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Annual influenza vaccination in community-dwelling elderly individuals and the risk of lower respiratory tract infections or pneumonia.
Arch Intern Med. 2006 Oct 09; 166(18):1980-5.AI

Abstract

BACKGROUND

Influenza vaccination has been associated with a reduction in the number of hospitalizations for respiratory conditions in elderly persons over the period from 1996 to 2002. Little is known, however, about the effect of influenza vaccination on the whole range of severity of respiratory tract infections.

METHODS

We investigated the effect of annual influenza vaccination on the occurrence of lower respiratory tract infections (LRTIs) in community-dwelling elderly individuals. From 1996 to 2002, we performed a population-based cohort study, using the computerized Integrated Primary Care Information database in the Netherlands, of community-dwelling subjects who were 65 years or older on January 1 of the year of study entry. For each year, the individual cumulative exposure to influenza vaccination since study entry was computed. We compared the risk of LRTI after a first vaccination or revaccination with the risk for no vaccination using a time-varying multivariate Cox proportional hazard model, adjusted for age, sex, smoking, and underlying disease.

RESULTS

In the study population of 26 071 subjects, 3412 developed LRTIs during follow-up. During the influenza epidemic periods, a first vaccination did not reduce risk for LRTI. In the total population, the hazard ratio following a first vaccination was 0.86 (95% confidence interval [CI], 0.71 to 1.05); in the population without or with comorbidity, these ratios were 0.90 (95% CI, 0.56 to 1.45) and 0.83 (95% CI, 0.66 to 1.04), respectively. During epidemic periods, revaccination reduced risk of LRTI by 33% (95% CI, 8% to 52%) in individuals without comorbidity. In individuals with comorbidity, the risk reduction of 5% was nonsignificant (95% CI, -10% to 18%).

CONCLUSION

In this study, annual influenza revaccination was associated with a reduction in LRTI in community-dwelling elderly individuals.

Authors+Show Affiliations

Pharmacoepidemiology Unit, Department of Internal Medicine and Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands. ac.voordouw@cbg-meb.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17030831

Citation

Voordouw, Bettie C G., et al. "Annual Influenza Vaccination in Community-dwelling Elderly Individuals and the Risk of Lower Respiratory Tract Infections or Pneumonia." Archives of Internal Medicine, vol. 166, no. 18, 2006, pp. 1980-5.
Voordouw BC, Sturkenboom MC, Dieleman JP, et al. Annual influenza vaccination in community-dwelling elderly individuals and the risk of lower respiratory tract infections or pneumonia. Arch Intern Med. 2006;166(18):1980-5.
Voordouw, B. C., Sturkenboom, M. C., Dieleman, J. P., Stijnen, T., van der Lei, J., & Stricker, B. H. (2006). Annual influenza vaccination in community-dwelling elderly individuals and the risk of lower respiratory tract infections or pneumonia. Archives of Internal Medicine, 166(18), 1980-5.
Voordouw BC, et al. Annual Influenza Vaccination in Community-dwelling Elderly Individuals and the Risk of Lower Respiratory Tract Infections or Pneumonia. Arch Intern Med. 2006 Oct 9;166(18):1980-5. PubMed PMID: 17030831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Annual influenza vaccination in community-dwelling elderly individuals and the risk of lower respiratory tract infections or pneumonia. AU - Voordouw,Bettie C G, AU - Sturkenboom,Miriam C J M, AU - Dieleman,Jeanne P, AU - Stijnen,Theo, AU - van der Lei,Johan, AU - Stricker,Bruno H C, PY - 2006/10/13/pubmed PY - 2006/11/11/medline PY - 2006/10/13/entrez SP - 1980 EP - 5 JF - Archives of internal medicine JO - Arch Intern Med VL - 166 IS - 18 N2 - BACKGROUND: Influenza vaccination has been associated with a reduction in the number of hospitalizations for respiratory conditions in elderly persons over the period from 1996 to 2002. Little is known, however, about the effect of influenza vaccination on the whole range of severity of respiratory tract infections. METHODS: We investigated the effect of annual influenza vaccination on the occurrence of lower respiratory tract infections (LRTIs) in community-dwelling elderly individuals. From 1996 to 2002, we performed a population-based cohort study, using the computerized Integrated Primary Care Information database in the Netherlands, of community-dwelling subjects who were 65 years or older on January 1 of the year of study entry. For each year, the individual cumulative exposure to influenza vaccination since study entry was computed. We compared the risk of LRTI after a first vaccination or revaccination with the risk for no vaccination using a time-varying multivariate Cox proportional hazard model, adjusted for age, sex, smoking, and underlying disease. RESULTS: In the study population of 26 071 subjects, 3412 developed LRTIs during follow-up. During the influenza epidemic periods, a first vaccination did not reduce risk for LRTI. In the total population, the hazard ratio following a first vaccination was 0.86 (95% confidence interval [CI], 0.71 to 1.05); in the population without or with comorbidity, these ratios were 0.90 (95% CI, 0.56 to 1.45) and 0.83 (95% CI, 0.66 to 1.04), respectively. During epidemic periods, revaccination reduced risk of LRTI by 33% (95% CI, 8% to 52%) in individuals without comorbidity. In individuals with comorbidity, the risk reduction of 5% was nonsignificant (95% CI, -10% to 18%). CONCLUSION: In this study, annual influenza revaccination was associated with a reduction in LRTI in community-dwelling elderly individuals. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/17030831/Annual_influenza_vaccination_in_community_dwelling_elderly_individuals_and_the_risk_of_lower_respiratory_tract_infections_or_pneumonia_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.166.18.1980 DB - PRIME DP - Unbound Medicine ER -