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Efficacy of dual vaccination of pandemic H1N1 2009 influenza and seasonal influenza on institutionalized elderly: a one-year prospective cohort study.
Vaccine 2011; 29(44):7773-8V

Abstract

BACKGROUND

The influenza A (H1N1) 2009 pandemic was declared by the WHO in April 2009. In Hong Kong, the vaccination program began in December 2009 in addition to the annual seasonal trivalent influenza vaccination program. The clinical efficacy of dual vaccination was unknown.

METHOD

From December 2009 to November 2010, a prospective 12-month cohort study on institutionalized elderly of nine nursing homes was conducted. Elderly persons who were followed up by the Hong Kong West Community Geriatric Assessment Team and had been vaccinated by the Department of Health were included. Outcome measures included all cause mortality, all cause hospitalization, hospitalization for fever on admission and hospitalization for pneumonia based on ICD-9-CM.

RESULTS

711 elderly persons were included. 274 received both seasonal influenza vaccine and (H1N1) 2009 vaccine (H1N1-TIV), 368 received seasonal influenza vaccine only (TIV alone) and 69 received no vaccination (unvaccinated). Baseline characteristics were well matched between the groups, except there were fewer females in the TIV alone. The 12-month mortality rates of the H1N1-TIV, TIV alone and unvaccinated were 10.6%, 19.8% and 29%, respectively. Multivariate analysis demonstrated that dual vaccination in the institutionalized elderly significantly reduced all cause mortality by 54% (Hazard Ratio [HR] 0.46; 95% confidence interval [CI] 0.29-0.72; p<0.001) and 74% (HR 0.26; CI 0.13-0.49; p<0.001), compared with vaccination of seasonal vaccination alone and no vaccination, respectively. Dual vaccination also reduced all cause hospitalization, hospitalization for fever on admission and hospitalization for pneumonia compared with seasonal vaccination alone and the unvaccinated group.

CONCLUSION

Dual vaccination with both H1N1 and seasonal vaccinations provided additional protection to institutionalized elderly in reducing mortality and hospitalization.

Authors+Show Affiliations

Department of Medicine and Geriatrics, Fung Yiu King Hospital, 9 Sandy Bay Road, Pokfulam, China. tuenching@yahoo.com.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21821084

Citation

Chan, T C., et al. "Efficacy of Dual Vaccination of Pandemic H1N1 2009 Influenza and Seasonal Influenza On Institutionalized Elderly: a One-year Prospective Cohort Study." Vaccine, vol. 29, no. 44, 2011, pp. 7773-8.
Chan TC, Hung IF, Luk JK, et al. Efficacy of dual vaccination of pandemic H1N1 2009 influenza and seasonal influenza on institutionalized elderly: a one-year prospective cohort study. Vaccine. 2011;29(44):7773-8.
Chan, T. C., Hung, I. F., Luk, J. K., Shea, Y. F., Chan, F. H., Woo, P. C., & Chu, L. W. (2011). Efficacy of dual vaccination of pandemic H1N1 2009 influenza and seasonal influenza on institutionalized elderly: a one-year prospective cohort study. Vaccine, 29(44), pp. 7773-8. doi:10.1016/j.vaccine.2011.07.112.
Chan TC, et al. Efficacy of Dual Vaccination of Pandemic H1N1 2009 Influenza and Seasonal Influenza On Institutionalized Elderly: a One-year Prospective Cohort Study. Vaccine. 2011 Oct 13;29(44):7773-8. PubMed PMID: 21821084.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of dual vaccination of pandemic H1N1 2009 influenza and seasonal influenza on institutionalized elderly: a one-year prospective cohort study. AU - Chan,T C, AU - Hung,I F N, AU - Luk,J K H, AU - Shea,Y F, AU - Chan,F H W, AU - Woo,P C Y, AU - Chu,L W, Y1 - 2011/08/05/ PY - 2011/03/01/received PY - 2011/07/07/revised PY - 2011/07/25/accepted PY - 2011/8/9/entrez PY - 2011/8/9/pubmed PY - 2012/1/24/medline SP - 7773 EP - 8 JF - Vaccine JO - Vaccine VL - 29 IS - 44 N2 - BACKGROUND: The influenza A (H1N1) 2009 pandemic was declared by the WHO in April 2009. In Hong Kong, the vaccination program began in December 2009 in addition to the annual seasonal trivalent influenza vaccination program. The clinical efficacy of dual vaccination was unknown. METHOD: From December 2009 to November 2010, a prospective 12-month cohort study on institutionalized elderly of nine nursing homes was conducted. Elderly persons who were followed up by the Hong Kong West Community Geriatric Assessment Team and had been vaccinated by the Department of Health were included. Outcome measures included all cause mortality, all cause hospitalization, hospitalization for fever on admission and hospitalization for pneumonia based on ICD-9-CM. RESULTS: 711 elderly persons were included. 274 received both seasonal influenza vaccine and (H1N1) 2009 vaccine (H1N1-TIV), 368 received seasonal influenza vaccine only (TIV alone) and 69 received no vaccination (unvaccinated). Baseline characteristics were well matched between the groups, except there were fewer females in the TIV alone. The 12-month mortality rates of the H1N1-TIV, TIV alone and unvaccinated were 10.6%, 19.8% and 29%, respectively. Multivariate analysis demonstrated that dual vaccination in the institutionalized elderly significantly reduced all cause mortality by 54% (Hazard Ratio [HR] 0.46; 95% confidence interval [CI] 0.29-0.72; p<0.001) and 74% (HR 0.26; CI 0.13-0.49; p<0.001), compared with vaccination of seasonal vaccination alone and no vaccination, respectively. Dual vaccination also reduced all cause hospitalization, hospitalization for fever on admission and hospitalization for pneumonia compared with seasonal vaccination alone and the unvaccinated group. CONCLUSION: Dual vaccination with both H1N1 and seasonal vaccinations provided additional protection to institutionalized elderly in reducing mortality and hospitalization. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/21821084/Efficacy_of_dual_vaccination_of_pandemic_H1N1_2009_influenza_and_seasonal_influenza_on_institutionalized_elderly:_a_one_year_prospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(11)01162-5 DB - PRIME DP - Unbound Medicine ER -