Does Influenza Vaccination Modify Influenza Severity? Data on Older Adults Hospitalized With Influenza During the 2012-2013 Season in the United States
Does Influenza Vaccination Modify Influenza Severity? Data on Older Adults Hospitalized With Influenza During the 2012-2013 Season in the United States
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DOI：
10.1093/infdis/jiv200
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发表时间：
2015-10-15
影响因子：
6.4
通讯作者：
Chaves, Sandra S.
中科院分区：
文献类型：
--
作者：
Arriola, Carmen S.;Anderson, Evan J.;Chaves, Sandra S.
背景。一些研究表明，流感疫苗接种可能对接种疫苗后感染流感的人有保护作用。我们使用来自大型监测网络的数据，进一步调查流感疫苗接种对实验室确诊流感住院的50岁成人流感严重程度的影响。我们利用流感住院监测网络（FluSurv-NET） 2012-2013年流感季节的数据分析了流感疫苗接种和流感严重程度。重症监护病房（ICU）入院、死亡、肺炎诊断以及住院和ICU住院时间作为疾病严重程度的衡量标准。采用多变量logistic回归、参数生存模型和倾向评分匹配（PSM）对数据进行分析。总体而言，在多变量logistic回归模型中没有观察到严重程度的差异。使用PSM，接种流感疫苗的50-64岁成年人（而不是其他年龄组）比未接种流感疫苗的人在ICU的住院时间短（出院风险比为1.84；95%可信区间为1.12-3.01）。我们的研究结果显示流感疫苗接种对疾病严重程度的影响不大。需要对具有不同优势菌株的季节数据进行分析，并对疫苗有效性进行更高的估计。
Background. Some studies suggest that influenza vaccination might be protective against severe influenza outcomes in vaccinated persons who become infected. We used data from a large surveillance network to further investigate the effect of influenza vaccination on influenza severity in adults aged >= 50 years who were hospitalized with laboratory-confirmed influenza.Methods. We analyzed influenza vaccination and influenza severity using Influenza Hospitalization Surveillance Network (FluSurv-NET) data for the 2012-2013 influenza season. Intensive care unit (ICU) admission, death, diagnosis of pneumonia, and hospital and ICU lengths of stay served as measures of disease severity. Data were analyzed by multivariable logistic regression, parametric survival models, and propensity score matching (PSM).Results. Overall, no differences in severity were observed in the multivariable logistic regression model. Using PSM, adults aged 50-64 years (but not other age groups) who were vaccinated against influenza had a shorter length of ICU stay than those who were unvaccinated (hazard ratio for discharge, 1.84; 95% confidence interval, 1.12-3.01).Conclusions. Our findings show a modest effect of influenza vaccination on disease severity. Analysis of data from seasons with different predominant strains and higher estimates of vaccine effectiveness are needed.