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Effectiveness of 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccine for pneumonia among the elderly - Selection of controls in a case-control study.
Vaccine 2017; 35(36):4806-4810V

Abstract

We conducted a case-control study to elucidate associations between pneumonia in elderly individuals and 23-valent pneumococcal polysaccharide vaccine (PPSV23) and seasonal influenza vaccine (influenza vaccine). Here, we examined selection of controls in our study using an analytic epidemiology approach. The study period was from October 1, 2009 through September 30, 2014. Cases comprised ≥65-year-old patients newly diagnosed with pneumonia. For every case with pneumonia, two patients with other diseases (one respiratory medicine, one non-respiratory medicine) who were sex-, age-, visit date- and visit hospital-matched were selected as controls. Odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for pneumonia were calculated using conditional logistic regression model. Similar analyses were also conducted based on the clinical department of controls. Analysis was conducted in 234 cases and 438 controls. Effectiveness of pneumococcal vaccination or influenza vaccination against pneumonia was not detected. Proportions of either vaccination in controls were greater among respiratory medicine (pneumococcal vaccine, 38%; influenza vaccine, 55%) than among non-respiratory medicine (23%; 48%). Analysis using controls restricted to respiratory medicine showed marginally significant effectiveness of pneumococcal vaccination (OR, 0.59; 95%CI, 0.34-1.03; P=0.064) and influenza vaccination (0.64; 0.40-1.04; 0.072). However, this effectiveness might have been overestimated by selection bias of controls, as pneumonia cases are not necessarily respiratory medicine patients. In the analysis using controls restricted to non-respiratory medicine, OR of pneumococcal vaccination for pneumonia was close to 1, presumably because the proportion of pneumococcal vaccination was higher in cases than in controls. Because pneumococcal vaccine was not routinely administered during the study period, differences in recommendations of vaccination by physician in different clinical departments might have greatly affected vaccination proportions. When we select controls, we should consider the background factors (underlying diseases, clinical department, etc.) which affect physicians' recommendation of vaccination.

Authors+Show Affiliations

Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan. Electronic address: kyou@med.osaka-cu.ac.jp.Nagoya City University, School of Nursing, Nagoya, Japan.Department of Community Health and Clinical Epidemiology, St. Mary's College, Kurume, Japan.Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan.Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan.Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan.Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan; Clinical Epidemiology Research Center, Medical Co. LTA, Fukuoka, Japan; College of Healthcare Management, Miyama, Japan.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28818473

Citation

Kondo, Kyoko, et al. "Effectiveness of 23-valent Pneumococcal Polysaccharide Vaccine and Seasonal Influenza Vaccine for Pneumonia Among the Elderly - Selection of Controls in a Case-control Study." Vaccine, vol. 35, no. 36, 2017, pp. 4806-4810.
Kondo K, Suzuki K, Washio M, et al. Effectiveness of 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccine for pneumonia among the elderly - Selection of controls in a case-control study. Vaccine. 2017;35(36):4806-4810.
Kondo, K., Suzuki, K., Washio, M., Ohfuji, S., Fukushima, W., Maeda, A., & Hirota, Y. (2017). Effectiveness of 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccine for pneumonia among the elderly - Selection of controls in a case-control study. Vaccine, 35(36), pp. 4806-4810. doi:10.1016/j.vaccine.2017.07.005.
Kondo K, et al. Effectiveness of 23-valent Pneumococcal Polysaccharide Vaccine and Seasonal Influenza Vaccine for Pneumonia Among the Elderly - Selection of Controls in a Case-control Study. Vaccine. 2017 08 24;35(36):4806-4810. PubMed PMID: 28818473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccine for pneumonia among the elderly - Selection of controls in a case-control study. AU - Kondo,Kyoko, AU - Suzuki,Kanzo, AU - Washio,Masakazu, AU - Ohfuji,Satoko, AU - Fukushima,Wakaba, AU - Maeda,Akiko, AU - Hirota,Yoshio, AU - ,, PY - 2016/05/18/received PY - 2016/10/05/revised PY - 2016/11/24/accepted PY - 2017/8/19/entrez PY - 2017/8/19/pubmed PY - 2018/4/20/medline KW - 23-valent pneumococcal polysaccharide vaccine KW - Case-control study KW - Effectiveness KW - Elderly people KW - Pneumonia KW - Seasonal influenza vaccine SP - 4806 EP - 4810 JF - Vaccine JO - Vaccine VL - 35 IS - 36 N2 - We conducted a case-control study to elucidate associations between pneumonia in elderly individuals and 23-valent pneumococcal polysaccharide vaccine (PPSV23) and seasonal influenza vaccine (influenza vaccine). Here, we examined selection of controls in our study using an analytic epidemiology approach. The study period was from October 1, 2009 through September 30, 2014. Cases comprised ≥65-year-old patients newly diagnosed with pneumonia. For every case with pneumonia, two patients with other diseases (one respiratory medicine, one non-respiratory medicine) who were sex-, age-, visit date- and visit hospital-matched were selected as controls. Odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for pneumonia were calculated using conditional logistic regression model. Similar analyses were also conducted based on the clinical department of controls. Analysis was conducted in 234 cases and 438 controls. Effectiveness of pneumococcal vaccination or influenza vaccination against pneumonia was not detected. Proportions of either vaccination in controls were greater among respiratory medicine (pneumococcal vaccine, 38%; influenza vaccine, 55%) than among non-respiratory medicine (23%; 48%). Analysis using controls restricted to respiratory medicine showed marginally significant effectiveness of pneumococcal vaccination (OR, 0.59; 95%CI, 0.34-1.03; P=0.064) and influenza vaccination (0.64; 0.40-1.04; 0.072). However, this effectiveness might have been overestimated by selection bias of controls, as pneumonia cases are not necessarily respiratory medicine patients. In the analysis using controls restricted to non-respiratory medicine, OR of pneumococcal vaccination for pneumonia was close to 1, presumably because the proportion of pneumococcal vaccination was higher in cases than in controls. Because pneumococcal vaccine was not routinely administered during the study period, differences in recommendations of vaccination by physician in different clinical departments might have greatly affected vaccination proportions. When we select controls, we should consider the background factors (underlying diseases, clinical department, etc.) which affect physicians' recommendation of vaccination. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/28818473/Effectiveness_of_23_valent_pneumococcal_polysaccharide_vaccine_and_seasonal_influenza_vaccine_for_pneumonia_among_the_elderly___Selection_of_controls_in_a_case_control_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(17)30901-5 DB - PRIME DP - Unbound Medicine ER -