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Influenza Vaccine Effectiveness Against Influenza-Related Mortality in Australian Hospitalized Patients: A Propensity Score Analysis.
Nation, Monica L; Moss, Robert; Spittal, Matthew J; Kotsimbos, Tom; Kelly, Paul M; Cheng, Allen C.
Afiliação
  • Nation ML; Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
  • Moss R; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
  • Spittal MJ; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
  • Kotsimbos T; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
  • Kelly PM; Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, Monash University, Monash University, Melbourne, Victoria, Australia.
  • Cheng AC; Australian National University Medical School, Monash University, Canberra, Australian Capital Territory, Australia.
Clin Infect Dis ; 72(1): 99-107, 2021 01 23.
Article em En | MEDLINE | ID: mdl-31903487
BACKGROUND: Data on influenza vaccine effectiveness (IVE) against mortality are limited, with no Australian data to guide vaccine uptake. We aimed to assess IVE against influenza-related mortality in Australian hospitalized patients, assess residual confounding in the association between influenza vaccination and mortality, and assess whether influenza vaccination reduces the severity of influenza illness. METHODS: Data were collected between 2010 and 2017 from a national Australian hospital-based sentinel surveillance system using a case-control design. Adults and children admitted to the 17 study hospitals with acute respiratory symptoms were tested for influenza using nucleic acid testing; all eligible test-positive cases, and a subset of test-negative controls, were included. Propensity score analysis and multivariable logistic regression were used to determine the adjusted odds ratio (aOR) of vaccination, with IVE = 1 - aOR × 100%. Residual confounding was assessed by examining mortality in controls. RESULTS: Over 8 seasons, 14038 patients were admitted with laboratory-confirmed influenza. The primary analysis included 9298 cases and 6451 controls, with 194 cases and 136 controls dying during hospitalization. Vaccination was associated with a 31% (95% confidence interval [CI], 3%-51%; P = .033) reduction in influenza-related mortality, with similar estimates in the National Immunisation Program target group. Residual confounding was identified in patients ≥65 years old (aOR, 1.92 [95% CI, 1.06-3.46]; P = .031). There was no evidence that vaccination reduced the severity of influenza illness (aOR, 1.07 [95% CI, .76-1.50]; P = .713). CONCLUSIONS: Influenza vaccination is associated with a moderate reduction in influenza-related mortality. This finding reinforces the utility of the Australian vaccination program in protecting those most at risk of influenza-related deaths.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vacinas contra Influenza / Influenza Humana Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Child / Humans País/Região como assunto: Oceania Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vacinas contra Influenza / Influenza Humana Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Child / Humans País/Região como assunto: Oceania Idioma: En Ano de publicação: 2021 Tipo de documento: Article