tetano
Editor, Senior Moderator
Vaccine. 2018 Nov 9. pii: S0264-410X(18)31490-7. doi: 10.1016/j.vaccine.2018.10.093. [Epub ahead of print]
[h=1]Influenza vaccine effectiveness among patients with high-risk medical conditions in the United States, 2012-2016.[/h] Shang M[SUP]1[/SUP], Chung JR[SUP]2[/SUP], Jackson ML[SUP]3[/SUP], Jackson LA[SUP]3[/SUP], Monto AS[SUP]4[/SUP], Martin ET[SUP]4[/SUP], Belongia EA[SUP]5[/SUP], McLean HQ[SUP]5[/SUP], Gaglani M[SUP]6[/SUP], Murthy K[SUP]6[/SUP], Zimmerman RK[SUP]7[/SUP], Nowalk MP[SUP]7[/SUP], Fry AM[SUP]2[/SUP], Flannery B[SUP]8[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Annual influenza vaccination has been recommended for persons with high-risk conditions since the 1960s. However, few estimates of influenza vaccine effectiveness (VE) for persons with high-risk conditions are available.
[h=4]METHODS:[/h] Data from the U.S. Influenza Vaccine Effectiveness Network from 2012 to 2016 were analyzed to compare VE of standard-dose inactivated vaccines against medically-attended influenza among patients aged ≥6 months with and without high-risk medical conditions. Patients with acute respiratory illness were tested for influenza by RT-PCR. Presence of high-risk conditions and vaccination status were obtained from medical records. VE by influenza virus type/subtype and age group was calculated for patients with and without high-risk conditions using the test-negative design. Interaction terms were used to test for differences in VE by high-risk conditions.
[h=4]RESULTS:[/h] Overall, 9643 (38%) of 25,369 patients enrolled during four influenza seasons had high-risk conditions; 2213 (23%) tested positive for influenza infection. For all ages, VE against any influenza was lower among patients with high-risk conditions (41%, 95% CI: 35-47%) than those without (48%, 95% CI: 43-52%; P-for-interaction = 0.02). For children aged <18 years, VE against any influenza was 51% (95% CI: 39-61%) and 52% (95% CI: 39-61%) among those with and without high-risk conditions, respectively (P-for-interaction = 0.54). For adults aged ≥18 years, VE against any influenza was 38% (95% CI: 30-45%) and 44% (95% CI: 38-50%) among those with and without high-risk conditions, respectively (P-for-interaction = 0.21). For both children aged <18 and adults aged ≥18 years, VEs against illness related to influenza A(H3N2), A(H1N1)pdm09, and influenza B virus infection were similar among those with and without high-risk conditions.
[h=4]CONCLUSIONS:[/h] Influenza vaccination provided protection against medically-attended influenza among patients with high-risk conditions, at levels approaching those observed among patients without high-risk conditions. Results from our analysis support recommendations of annual vaccination for patients with high-risk conditions.
Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Acute respiratory illness; High-risk medical conditions; Influenza; Vaccine; Vaccine effectiveness
PMID: 30420119 DOI: 10.1016/j.vaccine.2018.10.093
[h=1]Influenza vaccine effectiveness among patients with high-risk medical conditions in the United States, 2012-2016.[/h] Shang M[SUP]1[/SUP], Chung JR[SUP]2[/SUP], Jackson ML[SUP]3[/SUP], Jackson LA[SUP]3[/SUP], Monto AS[SUP]4[/SUP], Martin ET[SUP]4[/SUP], Belongia EA[SUP]5[/SUP], McLean HQ[SUP]5[/SUP], Gaglani M[SUP]6[/SUP], Murthy K[SUP]6[/SUP], Zimmerman RK[SUP]7[/SUP], Nowalk MP[SUP]7[/SUP], Fry AM[SUP]2[/SUP], Flannery B[SUP]8[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Annual influenza vaccination has been recommended for persons with high-risk conditions since the 1960s. However, few estimates of influenza vaccine effectiveness (VE) for persons with high-risk conditions are available.
[h=4]METHODS:[/h] Data from the U.S. Influenza Vaccine Effectiveness Network from 2012 to 2016 were analyzed to compare VE of standard-dose inactivated vaccines against medically-attended influenza among patients aged ≥6 months with and without high-risk medical conditions. Patients with acute respiratory illness were tested for influenza by RT-PCR. Presence of high-risk conditions and vaccination status were obtained from medical records. VE by influenza virus type/subtype and age group was calculated for patients with and without high-risk conditions using the test-negative design. Interaction terms were used to test for differences in VE by high-risk conditions.
[h=4]RESULTS:[/h] Overall, 9643 (38%) of 25,369 patients enrolled during four influenza seasons had high-risk conditions; 2213 (23%) tested positive for influenza infection. For all ages, VE against any influenza was lower among patients with high-risk conditions (41%, 95% CI: 35-47%) than those without (48%, 95% CI: 43-52%; P-for-interaction = 0.02). For children aged <18 years, VE against any influenza was 51% (95% CI: 39-61%) and 52% (95% CI: 39-61%) among those with and without high-risk conditions, respectively (P-for-interaction = 0.54). For adults aged ≥18 years, VE against any influenza was 38% (95% CI: 30-45%) and 44% (95% CI: 38-50%) among those with and without high-risk conditions, respectively (P-for-interaction = 0.21). For both children aged <18 and adults aged ≥18 years, VEs against illness related to influenza A(H3N2), A(H1N1)pdm09, and influenza B virus infection were similar among those with and without high-risk conditions.
[h=4]CONCLUSIONS:[/h] Influenza vaccination provided protection against medically-attended influenza among patients with high-risk conditions, at levels approaching those observed among patients without high-risk conditions. Results from our analysis support recommendations of annual vaccination for patients with high-risk conditions.
Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Acute respiratory illness; High-risk medical conditions; Influenza; Vaccine; Vaccine effectiveness
PMID: 30420119 DOI: 10.1016/j.vaccine.2018.10.093