tetano
Editor, Senior Moderator
J Infect Dis. 2018 Feb 14. doi: 10.1093/infdis/jiy088. [Epub ahead of print]
[h=1]Relative Vaccine Effectiveness of High-Dose versus Standard-Dose Influenza Vaccines among Veterans Health Administration Patients.[/h] Young-Xu Y[SUP]1,[/SUP][SUP]2[/SUP], Van Aalst R[SUP]1[/SUP], Mahmud SM[SUP]3,[/SUP][SUP]4[/SUP], Rothman KJ[SUP]5,[/SUP][SUP]6[/SUP], Thornton Snider J[SUP]7[/SUP], Westreich D[SUP]8[/SUP], Mor V[SUP]9,[/SUP][SUP]10[/SUP], Gravenstein S[SUP]10,[/SUP][SUP]11,[/SUP][SUP]12,[/SUP][SUP]13[/SUP], Lee JKH[SUP]14,[/SUP][SUP]15[/SUP], Thommes EW[SUP]16,[/SUP][SUP]17[/SUP], Decker MD[SUP]16,[/SUP][SUP]18[/SUP], Chit A[SUP]14,[/SUP][SUP]16[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] To examine whether a high-dose inactivated influenza vaccine was more efficacious in preventing hospitalizations than a standard-dose vaccine in the Veterans Health Administration (VHA) senior population.
[h=4]Methods:[/h] This study estimated the relative vaccine effectiveness (rVE) of high-dose versus standard-dose using a retrospective cohort of VHA patients 65 years of age or older in the 2015-16 influenza season. To adjust for measured confounders, we matched each high-dose recipient with up to four standard-dose recipients vaccinated at the same location within a two-week period and having two or more pre-existing medical co-morbidities. We used the previous event rate ratio method (PERR), a type of difference-in-differences analysis, to adjust for unmeasured confounders.
[h=4]Findings:[/h] We evaluated 104,965 standard-dose and 125,776 high-dose recipients; matching decreased the population to 49,091 standard-dose and 24,682 high-dose recipients. The matched, PERR-adjusted rVE was 25% (95% CI: 2-43%) against influenza- or pneumonia-associated hospitalization, 7% (95% CI: -2-14%) against all-cause hospitalization, 14% (95% CI: -8-32%) against influenza- or pneumonia-associated outpatient visit, 5% (95% CI: 2-8%) against all-cause outpatient visit, and 38% (95% CI: -5-65%) against laboratory-confirmed influenza.
[h=4]Interpretation:[/h] In protecting senior VHA patients against influenza- or pneumonia-associated hospitalization, a high-dose influenza vaccine is more effective than a standard-dose vaccine.
PMID: 29452380 DOI: 10.1093/infdis/jiy088
[h=1]Relative Vaccine Effectiveness of High-Dose versus Standard-Dose Influenza Vaccines among Veterans Health Administration Patients.[/h] Young-Xu Y[SUP]1,[/SUP][SUP]2[/SUP], Van Aalst R[SUP]1[/SUP], Mahmud SM[SUP]3,[/SUP][SUP]4[/SUP], Rothman KJ[SUP]5,[/SUP][SUP]6[/SUP], Thornton Snider J[SUP]7[/SUP], Westreich D[SUP]8[/SUP], Mor V[SUP]9,[/SUP][SUP]10[/SUP], Gravenstein S[SUP]10,[/SUP][SUP]11,[/SUP][SUP]12,[/SUP][SUP]13[/SUP], Lee JKH[SUP]14,[/SUP][SUP]15[/SUP], Thommes EW[SUP]16,[/SUP][SUP]17[/SUP], Decker MD[SUP]16,[/SUP][SUP]18[/SUP], Chit A[SUP]14,[/SUP][SUP]16[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] To examine whether a high-dose inactivated influenza vaccine was more efficacious in preventing hospitalizations than a standard-dose vaccine in the Veterans Health Administration (VHA) senior population.
[h=4]Methods:[/h] This study estimated the relative vaccine effectiveness (rVE) of high-dose versus standard-dose using a retrospective cohort of VHA patients 65 years of age or older in the 2015-16 influenza season. To adjust for measured confounders, we matched each high-dose recipient with up to four standard-dose recipients vaccinated at the same location within a two-week period and having two or more pre-existing medical co-morbidities. We used the previous event rate ratio method (PERR), a type of difference-in-differences analysis, to adjust for unmeasured confounders.
[h=4]Findings:[/h] We evaluated 104,965 standard-dose and 125,776 high-dose recipients; matching decreased the population to 49,091 standard-dose and 24,682 high-dose recipients. The matched, PERR-adjusted rVE was 25% (95% CI: 2-43%) against influenza- or pneumonia-associated hospitalization, 7% (95% CI: -2-14%) against all-cause hospitalization, 14% (95% CI: -8-32%) against influenza- or pneumonia-associated outpatient visit, 5% (95% CI: 2-8%) against all-cause outpatient visit, and 38% (95% CI: -5-65%) against laboratory-confirmed influenza.
[h=4]Interpretation:[/h] In protecting senior VHA patients against influenza- or pneumonia-associated hospitalization, a high-dose influenza vaccine is more effective than a standard-dose vaccine.
PMID: 29452380 DOI: 10.1093/infdis/jiy088