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Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly.

Abstract

During the winter of 1989-1990, influenza type A(H3N2) circulated widely, causing excess morbidity and mortality nationwide. From November through April, 1989-1990, hospitalized cases of pneumonia and influenza occurring among noninstitutionalized individuals 65 or more years of age were identified by 20 acute care hospitals in southern lower Michigan. These cases were group matched on age, sex, race, and zip code to randomly sampled, community-based controls from a comprehensive listing of Medicare beneficiaries residing in the study area. Self-reported data were collected from cases and controls on influenza vaccine status for the 1989-1990 season and on a number of other factors which could have influenced vaccination status or outcome. Questionnaires were completed by 1,907 individuals, 449 of whom were cases, resulting in an overall response rate of 76%. A community-based influenza surveillance system was implemented to determine the timing and intensity of viral activity and influenza-like illness. Vaccine effectiveness in preventing overall pneumonia and influenza hospitalizations was estimated by logistic regression. During the 3-month period of surveillance-confirmed peak influenza type A(H3N2) circulation, vaccine effectiveness was 45% (95% confidence interval 14-64, p = 0.009). However, during the 3-month period of low or absent virus activity, identical methodology and model specification resulted in an effectiveness estimate of 21% that was not statistically different from zero (p = 0.36). The effectiveness determined during the peak period of virus circulation is felt to be a conservative estimate, since agents other than influenza are responsible for pneumonia and influenza hospitalizations, even during times of peak influenza activity.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology, School of Public Health I, University of Michigan, Ann Arbor 48109-2029.

    , , , , ,

    Source

    American journal of epidemiology 136:3 1992 Aug 01 pg 296-307

    MeSH

    Aged
    Aged, 80 and over
    Bacterial Vaccines
    Case-Control Studies
    Comorbidity
    Continental Population Groups
    Female
    Hospitalization
    Humans
    Influenza A virus
    Influenza Vaccines
    Influenza, Human
    Logistic Models
    Male
    Michigan
    Pneumonia, Pneumococcal
    Population Surveillance
    Risk Factors
    Seasons

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    1415151

    Citation

    Foster, D A., et al. "Influenza Vaccine Effectiveness in Preventing Hospitalization for Pneumonia in the Elderly." American Journal of Epidemiology, vol. 136, no. 3, 1992, pp. 296-307.
    Foster DA, Talsma A, Furumoto-Dawson A, et al. Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. Am J Epidemiol. 1992;136(3):296-307.
    Foster, D. A., Talsma, A., Furumoto-Dawson, A., Ohmit, S. E., Margulies, J. R., Arden, N. H., & Monto, A. S. (1992). Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. American Journal of Epidemiology, 136(3), pp. 296-307.
    Foster DA, et al. Influenza Vaccine Effectiveness in Preventing Hospitalization for Pneumonia in the Elderly. Am J Epidemiol. 1992 Aug 1;136(3):296-307. PubMed PMID: 1415151.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. AU - Foster,D A, AU - Talsma,A, AU - Furumoto-Dawson,A, AU - Ohmit,S E, AU - Margulies,J R, AU - Arden,N H, AU - Monto,A S, PY - 1992/8/1/pubmed PY - 1992/8/1/medline PY - 1992/8/1/entrez SP - 296 EP - 307 JF - American journal of epidemiology JO - Am. J. Epidemiol. VL - 136 IS - 3 N2 - During the winter of 1989-1990, influenza type A(H3N2) circulated widely, causing excess morbidity and mortality nationwide. From November through April, 1989-1990, hospitalized cases of pneumonia and influenza occurring among noninstitutionalized individuals 65 or more years of age were identified by 20 acute care hospitals in southern lower Michigan. These cases were group matched on age, sex, race, and zip code to randomly sampled, community-based controls from a comprehensive listing of Medicare beneficiaries residing in the study area. Self-reported data were collected from cases and controls on influenza vaccine status for the 1989-1990 season and on a number of other factors which could have influenced vaccination status or outcome. Questionnaires were completed by 1,907 individuals, 449 of whom were cases, resulting in an overall response rate of 76%. A community-based influenza surveillance system was implemented to determine the timing and intensity of viral activity and influenza-like illness. Vaccine effectiveness in preventing overall pneumonia and influenza hospitalizations was estimated by logistic regression. During the 3-month period of surveillance-confirmed peak influenza type A(H3N2) circulation, vaccine effectiveness was 45% (95% confidence interval 14-64, p = 0.009). However, during the 3-month period of low or absent virus activity, identical methodology and model specification resulted in an effectiveness estimate of 21% that was not statistically different from zero (p = 0.36). The effectiveness determined during the peak period of virus circulation is felt to be a conservative estimate, since agents other than influenza are responsible for pneumonia and influenza hospitalizations, even during times of peak influenza activity. SN - 0002-9262 UR - https://www.unboundmedicine.com/medline/citation/1415151/Influenza_vaccine_effectiveness_in_preventing_hospitalization_for_pneumonia_in_the_elderly_ L2 - https://academic.oup.com/aje/article-lookup/doi/10.1093/oxfordjournals.aje.a116495 DB - PRIME DP - Unbound Medicine ER -