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Comparative effectiveness of high-dose versus standard-dose influenza vaccination in community-dwelling veterans.
Clin Infect Dis 2015; 61(2):171-6CI

Abstract

BACKGROUND

Influenza is a significant cause of morbidity and mortality in older adults. High-dose (HD) trivalent inactivated vaccine has increased immunogenicity in older adults compared with standard-dose (SD) vaccine. We assessed the relative effectiveness of HD influenza vaccination (vs SD influenza vaccination).

METHODS

We conducted a retrospective cohort study among patients who receive primary care at Veteran Health Administration (VHA) medical centers, and who received influenza vaccine in the 2010-2011 influenza season. The primary outcome was hospitalization for influenza or pneumonia. We also conducted an analysis in subgroups defined by age.

RESULTS

We evaluated 25 714 patients who received HD vaccine and 139 511 who received SD vaccine in 23 VHA medical centers. The rate of hospitalization for influenza or pneumonia was 0.3% in both groups in the influenza season. After accounting for patient characteristics in propensity-adjusted analyses, the risk of hospitalization for influenza or pneumonia was not significantly lower among patients receiving HD vaccine vs those receiving SD vaccine (risk ratio, 0.98; 95% confidence interval, .68-1.40). In the subgroup of patients ≥85 years of age, receiving HD (compared with SD) vaccine was associated with lower rates of hospitalization for influenza or pneumonia.

CONCLUSIONS

HD vaccine was not found to be more effective than SD vaccine in protecting against hospitalization for influenza or pneumonia; however, we found a protective effect in the oldest subgroup of patients. Additional studies are needed to evaluate the effectiveness of HD vaccine.

Authors+Show Affiliations

Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center.Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center.Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center.Division of Infectious Diseases, Department of Medicine, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania Division of Infectious Diseases, Department of Medicine, Philadelphia Veterans Affairs Medical Center, Pennsylvania.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

25829001

Citation

Richardson, Diane M., et al. "Comparative Effectiveness of High-dose Versus Standard-dose Influenza Vaccination in Community-dwelling Veterans." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 61, no. 2, 2015, pp. 171-6.
Richardson DM, Medvedeva EL, Roberts CB, et al. Comparative effectiveness of high-dose versus standard-dose influenza vaccination in community-dwelling veterans. Clin Infect Dis. 2015;61(2):171-6.
Richardson, D. M., Medvedeva, E. L., Roberts, C. B., & Linkin, D. R. (2015). Comparative effectiveness of high-dose versus standard-dose influenza vaccination in community-dwelling veterans. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 61(2), pp. 171-6. doi:10.1093/cid/civ261.
Richardson DM, et al. Comparative Effectiveness of High-dose Versus Standard-dose Influenza Vaccination in Community-dwelling Veterans. Clin Infect Dis. 2015 Jul 15;61(2):171-6. PubMed PMID: 25829001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative effectiveness of high-dose versus standard-dose influenza vaccination in community-dwelling veterans. AU - Richardson,Diane M, AU - Medvedeva,Elina L, AU - Roberts,Christopher B, AU - Linkin,Darren R, AU - ,, Y1 - 2015/03/31/ PY - 2014/12/07/received PY - 2015/03/21/accepted PY - 2015/4/2/entrez PY - 2015/4/2/pubmed PY - 2016/4/16/medline KW - comparative effectiveness research KW - elderly KW - influenza human KW - influenza vaccines SP - 171 EP - 6 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 61 IS - 2 N2 - BACKGROUND: Influenza is a significant cause of morbidity and mortality in older adults. High-dose (HD) trivalent inactivated vaccine has increased immunogenicity in older adults compared with standard-dose (SD) vaccine. We assessed the relative effectiveness of HD influenza vaccination (vs SD influenza vaccination). METHODS: We conducted a retrospective cohort study among patients who receive primary care at Veteran Health Administration (VHA) medical centers, and who received influenza vaccine in the 2010-2011 influenza season. The primary outcome was hospitalization for influenza or pneumonia. We also conducted an analysis in subgroups defined by age. RESULTS: We evaluated 25 714 patients who received HD vaccine and 139 511 who received SD vaccine in 23 VHA medical centers. The rate of hospitalization for influenza or pneumonia was 0.3% in both groups in the influenza season. After accounting for patient characteristics in propensity-adjusted analyses, the risk of hospitalization for influenza or pneumonia was not significantly lower among patients receiving HD vaccine vs those receiving SD vaccine (risk ratio, 0.98; 95% confidence interval, .68-1.40). In the subgroup of patients ≥85 years of age, receiving HD (compared with SD) vaccine was associated with lower rates of hospitalization for influenza or pneumonia. CONCLUSIONS: HD vaccine was not found to be more effective than SD vaccine in protecting against hospitalization for influenza or pneumonia; however, we found a protective effect in the oldest subgroup of patients. Additional studies are needed to evaluate the effectiveness of HD vaccine. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/25829001/Comparative_effectiveness_of_high_dose_versus_standard_dose_influenza_vaccination_in_community_dwelling_veterans_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ261 DB - PRIME DP - Unbound Medicine ER -