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. 2022 Sep 24;16(6):984–990. doi: 10.1007/s11684-022-0930-5

Seroprevalence of influenza viruses in Shandong, Northern China during the COVID-19 pandemic

Chuansong Quan 1,#, Zhenjie Zhang 1,#, Guoyong Ding 2,#, Fengwei Sun 3,#, Hengxia Zhao 4,#, Qinghua Liu 5, Chuanmin Ma 1, Jing Wang 1, Liang Wang 1, Wenbo Zhao 1, Jinjie He 4, Yu Wang 6, Qian He 2, Michael J Carr 7,8, Dayan Wang 9, Qiang Xiao 5,✉, Weifeng Shi 1,2,✉
PMCID: PMC9510416  PMID: 36152125

Abstract

Nonpharmaceutical interventions (NPIs) have been commonly deployed to prevent and control the spread of the coronavirus disease 2019 (COVID-19), resulting in a worldwide decline in influenza prevalence. However, the influenza risk in China warrants cautious assessment. We conducted a cross-sectional, seroepidemiological study in Shandong Province, Northern China in mid-2021. Hemagglutination inhibition was performed to test antibodies against four influenza vaccine strains. A combination of descriptive and meta-analyses was adopted to compare the seroprevalence of influenza antibodies before and during the COVID-19 pandemic. The overall seroprevalence values against A/H1N1pdm09, A/H3N2, B/Victoria, and B/Yamagata were 17.8% (95% CI 16.2%–19.5%), 23.5% (95% CI 21.7%–25.4%), 7.6% (95% CI 6.6%–8.7%), and 15.0 (95% CI 13.5%–16.5%), respectively, in the study period. The overall vaccination rate was extremely low (2.6%). Our results revealed that antibody titers in vaccinated participants were significantly higher than those in unvaccinated individuals (P < 0.001). Notably, the meta-analysis showed that antibodies against A/H1N1pdm09 and A/H3N2 were significantly low in adults after the COVID-19 pandemic (P < 0.01). Increasing vaccination rates and maintaining NPIs are recommended to prevent an elevated influenza risk in China.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at 10.1007/s11684-022-0930-5 and is accessible for authorized users.

Keywords: influenza virus, seroprevalence, antibody, COVID-19, cross-sectional study

Acknowledgements

We thank the participants of this study, as well as the staff of the Second Affiliated Hospital of Shandong First Medical University and Boshan District Hospital who made the survey possible. We thank the help from Ti Liu and Julong Wu in Shandong Center for Disease Control and Prevention. This work was supported by the Academic Promotion Programme of Shandong First Medical University (No. 2019QL006) and the Natural Science Foundation of Shandong Province (Nos. ZR2020QH133, ZR2020MH339, and ZR2021MC001).

Supplementary Appendix

11684_2022_930_MOESM1_ESM.pdf (463.7KB, pdf)

Seroprevalence of influenza viruses in Shandong, Northern China during the COVID-19 pandemic

Footnotes

Compliance with ethics guidelines

Chuansong Quan, Zhenjie Zhang, Guoyong Ding, Fengwei Sun, Hengxia Zhao, Qinghua Liu, Chuanmin Ma, Jing Wang, Liang Wang, Wenbo Zhao, Jinjie He, Yu Wang, Qian He, Michael J. Carr, Dayan Wang, Qiang Xiao, and Weifeng Shi declare that they have no actual or potential competing financial interests. This study was approved by the Ethics Committee of Shandong First Medical University &amp; Shandong Academy of Medical Sciences (approved No. R202105170154). The study conformed to the principles of the Declaration of Helsinki, and the standards of Good Clinical Practice defined by the International Conference on Harmonization. Written informed consent was obtained from all adult participants, and from legal guardians for participants ≤ 15 years old.

These authors contributed equally to this work.

Contributor Information

Qiang Xiao, Email: tyfy8011@126.com.

Weifeng Shi, Email: shiwf@ioz.ac.cn.

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