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A cohort study of the effectiveness of influenza vaccine in older people, performed using the United Kingdom general practice research database.
J Infect Dis 2004; 190(1):1-10JI

Abstract

BACKGROUND

The effectiveness of influenza vaccination against hospitalization and death can only ethically be assessed in observational studies. A concern is that individuals who are vaccinated are healthier than individuals who are not vaccinated, potentially biasing estimates of effectiveness upward.

METHODS

We conducted a historical cohort study of individuals >64 years of age, for whom there were data available in the General Practice Research Database for 1989 to 1999 in England and Wales. Rates of admissions for acute respiratory diseases and rates of death due to respiratory disease were compared over 692,819 person-years in vaccine recipients and 1,534,280 person-years in vaccine nonrecipients.

RESULTS

The pooled effectiveness of vaccine against hospitalizations for acute respiratory disease was 21% (95% confidence interval [CI], 17%-26%). The rate reduction attributable to vaccination was 4.15 hospitalizations/100,000 person-weeks in the influenza season. Among vaccine recipients, no important reduction in the number of admissions to the hospital was seen outside influenza seasons. The pooled effectiveness of vaccine against deaths due to respiratory disease was 12% (95% CI, 8%-16%). A greater proportionate reduction was seen among people without medical disorders, but absolute rate reduction was higher in individuals with medical disorders, compared with individuals without such disorders (6.14 deaths due to respiratory disease/100,000 person-weeks vs. 3.12 deaths due to respiratory disease/100,000 person-weeks). Clear protection against death due to all causes was not seen.

CONCLUSIONS

Influenza vaccination reduces the number of hospitalizations and deaths due to respiratory disease, after correction for confounding in individuals >64 years of age who had a high risk or a low risk for influenza. For elderly people, untargeted influenza vaccination is of confirmed benefit against serious outcomes.

Authors+Show Affiliations

London School of Hygiene and Tropical Medicine, London, United Kingdom. punam.mangtani@lshtm.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15195237

Citation

Mangtani, Punam, et al. "A Cohort Study of the Effectiveness of Influenza Vaccine in Older People, Performed Using the United Kingdom General Practice Research Database." The Journal of Infectious Diseases, vol. 190, no. 1, 2004, pp. 1-10.
Mangtani P, Cumberland P, Hodgson CR, et al. A cohort study of the effectiveness of influenza vaccine in older people, performed using the United Kingdom general practice research database. J Infect Dis. 2004;190(1):1-10.
Mangtani, P., Cumberland, P., Hodgson, C. R., Roberts, J. A., Cutts, F. T., & Hall, A. J. (2004). A cohort study of the effectiveness of influenza vaccine in older people, performed using the United Kingdom general practice research database. The Journal of Infectious Diseases, 190(1), pp. 1-10.
Mangtani P, et al. A Cohort Study of the Effectiveness of Influenza Vaccine in Older People, Performed Using the United Kingdom General Practice Research Database. J Infect Dis. 2004 Jul 1;190(1):1-10. PubMed PMID: 15195237.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A cohort study of the effectiveness of influenza vaccine in older people, performed using the United Kingdom general practice research database. AU - Mangtani,Punam, AU - Cumberland,Phillippa, AU - Hodgson,Cathy R, AU - Roberts,Jennifer A, AU - Cutts,Felicity T, AU - Hall,Andrew J, Y1 - 2004/05/26/ PY - 2003/08/19/received PY - 2003/12/23/accepted PY - 2004/6/15/pubmed PY - 2004/8/4/medline PY - 2004/6/15/entrez SP - 1 EP - 10 JF - The Journal of infectious diseases JO - J. Infect. Dis. VL - 190 IS - 1 N2 - BACKGROUND: The effectiveness of influenza vaccination against hospitalization and death can only ethically be assessed in observational studies. A concern is that individuals who are vaccinated are healthier than individuals who are not vaccinated, potentially biasing estimates of effectiveness upward. METHODS: We conducted a historical cohort study of individuals >64 years of age, for whom there were data available in the General Practice Research Database for 1989 to 1999 in England and Wales. Rates of admissions for acute respiratory diseases and rates of death due to respiratory disease were compared over 692,819 person-years in vaccine recipients and 1,534,280 person-years in vaccine nonrecipients. RESULTS: The pooled effectiveness of vaccine against hospitalizations for acute respiratory disease was 21% (95% confidence interval [CI], 17%-26%). The rate reduction attributable to vaccination was 4.15 hospitalizations/100,000 person-weeks in the influenza season. Among vaccine recipients, no important reduction in the number of admissions to the hospital was seen outside influenza seasons. The pooled effectiveness of vaccine against deaths due to respiratory disease was 12% (95% CI, 8%-16%). A greater proportionate reduction was seen among people without medical disorders, but absolute rate reduction was higher in individuals with medical disorders, compared with individuals without such disorders (6.14 deaths due to respiratory disease/100,000 person-weeks vs. 3.12 deaths due to respiratory disease/100,000 person-weeks). Clear protection against death due to all causes was not seen. CONCLUSIONS: Influenza vaccination reduces the number of hospitalizations and deaths due to respiratory disease, after correction for confounding in individuals >64 years of age who had a high risk or a low risk for influenza. For elderly people, untargeted influenza vaccination is of confirmed benefit against serious outcomes. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/15195237/A_cohort_study_of_the_effectiveness_of_influenza_vaccine_in_older_people_performed_using_the_United_Kingdom_general_practice_research_database_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/421274 DB - PRIME DP - Unbound Medicine ER -