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Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination.
JAMA 2015; 314(14):1488-97JAMA

Abstract

IMPORTANCE

Few studies have evaluated the relationship between influenza vaccination and pneumonia, a serious complication of influenza infection.

OBJECTIVE

To assess the association between influenza vaccination status and hospitalization for community-acquired laboratory-confirmed influenza pneumonia.

DESIGN, SETTING, AND PARTICIPANTS

The Etiology of Pneumonia in the Community (EPIC) study was a prospective observational multicenter study of hospitalizations for community-acquired pneumonia conducted from January 2010 through June 2012 at 4 US sites. In this case-control study, we used EPIC data from patients 6 months or older with laboratory-confirmed influenza infection and verified vaccination status during the influenza seasons and excluded patients with recent hospitalization, from chronic care residential facilities, and with severe immunosuppression. Logistic regression was used to calculate odds ratios, comparing the odds of vaccination between influenza-positive (case) and influenza-negative (control) patients with pneumonia, controlling for demographics, comorbidities, season, study site, and timing of disease onset. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%.

EXPOSURE

Influenza vaccination, verified through record review.

MAIN OUTCOMES AND MEASURES

Influenza pneumonia, confirmed by real-time reverse-transcription polymerase chain reaction performed on nasal/oropharyngeal swabs.

RESULTS

Overall, 2767 patients hospitalized for pneumonia were eligible for the study; 162 (5.9%) had laboratory-confirmed influenza. Twenty-eight of 162 cases (17%) with influenza-associated pneumonia and 766 of 2605 controls (29%) with influenza-negative pneumonia had been vaccinated. The adjusted odds ratio of prior influenza vaccination between cases and controls was 0.43 (95% CI, 0.28-0.68; estimated vaccine effectiveness, 56.7%; 95% CI, 31.9%-72.5%).

CONCLUSIONS AND RELEVANCE

Among children and adults hospitalized with community-acquired pneumonia, those with laboratory-confirmed influenza-associated pneumonia, compared with those with pneumonia not associated with influenza, had lower odds of having received influenza vaccination.

Authors+Show Affiliations

Vanderbilt University School of Medicine, Nashville, Tennessee2Geriatric Research Education Clinical Center (GRECC), VA Tennessee Valley, Nashville.Vanderbilt University School of Medicine, Nashville, Tennessee.Vanderbilt University School of Medicine, Nashville, Tennessee.Vanderbilt University School of Medicine, Nashville, Tennessee.University of Utah School of Medicine, Salt Lake City.University of Utah School of Medicine, Salt Lake City.University of Utah School of Medicine, Salt Lake City.University of Tennessee School of Medicine, Memphis.University of Tennessee School of Medicine, Memphis.Northwestern University School of Medicine, Chicago, Illinois.Emory University School of Medicine, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia8Battelle Memorial Institute, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Vanderbilt University School of Medicine, Nashville, Tennessee2Geriatric Research Education Clinical Center (GRECC), VA Tennessee Valley, Nashville.Vanderbilt University School of Medicine, Nashville, Tennessee.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

26436611

Citation

Grijalva, Carlos G., et al. "Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination." JAMA, vol. 314, no. 14, 2015, pp. 1488-97.
Grijalva CG, Zhu Y, Williams DJ, et al. Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination. JAMA. 2015;314(14):1488-97.
Grijalva, C. G., Zhu, Y., Williams, D. J., Self, W. H., Ampofo, K., Pavia, A. T., ... Edwards, K. M. (2015). Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination. JAMA, 314(14), pp. 1488-97. doi:10.1001/jama.2015.12160.
Grijalva CG, et al. Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination. JAMA. 2015 Oct 13;314(14):1488-97. PubMed PMID: 26436611.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination. AU - Grijalva,Carlos G, AU - Zhu,Yuwei, AU - Williams,Derek J, AU - Self,Wesley H, AU - Ampofo,Krow, AU - Pavia,Andrew T, AU - Stockmann,Chris R, AU - McCullers,Jonathan, AU - Arnold,Sandra R, AU - Wunderink,Richard G, AU - Anderson,Evan J, AU - Lindstrom,Stephen, AU - Fry,Alicia M, AU - Foppa,Ivo M, AU - Finelli,Lyn, AU - Bramley,Anna M, AU - Jain,Seema, AU - Griffin,Marie R, AU - Edwards,Kathryn M, PY - 2015/10/6/entrez PY - 2015/10/6/pubmed PY - 2015/10/20/medline SP - 1488 EP - 97 JF - JAMA JO - JAMA VL - 314 IS - 14 N2 - IMPORTANCE: Few studies have evaluated the relationship between influenza vaccination and pneumonia, a serious complication of influenza infection. OBJECTIVE: To assess the association between influenza vaccination status and hospitalization for community-acquired laboratory-confirmed influenza pneumonia. DESIGN, SETTING, AND PARTICIPANTS: The Etiology of Pneumonia in the Community (EPIC) study was a prospective observational multicenter study of hospitalizations for community-acquired pneumonia conducted from January 2010 through June 2012 at 4 US sites. In this case-control study, we used EPIC data from patients 6 months or older with laboratory-confirmed influenza infection and verified vaccination status during the influenza seasons and excluded patients with recent hospitalization, from chronic care residential facilities, and with severe immunosuppression. Logistic regression was used to calculate odds ratios, comparing the odds of vaccination between influenza-positive (case) and influenza-negative (control) patients with pneumonia, controlling for demographics, comorbidities, season, study site, and timing of disease onset. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%. EXPOSURE: Influenza vaccination, verified through record review. MAIN OUTCOMES AND MEASURES: Influenza pneumonia, confirmed by real-time reverse-transcription polymerase chain reaction performed on nasal/oropharyngeal swabs. RESULTS: Overall, 2767 patients hospitalized for pneumonia were eligible for the study; 162 (5.9%) had laboratory-confirmed influenza. Twenty-eight of 162 cases (17%) with influenza-associated pneumonia and 766 of 2605 controls (29%) with influenza-negative pneumonia had been vaccinated. The adjusted odds ratio of prior influenza vaccination between cases and controls was 0.43 (95% CI, 0.28-0.68; estimated vaccine effectiveness, 56.7%; 95% CI, 31.9%-72.5%). CONCLUSIONS AND RELEVANCE: Among children and adults hospitalized with community-acquired pneumonia, those with laboratory-confirmed influenza-associated pneumonia, compared with those with pneumonia not associated with influenza, had lower odds of having received influenza vaccination. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/26436611/Association_Between_Hospitalization_With_Community_Acquired_Laboratory_Confirmed_Influenza_Pneumonia_and_Prior_Receipt_of_Influenza_Vaccination_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2015.12160 DB - PRIME DP - Unbound Medicine ER -