tetano
Editor, Senior Moderator
J Infect
. 2024 Sep 18:106276.
doi: 10.1016/j.jinf.2024.106276. Online ahead of print. Time of day for vaccination, outcomes, and relative effectiveness of high-dose vs. standard-dose quadrivalent influenza vaccine: a post-hoc analysis of the DANFLU-1 randomized clinical trial
Jacob Christensen[SUP] 1 [/SUP], Niklas Dyrby Johansen[SUP] 1 [/SUP], Kira Hyldekær Janstrup[SUP] 1 [/SUP], Daniel Modin[SUP] 1 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 1 [/SUP], Joshua Nealon[SUP] 2 [/SUP], Sandrine Samson[SUP] 2 [/SUP], Matthew Loiacono[SUP] 3 [/SUP], Rebecca Harris[SUP] 4 [/SUP], Carsten Schade Larsen[SUP] 5 [/SUP], Anne Marie Reimer Jensen[SUP] 1 [/SUP], Nino Emanuel Landler[SUP] 1 [/SUP], Brian L Claggett[SUP] 6 [/SUP], Scott D Solomon[SUP] 7 [/SUP], Gunnar H Gislason[SUP] 8 [/SUP], Lars Køber[SUP] 9 [/SUP], Martin J Landray[SUP] 10 [/SUP], Pradeesh Sivapalan[SUP] 11 [/SUP], Jens Ulrik Stæhr Jensen[SUP] 11 [/SUP], Tor Biering-Sørensen[SUP] 12 [/SUP]
Affiliations
Objectives: Morning influenza vaccination enhances antibody response. In this posthoc analysis of the DANFLU-1 trial, we sought to evaluate the association between time of day for vaccination (ToV) and outcomes, and whether ToV modified the relative effectiveness of high-dose (QIV-HD) vs. standard-dose (QIV-SD) quadrivalent influenza vaccine.
Methods: DANFLU-1 was a pragmatic feasibility trial of QIV-HD vs. QIV-SD. Outcomes included hospitalizations and mortality. For subgroup analysis, the population was dichotomized at median ToV into two groups (early and late).
Results: The study population included 12,477 participants. Mean age was 71.7±3.9 years with 5,877 (47.1%) female participants. Median ToV was 11.29AM. Earlier ToV was associated with fewer respiratory hospitalizations independent of vaccine type, which persisted in adjusted analysis (IRR 0.88 per 1-hour decrement (95% CI 0.78- 0.98, p=0.025). No effect modification by continuous or dichotomous ToV was found. In subgroup analysis, effects consistently favored QIV-HD against hospitalizations for pneumonia or influenza (early: IRR 0.30; late: 0.29), all-cause hospitalizations (early: IRR 0.87; late: 0.86), and mortality (early: HR 0.53; late: 0.50).
Conclusion: In this exploratory post-hoc analysis, earlier ToV was associated with fewer respiratory hospitalizations. The relative effectiveness of QIV-HD vs. QIV-SD was not modified by ToV. Further research is needed to confirm findings.
Trial registration: Clinicaltrials.gov: NCT05048589.
Keywords: Influenza, Human; Outcome Assessment, Health Care; Pragmatic Clinical Trial; Vaccination.
. 2024 Sep 18:106276.
doi: 10.1016/j.jinf.2024.106276. Online ahead of print. Time of day for vaccination, outcomes, and relative effectiveness of high-dose vs. standard-dose quadrivalent influenza vaccine: a post-hoc analysis of the DANFLU-1 randomized clinical trial
Jacob Christensen[SUP] 1 [/SUP], Niklas Dyrby Johansen[SUP] 1 [/SUP], Kira Hyldekær Janstrup[SUP] 1 [/SUP], Daniel Modin[SUP] 1 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 1 [/SUP], Joshua Nealon[SUP] 2 [/SUP], Sandrine Samson[SUP] 2 [/SUP], Matthew Loiacono[SUP] 3 [/SUP], Rebecca Harris[SUP] 4 [/SUP], Carsten Schade Larsen[SUP] 5 [/SUP], Anne Marie Reimer Jensen[SUP] 1 [/SUP], Nino Emanuel Landler[SUP] 1 [/SUP], Brian L Claggett[SUP] 6 [/SUP], Scott D Solomon[SUP] 7 [/SUP], Gunnar H Gislason[SUP] 8 [/SUP], Lars Køber[SUP] 9 [/SUP], Martin J Landray[SUP] 10 [/SUP], Pradeesh Sivapalan[SUP] 11 [/SUP], Jens Ulrik Stæhr Jensen[SUP] 11 [/SUP], Tor Biering-Sørensen[SUP] 12 [/SUP]
Affiliations
- PMID: 39303788
- DOI: 10.1016/j.jinf.2024.106276
Objectives: Morning influenza vaccination enhances antibody response. In this posthoc analysis of the DANFLU-1 trial, we sought to evaluate the association between time of day for vaccination (ToV) and outcomes, and whether ToV modified the relative effectiveness of high-dose (QIV-HD) vs. standard-dose (QIV-SD) quadrivalent influenza vaccine.
Methods: DANFLU-1 was a pragmatic feasibility trial of QIV-HD vs. QIV-SD. Outcomes included hospitalizations and mortality. For subgroup analysis, the population was dichotomized at median ToV into two groups (early and late).
Results: The study population included 12,477 participants. Mean age was 71.7±3.9 years with 5,877 (47.1%) female participants. Median ToV was 11.29AM. Earlier ToV was associated with fewer respiratory hospitalizations independent of vaccine type, which persisted in adjusted analysis (IRR 0.88 per 1-hour decrement (95% CI 0.78- 0.98, p=0.025). No effect modification by continuous or dichotomous ToV was found. In subgroup analysis, effects consistently favored QIV-HD against hospitalizations for pneumonia or influenza (early: IRR 0.30; late: 0.29), all-cause hospitalizations (early: IRR 0.87; late: 0.86), and mortality (early: HR 0.53; late: 0.50).
Conclusion: In this exploratory post-hoc analysis, earlier ToV was associated with fewer respiratory hospitalizations. The relative effectiveness of QIV-HD vs. QIV-SD was not modified by ToV. Further research is needed to confirm findings.
Trial registration: Clinicaltrials.gov: NCT05048589.
Keywords: Influenza, Human; Outcome Assessment, Health Care; Pragmatic Clinical Trial; Vaccination.