immunization (two year), prior pneumococcal immunization, medical visits prior year, and Elixhauser index.</p>b<p>Adjusted for select influential covariates of age, prior influenza (two year) and pneumococcal immunization and medical visits prior year.</p>c<p>Matched on propensity scores, calculated based on age, sex, socio-economic status, urban residency, prior influenza immunization (two year), prior pneumococcal immunization, medical visits prior year, and Elixhauser index.</p>d<p>Select adjustment includes pneumococcal immunization, medical visits prior year, and age.</p>e<p>Data aggregated across all six seasons for hospitalization and across all seasons except 2003–04 for mortality.</p