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Annual revaccination against influenza and mortality risk in community-dwelling elderly persons.
JAMA. 2004 Nov 03; 292(17):2089-95.JAMA

Abstract

CONTEXT

Although large-scale observational studies have demonstrated the effectiveness of influenza vaccination, no large studies have systematically addressed the clinical benefit of annual revaccinations.

OBJECTIVE

To investigate the effect of annual influenza revaccination on mortality in community-dwelling elderly persons.

DESIGN, SETTING, AND PARTICIPANTS

A population-based cohort study using the computerized Integrated Primary Care Information (IPCI) database in the Netherlands including community-dwelling individuals aged 65 years or older from 1996 through 2002. For each year, we computed the individual cumulative exposure to influenza vaccination since study start.

MAIN OUTCOME MEASURE

Association between the number of consecutive influenza vaccinations and all-cause mortality vs no vaccination after adjusting for age, sex, chronic respiratory and cardiovascular disease, hypertension, diabetes mellitus, renal failure, and cancer.

RESULTS

The study population included 26,071 individuals, of whom 3485 died during follow-up. Overall, a first vaccination was associated with a nonsignificant annual reduction of mortality risk of 10% (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.78-1.03) while revaccination was associated with a reduced mortality risk of 24% (HR, 0.76; 95% CI, 0.70-0.83). Compared with a first vaccination, revaccination was associated with a reduced annual mortality risk of 15% (HR, 0.85; 95% CI, 0.75-0.96). During the epidemic periods this reduction was 28% (HR, 0.72; 95% CI, 0.53-0.96). Similar estimates were obtained for persons with and without chronic comorbidity and those aged 70 years or older at baseline. Overall, influenza vaccination is estimated to prevent 1 death for every 302 vaccinees at a vaccination coverage that varied between 64% and 74%.

CONCLUSION

Annual influenza vaccination is associated with a reduction in all-cause mortality risk in a population of community-dwelling elderly persons, particularly in older individuals.

Authors+Show Affiliations

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

15523069

Citation

Voordouw, A C G., et al. "Annual Revaccination Against Influenza and Mortality Risk in Community-dwelling Elderly Persons." JAMA, vol. 292, no. 17, 2004, pp. 2089-95.
Voordouw AC, Sturkenboom MC, Dieleman JP, et al. Annual revaccination against influenza and mortality risk in community-dwelling elderly persons. JAMA. 2004;292(17):2089-95.
Voordouw, A. C., Sturkenboom, M. C., Dieleman, J. P., Stijnen, T., Smith, D. J., van der Lei, J., & Stricker, B. H. (2004). Annual revaccination against influenza and mortality risk in community-dwelling elderly persons. JAMA, 292(17), 2089-95.
Voordouw AC, et al. Annual Revaccination Against Influenza and Mortality Risk in Community-dwelling Elderly Persons. JAMA. 2004 Nov 3;292(17):2089-95. PubMed PMID: 15523069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Annual revaccination against influenza and mortality risk in community-dwelling elderly persons. AU - Voordouw,A C G, AU - Sturkenboom,M C J M, AU - Dieleman,J P, AU - Stijnen,Th, AU - Smith,D J, AU - van der Lei,J, AU - Stricker,Bruno H Ch, PY - 2004/11/4/pubmed PY - 2004/11/9/medline PY - 2004/11/4/entrez SP - 2089 EP - 95 JF - JAMA JO - JAMA VL - 292 IS - 17 N2 - CONTEXT: Although large-scale observational studies have demonstrated the effectiveness of influenza vaccination, no large studies have systematically addressed the clinical benefit of annual revaccinations. OBJECTIVE: To investigate the effect of annual influenza revaccination on mortality in community-dwelling elderly persons. DESIGN, SETTING, AND PARTICIPANTS: A population-based cohort study using the computerized Integrated Primary Care Information (IPCI) database in the Netherlands including community-dwelling individuals aged 65 years or older from 1996 through 2002. For each year, we computed the individual cumulative exposure to influenza vaccination since study start. MAIN OUTCOME MEASURE: Association between the number of consecutive influenza vaccinations and all-cause mortality vs no vaccination after adjusting for age, sex, chronic respiratory and cardiovascular disease, hypertension, diabetes mellitus, renal failure, and cancer. RESULTS: The study population included 26,071 individuals, of whom 3485 died during follow-up. Overall, a first vaccination was associated with a nonsignificant annual reduction of mortality risk of 10% (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.78-1.03) while revaccination was associated with a reduced mortality risk of 24% (HR, 0.76; 95% CI, 0.70-0.83). Compared with a first vaccination, revaccination was associated with a reduced annual mortality risk of 15% (HR, 0.85; 95% CI, 0.75-0.96). During the epidemic periods this reduction was 28% (HR, 0.72; 95% CI, 0.53-0.96). Similar estimates were obtained for persons with and without chronic comorbidity and those aged 70 years or older at baseline. Overall, influenza vaccination is estimated to prevent 1 death for every 302 vaccinees at a vaccination coverage that varied between 64% and 74%. CONCLUSION: Annual influenza vaccination is associated with a reduction in all-cause mortality risk in a population of community-dwelling elderly persons, particularly in older individuals. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/15523069/Annual_revaccination_against_influenza_and_mortality_risk_in_community_dwelling_elderly_persons_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.292.17.2089 DB - PRIME DP - Unbound Medicine ER -