Influenza vaccination effectiveness for people aged under 65years in Japan, 2013/2014 season: application of a doubly robust method to a large-scale, real-world dataset
Influenza vaccination effectiveness for people aged under 65years in Japan, 2013/2014 season: application of a doubly robust method to a large-scale, real-world dataset
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DOI：
10.1186/s12879-019-4186-x
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发表时间：
2019-07-05
影响因子：
3.7
通讯作者：
Urushihara, Hisashi
中科院分区：
文献类型：
--
作者：
Shibata, Natsumi;Kimura, Shinya;Urushihara, Hisashi
背景流感疫苗接种被认为是预防患者患病、减轻流感给医学界和经济带来的社会负担的主要公共卫生干预措施。到目前为止，日本还没有进行过流感疫苗接种的有效性研究，包括年龄跨度较大的大量人群。在这里，我们评估了大量日本人接种流感疫苗的临床效果。方法我们使用大规模的员工医疗保险计划索赔数据库进行了一项队列研究。使用流感疫苗接种补贴的计划记录来确定疫苗接种状态。由于无法获得疫苗接种记录，我们排除了65岁或以上的人。结果在2013/2014流感季节，369,425名1岁至64岁的受试者符合条件。经双稳健校正后，疫苗接种率为39.5%，流感发病的估计优势比(OR)为0.775。年龄分层的OR值在所有年龄组中都显著降低；1至4岁的受试者最低(0.600)，13至19岁的受试者最高(0.938)。所有流感并发症的ORS也有统计学意义(0.403-0.709)。结论我们证实了1-64岁人群接种流感疫苗的临床效果。接种流感疫苗显著预防了流感的发生，并在减少流感并发症的继发性风险方面更有效。
BackgroundInfluenza vaccination is recognized as a primary public health intervention which prevents the illness of patients and relieves the societal burdens of influenza for medical community as well as the economy. To date, no effectiveness study of influenza vaccination has been conducted including a large population with a wide age span, in Japan. Here, we evaluated the clinical effectiveness of influenza vaccination in a large Japanese population.MethodsWe conducted a cohort study using a large-scale claims database for employee health care insurance plans. Vaccination status was identified using plan records for influenza vaccination subsidies. We excluded people aged 65years or more because of the unavailability of vaccination records. Effectiveness of vaccination in preventing influenza and its complication was evaluated with doubly robust methods using inversed probability treatment weighting to adjust health conscious behaviours and other confounders.ResultsDuring the 2013/2014 influenza season, 369,425 subjects with age range from 1 to 64years were eligible. Vaccination rate was 39.5% and an estimated odds ratio (OR) for influenza onset was 0.775 after doubly robust adjustment. Age-stratified ORs were significantly reduced in all age groups; lowest in subjects aged 1 to 4years (0.600) and highest in those aged 13 to 19 (0.938). ORs for all the influenza complication outcomes were also statistically significant (0.403-0.709).ConclusionsWe confirmed the clinical effectiveness of influenza vaccination in people aged 1 to 64years. Influenza vaccination significantly prevented influenza onset and was more effective in reducing secondary risks of influenza complications.