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Influenza vaccination in community-dwelling elderly: impact on mortality and influenza-associated morbidity.
Arch Intern Med 2003; 163(9):1089-94AI

Abstract

BACKGROUND

Influenza-related morbidity and mortality have been extensively studied with hospital and reimbursement data. However, little is known about the effectiveness of the annual vaccination programs in generally healthy community-dwelling elderly. The objective of our study was to investigate the effectiveness of influenza vaccination in community-dwelling elderly during the 1996 to 1997 influenza epidemic.

METHODS

We performed a population-based cohort study using the computerized Integrated Primary Care Information database in the Netherlands. Subjects who were 65 years and older in 1996 with a permanent status in a practice in the source population were considered eligible for study participation. Two cohorts were defined on the basis of vaccination status. We estimated and compared all-cause mortality, pneumonia, and clinical influenza infection rates between the cohorts.

RESULTS

Influenza vaccination was associated with a significant reduction of morbidity and mortality in vaccinated elderly (relative risk [RR], 0.72; 95% confidence interval [CI], 0.60-0.87). Influenza infections decreased significantly in the vaccinated population (RR, 0.48; 95% CI, 0.26-0.91). Mortality was reduced significantly in elderly with comorbidity (RR, 0.67; 95% CI, 0.48-0.94). The risk reduction for pneumonia was nonsignificant (RR, 0.77; 95% CI, 0.55-1.07) but was temporally related to the peak influenza activity.

CONCLUSIONS

In this study, influenza vaccination was associated with decreased mortality and influenza infections in community-dwelling elderly. Our results indicate that, in a season of mild influenza activity and good antigenic match between vaccine strains and circulating strains, influenza vaccination reduced mortality in the vaccinated population. Our data support an annual vaccination strategy for all community-dwelling elderly.

Authors+Show Affiliations

Pharmaco-epidemiology Unit, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12742808

Citation

Voordouw, Bettie C G., et al. "Influenza Vaccination in Community-dwelling Elderly: Impact On Mortality and Influenza-associated Morbidity." Archives of Internal Medicine, vol. 163, no. 9, 2003, pp. 1089-94.
Voordouw BC, van der Linden PD, Simonian S, et al. Influenza vaccination in community-dwelling elderly: impact on mortality and influenza-associated morbidity. Arch Intern Med. 2003;163(9):1089-94.
Voordouw, B. C., van der Linden, P. D., Simonian, S., van der Lei, J., Sturkenboom, M. C., & Stricker, B. H. (2003). Influenza vaccination in community-dwelling elderly: impact on mortality and influenza-associated morbidity. Archives of Internal Medicine, 163(9), pp. 1089-94.
Voordouw BC, et al. Influenza Vaccination in Community-dwelling Elderly: Impact On Mortality and Influenza-associated Morbidity. Arch Intern Med. 2003 May 12;163(9):1089-94. PubMed PMID: 12742808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza vaccination in community-dwelling elderly: impact on mortality and influenza-associated morbidity. AU - Voordouw,Bettie C G, AU - van der Linden,Paul D, AU - Simonian,Simon, AU - van der Lei,Johan, AU - Sturkenboom,Miriam C J M, AU - Stricker,Bruno H C, PY - 2003/5/14/pubmed PY - 2003/5/29/medline PY - 2003/5/14/entrez SP - 1089 EP - 94 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 163 IS - 9 N2 - BACKGROUND: Influenza-related morbidity and mortality have been extensively studied with hospital and reimbursement data. However, little is known about the effectiveness of the annual vaccination programs in generally healthy community-dwelling elderly. The objective of our study was to investigate the effectiveness of influenza vaccination in community-dwelling elderly during the 1996 to 1997 influenza epidemic. METHODS: We performed a population-based cohort study using the computerized Integrated Primary Care Information database in the Netherlands. Subjects who were 65 years and older in 1996 with a permanent status in a practice in the source population were considered eligible for study participation. Two cohorts were defined on the basis of vaccination status. We estimated and compared all-cause mortality, pneumonia, and clinical influenza infection rates between the cohorts. RESULTS: Influenza vaccination was associated with a significant reduction of morbidity and mortality in vaccinated elderly (relative risk [RR], 0.72; 95% confidence interval [CI], 0.60-0.87). Influenza infections decreased significantly in the vaccinated population (RR, 0.48; 95% CI, 0.26-0.91). Mortality was reduced significantly in elderly with comorbidity (RR, 0.67; 95% CI, 0.48-0.94). The risk reduction for pneumonia was nonsignificant (RR, 0.77; 95% CI, 0.55-1.07) but was temporally related to the peak influenza activity. CONCLUSIONS: In this study, influenza vaccination was associated with decreased mortality and influenza infections in community-dwelling elderly. Our results indicate that, in a season of mild influenza activity and good antigenic match between vaccine strains and circulating strains, influenza vaccination reduced mortality in the vaccinated population. Our data support an annual vaccination strategy for all community-dwelling elderly. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/12742808/Influenza_vaccination_in_community_dwelling_elderly:_impact_on_mortality_and_influenza_associated_morbidity_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/163/pg/1089 DB - PRIME DP - Unbound Medicine ER -