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Prevention of mortality and pneumonia among nursing home older adults by dual pneumococcal and seasonal influenza vaccination during a pandemic caused by novel pandemic influenza A (H1N1).

Abstract

OBJECTIVE

To evaluate the efficacy of dual vaccination of seasonal influenza and pneumococcus in nursing home older adults during a novel pandemic of influenza A (H1N1).

SETTING

Nine nursing homes in Hong Kong.

PARTICIPANTS

A total of 532 nursing home older adults were included in the study.

MEASUREMENTS

Efficacy of dual vaccination of seasonal influenza and pneumococcus in nursing home older adults during a novel pandemic influenza A (H1N1).

DESIGN

A prospective 12-month cohort study was conducted on older residents from December 2009 to November 2010. Participants were divided into 3 groups according to their choice of vaccination: received both seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPV-TIV group), received seasonal influenza vaccine alone (TIV group), and those who refused both vaccinations (unvaccinated group). Those who had received vaccination for influenza A (H1N1) were excluded. Outcome measures included mortality from all causes, pneumonia, and vascular causes.

RESULTS

There were 246 in the PPV-TIV group, 211 in the TIV group, and 75 in the unvaccinated group. Baseline characteristics were similar among the groups. The 12-month mortality rates of the PPV-TIV, TIV alone group, and unvaccinated group were 17.1%, 27.0%, and 37.3% respectively (P < .001). Multivariate analysis demonstrated that, compared with vaccination of seasonal influenza alone, dual vaccination significantly reduced all-cause mortality (hazard ratio [HR] 0.54; 95% confidence interval [CI]: 0.35-0.84; P < .01), mortality from pneumonia (HR 0.60; 95% CI: 0.35-0.99; P < .05), and mortality from vascular causes (HR 0.24; 95% CI: 0.09-0.64; P < .01).

CONCLUSIONS

During an influenza pandemic or when the circulating influenza strain was not matched by the trivalent seasonal influenza vaccine, dual vaccination of influenza and pneumococcus provided additional protection to nursing home older adults in reducing mortality.

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  • Authors+Show Affiliations

    ,

    Department of Medicine and Geriatrics, Fung Yiu King Hospital, Pokfulam, Hong Kong SAR, China. tuenching@yahoo.com.hk

    , , , , ,

    Source

    MeSH

    Aged
    Aged, 80 and over
    Female
    Hong Kong
    Humans
    Immunization Schedule
    Influenza A Virus, H1N1 Subtype
    Influenza Vaccines
    Influenza, Human
    Male
    Nursing Homes
    Pandemics
    Pneumococcal Infections
    Pneumococcal Vaccines
    Pneumonia
    Prospective Studies
    Sex Distribution
    Streptococcus pneumoniae

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22722051

    Citation

    Chan, Tuen-Ching, et al. "Prevention of Mortality and Pneumonia Among Nursing Home Older Adults By Dual Pneumococcal and Seasonal Influenza Vaccination During a Pandemic Caused By Novel Pandemic Influenza a (H1N1)." Journal of the American Medical Directors Association, vol. 13, no. 8, 2012, pp. 698-703.
    Chan TC, Hung IF, Luk JK, et al. Prevention of mortality and pneumonia among nursing home older adults by dual pneumococcal and seasonal influenza vaccination during a pandemic caused by novel pandemic influenza A (H1N1). J Am Med Dir Assoc. 2012;13(8):698-703.
    Chan, T. C., Hung, I. F., Luk, J. K., Shea, Y. F., Chan, F. H., Woo, P. C., & Chu, L. W. (2012). Prevention of mortality and pneumonia among nursing home older adults by dual pneumococcal and seasonal influenza vaccination during a pandemic caused by novel pandemic influenza A (H1N1). Journal of the American Medical Directors Association, 13(8), pp. 698-703. doi:10.1016/j.jamda.2012.05.009.
    Chan TC, et al. Prevention of Mortality and Pneumonia Among Nursing Home Older Adults By Dual Pneumococcal and Seasonal Influenza Vaccination During a Pandemic Caused By Novel Pandemic Influenza a (H1N1). J Am Med Dir Assoc. 2012;13(8):698-703. PubMed PMID: 22722051.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prevention of mortality and pneumonia among nursing home older adults by dual pneumococcal and seasonal influenza vaccination during a pandemic caused by novel pandemic influenza A (H1N1). AU - Chan,Tuen-Ching, AU - Hung,Ivan Fan-Ngai, AU - Luk,James Ka-Hay, AU - Shea,Yat-Fung, AU - Chan,Felix Hon-Wai, AU - Woo,Patrick Chiu-Yat, AU - Chu,Leung-Wing, Y1 - 2012/06/20/ PY - 2012/04/03/received PY - 2012/05/11/revised PY - 2012/05/11/accepted PY - 2012/6/23/entrez PY - 2012/6/23/pubmed PY - 2013/2/21/medline SP - 698 EP - 703 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 13 IS - 8 N2 - OBJECTIVE: To evaluate the efficacy of dual vaccination of seasonal influenza and pneumococcus in nursing home older adults during a novel pandemic of influenza A (H1N1). SETTING: Nine nursing homes in Hong Kong. PARTICIPANTS: A total of 532 nursing home older adults were included in the study. MEASUREMENTS: Efficacy of dual vaccination of seasonal influenza and pneumococcus in nursing home older adults during a novel pandemic influenza A (H1N1). DESIGN: A prospective 12-month cohort study was conducted on older residents from December 2009 to November 2010. Participants were divided into 3 groups according to their choice of vaccination: received both seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPV-TIV group), received seasonal influenza vaccine alone (TIV group), and those who refused both vaccinations (unvaccinated group). Those who had received vaccination for influenza A (H1N1) were excluded. Outcome measures included mortality from all causes, pneumonia, and vascular causes. RESULTS: There were 246 in the PPV-TIV group, 211 in the TIV group, and 75 in the unvaccinated group. Baseline characteristics were similar among the groups. The 12-month mortality rates of the PPV-TIV, TIV alone group, and unvaccinated group were 17.1%, 27.0%, and 37.3% respectively (P < .001). Multivariate analysis demonstrated that, compared with vaccination of seasonal influenza alone, dual vaccination significantly reduced all-cause mortality (hazard ratio [HR] 0.54; 95% confidence interval [CI]: 0.35-0.84; P < .01), mortality from pneumonia (HR 0.60; 95% CI: 0.35-0.99; P < .05), and mortality from vascular causes (HR 0.24; 95% CI: 0.09-0.64; P < .01). CONCLUSIONS: During an influenza pandemic or when the circulating influenza strain was not matched by the trivalent seasonal influenza vaccine, dual vaccination of influenza and pneumococcus provided additional protection to nursing home older adults in reducing mortality. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/22722051/Prevention_of_mortality_and_pneumonia_among_nursing_home_older_adults_by_dual_pneumococcal_and_seasonal_influenza_vaccination_during_a_pandemic_caused_by_novel_pandemic_influenza_A__H1N1__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1525-8610(12)00160-0 DB - PRIME DP - Unbound Medicine ER -