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Influenza vaccination and all-cause mortality in community-dwelling elderly in Ontario, Canada, a cohort study.
Vaccine. 2010 Dec 16; 29(2):240-6.V

Abstract

The objective of this study was to evaluate the effectiveness of influenza vaccines in reducing all-cause mortality among community-dwelling elderly. We included 25,922 Ontario residents over age 65 who responded to population health surveys. After full adjustment, influenza vaccination was associated with a statistically significant reduction in all-cause mortality during influenza seasons (hazard ratio (HR)=0.61; 95% CI 0.47-0.79). Contrary to expectations, statistically significant associations between influenza vaccination and mortality were also observed during periods preceding (HR=0.55; 95% CI 0.40-0.75) and following (HR=0.74; 95% CI 0.59-0.94) influenza seasons, indicating the presence of residual confounding. Adjustment for functional status indicators, excluding individuals with high one-year predicted mortality at baseline, and moving the start date of follow-up failed to eliminate the refractory confounding. Since observational studies are prone to bias, future efforts to estimate vaccine effectiveness in the elderly should strive to minimize bias through improved data quality, novel data sources, and/or new analytical techniques.

Authors+Show Affiliations

The Institute for Clinical Evaluative Sciences, Toronto, Canada.No 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

21044667

Citation

Campitelli, Michael A., et al. "Influenza Vaccination and All-cause Mortality in Community-dwelling Elderly in Ontario, Canada, a Cohort Study." Vaccine, vol. 29, no. 2, 2010, pp. 240-6.
Campitelli MA, Rosella LC, Stukel TA, et al. Influenza vaccination and all-cause mortality in community-dwelling elderly in Ontario, Canada, a cohort study. Vaccine. 2010;29(2):240-6.
Campitelli, M. A., Rosella, L. C., Stukel, T. A., & Kwong, J. C. (2010). Influenza vaccination and all-cause mortality in community-dwelling elderly in Ontario, Canada, a cohort study. Vaccine, 29(2), 240-6. https://doi.org/10.1016/j.vaccine.2010.10.049
Campitelli MA, et al. Influenza Vaccination and All-cause Mortality in Community-dwelling Elderly in Ontario, Canada, a Cohort Study. Vaccine. 2010 Dec 16;29(2):240-6. PubMed PMID: 21044667.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza vaccination and all-cause mortality in community-dwelling elderly in Ontario, Canada, a cohort study. AU - Campitelli,Michael A, AU - Rosella,Laura C, AU - Stukel,Therese A, AU - Kwong,Jeffrey C, Y1 - 2010/10/31/ PY - 2009/10/06/received PY - 2010/10/14/revised PY - 2010/10/20/accepted PY - 2010/11/4/entrez PY - 2010/11/4/pubmed PY - 2011/3/11/medline SP - 240 EP - 6 JF - Vaccine JO - Vaccine VL - 29 IS - 2 N2 - The objective of this study was to evaluate the effectiveness of influenza vaccines in reducing all-cause mortality among community-dwelling elderly. We included 25,922 Ontario residents over age 65 who responded to population health surveys. After full adjustment, influenza vaccination was associated with a statistically significant reduction in all-cause mortality during influenza seasons (hazard ratio (HR)=0.61; 95% CI 0.47-0.79). Contrary to expectations, statistically significant associations between influenza vaccination and mortality were also observed during periods preceding (HR=0.55; 95% CI 0.40-0.75) and following (HR=0.74; 95% CI 0.59-0.94) influenza seasons, indicating the presence of residual confounding. Adjustment for functional status indicators, excluding individuals with high one-year predicted mortality at baseline, and moving the start date of follow-up failed to eliminate the refractory confounding. Since observational studies are prone to bias, future efforts to estimate vaccine effectiveness in the elderly should strive to minimize bias through improved data quality, novel data sources, and/or new analytical techniques. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/21044667/Influenza_vaccination_and_all_cause_mortality_in_community_dwelling_elderly_in_Ontario_Canada_a_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(10)01550-1 DB - PRIME DP - Unbound Medicine ER -