Adjuvanted versus nonadjuvanted influenza vaccines and risk of hospitalizations for pneumonia and cerebro/cardiovascular events in the elderly
Adjuvanted versus nonadjuvanted influenza vaccines and risk of hospitalizations for pneumonia and cerebro/cardiovascular events in the elderly
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DOI：
10.1080/14760584.2019.1622418
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发表时间：
2019-05-31
影响因子：
6.2
通讯作者：
Cricelli, Claudio
中科院分区：
文献类型：
--
作者：
Lapi, Francesco;Marconi, Ettore;Cricelli, Claudio
背景资料：考虑到流感季节少、局部和异质性环境，发现MF 59（R）佐剂三价流感疫苗（MF 59-TIV）在预防流感相关住院方面的有效性高于无佐剂TIV。本研究评价了MF 59-TIV与无佐剂TIV在连续15个流感季节中对肺炎和脑/心血管事件住院风险的相对疫苗有效性（rVE）。研究设计和方法：使用健康搜索数据库，在MF 59-TIV或TIV疫苗接种的老年人队列中进行病例对照研究。使用条件logistic回归估计接种MF 59-TIV或TIV疫苗的患者中可能与流感相关的住院的比值比和95%置信区间（CI）。结果如下：在首次接种MF 59-TIV（66.2%）和TIV（33.8%）的43，000例患者中，在15个流感季节期间确定了103例因肺炎或脑/心血管事件住院（0.11/1，000人-周）。与TIV相比，MF 59-TIV与肺炎和脑/心血管事件住院风险降低相关[rVE：39%（95% CI：4-61%）]。结论：在15个季节的老年人队列中，与无佐剂TIV相比，MF 59-TIV似乎降低了因肺炎和脑/心血管事件住院的风险。我们的研究结果支持MF 59-TIV在老年人群中的建议。
Background: The higher effectiveness of MF59 (R)-adjuvanted trivalent influenza vaccine (MF59-TIV) vs. nonadjuvanted TIV in preventing influenza-related hospitalizations was found considering few influenza seasons, local and heterogeneous settings. This study evaluated the relative vaccine effectiveness (rVE) of MF59-TIV vs. nonadjuvanted TIV on the risk of hospitalization for pneumonia and cerebro/cardiovascular events across 15 consecutive influenza seasons. Research design and methods: Using Health Search Database, a case-control study was nested in a cohort of elderly vaccinated with MF59-TIV or TIV. Conditional logistic regression was used to estimate the odds ratio with 95% confidence intervals (CI) of hospitalizations potentially related to influenza in patients vaccinated with MF59-TIV or TIV. Results: Of 43,000 patients vaccinated with MF59-TIV (66.2%) and TIV (33.8%) for the first time, 103 cases of hospitalization for pneumonia or cerebro/cardiovascular events (0.11 per 1,000 person-weeks) during 15 influenza seasons were identified. The MF59-TIV was associated with a reduced risk of hospitalizations for pneumonia and cerebro/cardiovascular events vs. TIV [rVE: 39% (95% CI: 4-61%)]. Conclusions: In a 15-season cohort of elderly, MF59-TIV seems to reduce the risk of hospitalizations for pneumonia and cerebro/cardiovascular events when compared with nonadjuvanted TIV. Our findings support the recommendation for MF59-TIV in the elderly population.