Tags

Type your tag names separated by a space and hit enter

Influenza Vaccine Effectiveness Against All-Cause Mortality Following Laboratory-Confirmed Influenza in Older Adults, 2010-2011 to 2015-2016 Seasons in Ontario, Canada.
Clin Infect Dis. 2021 09 07; 73(5):e1191-e1199.CI

Abstract

BACKGROUND

Older adults are at increased risk of mortality from influenza infections. We estimated influenza vaccine effectiveness (VE) against mortality following laboratory-confirmed influenza.

METHODS

Using a test-negative design study and linked laboratory and health administrative databases in Ontario, Canada, we estimated VE against all-cause mortality following laboratory-confirmed influenza for community-dwelling adults aged >65 years during the 2010-2011 to 2015-2016 influenza seasons.

RESULTS

Among 54 116 older adults tested for influenza across the 6 seasons, 6837 died within 30 days of specimen collection. Thirteen percent (925 individuals) tested positive for influenza, and 50.6% were considered vaccinated for that season. Only 23.2% of influenza test-positive cases had influenza recorded as their underlying cause of death. Before and after multivariable adjustment, we estimated VE against all-cause mortality following laboratory-confirmed influenza to be 20% (95% confidence interval [CI], 8%-30%) and 20% (95% CI, 7%-30%), respectively. This estimate increased to 34% after correcting for influenza vaccination exposure misclassification. We observed significant VE against deaths following influenza confirmation during 2014-2015 (VE = 26% [95% CI, 5%-42%]). We also observed significant VE against deaths following confirmation of influenza A/H1N1 and A/H3N2, and against deaths with COPD as the underlying cause.

CONCLUSIONS

These results support the importance of influenza vaccination in older adults, who account for most influenza-associated deaths annually.

Authors+Show Affiliations

Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada.Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada. Public Health Ontario, Toronto, Ontario, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.Hospital for Sick Children, Toronto, Ontario, Canada. London Health Sciences Centre, London, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada.Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Toronto Public Health, Toronto, Ontario, Canada.Public Health Ontario, Toronto, Ontario, Canada. Hospital for Sick Children, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.North York General Hospital, Toronto, Ontario, Canada.Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Sinai Health System, Toronto, Ontario, Canada.Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.Public Health Ontario, Toronto, Ontario, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.William Osler Health System, Brampton, Ontario, Canada.Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada. Public Health Ontario, Toronto, Ontario, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada. Public Health Ontario, Toronto, Ontario, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.McMaster University, Hamilton, Ontario, Canada.London Health Sciences Centre, London, Ontario, Canada. Newfoundland and Labrador Public Health Laboratory, St. John's, NF&L, Canada.Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada. Public Health Ontario, Toronto, Ontario, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada. Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada. University Health Network, Toronto, Ontario, Canada.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33354709

Citation

Chung, Hannah, et al. "Influenza Vaccine Effectiveness Against All-Cause Mortality Following Laboratory-Confirmed Influenza in Older Adults, 2010-2011 to 2015-2016 Seasons in Ontario, Canada." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 73, no. 5, 2021, pp. e1191-e1199.
Chung H, Buchan SA, Campigotto A, et al. Influenza Vaccine Effectiveness Against All-Cause Mortality Following Laboratory-Confirmed Influenza in Older Adults, 2010-2011 to 2015-2016 Seasons in Ontario, Canada. Clin Infect Dis. 2021;73(5):e1191-e1199.
Chung, H., Buchan, S. A., Campigotto, A., Campitelli, M. A., Crowcroft, N. S., Dubey, V., Gubbay, J. B., Karnauchow, T., Katz, K., McGeer, A. J., McNally, J. D., Mubareka, S., Murti, M., Richardson, D. C., Rosella, L. C., Schwartz, K. L., Smieja, M., Zahariadis, G., & Kwong, J. C. (2021). Influenza Vaccine Effectiveness Against All-Cause Mortality Following Laboratory-Confirmed Influenza in Older Adults, 2010-2011 to 2015-2016 Seasons in Ontario, Canada. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 73(5), e1191-e1199. https://doi.org/10.1093/cid/ciaa1862
Chung H, et al. Influenza Vaccine Effectiveness Against All-Cause Mortality Following Laboratory-Confirmed Influenza in Older Adults, 2010-2011 to 2015-2016 Seasons in Ontario, Canada. Clin Infect Dis. 2021 09 7;73(5):e1191-e1199. PubMed PMID: 33354709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza Vaccine Effectiveness Against All-Cause Mortality Following Laboratory-Confirmed Influenza in Older Adults, 2010-2011 to 2015-2016 Seasons in Ontario, Canada. AU - Chung,Hannah, AU - Buchan,Sarah A, AU - Campigotto,Aaron, AU - Campitelli,Michael A, AU - Crowcroft,Natasha S, AU - Dubey,Vinita, AU - Gubbay,Jonathan B, AU - Karnauchow,Timothy, AU - Katz,Kevin, AU - McGeer,Allison J, AU - McNally,J Dayre, AU - Mubareka,Samira, AU - Murti,Michelle, AU - Richardson,David C, AU - Rosella,Laura C, AU - Schwartz,Kevin L, AU - Smieja,Marek, AU - Zahariadis,George, AU - Kwong,Jeffrey C, PY - 2020/09/02/received PY - 2020/12/21/accepted PY - 2020/12/24/pubmed PY - 2021/9/23/medline PY - 2020/12/23/entrez KW - influenza vaccine KW - mortality KW - older adults KW - vaccine effectiveness SP - e1191 EP - e1199 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 73 IS - 5 N2 - BACKGROUND: Older adults are at increased risk of mortality from influenza infections. We estimated influenza vaccine effectiveness (VE) against mortality following laboratory-confirmed influenza. METHODS: Using a test-negative design study and linked laboratory and health administrative databases in Ontario, Canada, we estimated VE against all-cause mortality following laboratory-confirmed influenza for community-dwelling adults aged >65 years during the 2010-2011 to 2015-2016 influenza seasons. RESULTS: Among 54 116 older adults tested for influenza across the 6 seasons, 6837 died within 30 days of specimen collection. Thirteen percent (925 individuals) tested positive for influenza, and 50.6% were considered vaccinated for that season. Only 23.2% of influenza test-positive cases had influenza recorded as their underlying cause of death. Before and after multivariable adjustment, we estimated VE against all-cause mortality following laboratory-confirmed influenza to be 20% (95% confidence interval [CI], 8%-30%) and 20% (95% CI, 7%-30%), respectively. This estimate increased to 34% after correcting for influenza vaccination exposure misclassification. We observed significant VE against deaths following influenza confirmation during 2014-2015 (VE = 26% [95% CI, 5%-42%]). We also observed significant VE against deaths following confirmation of influenza A/H1N1 and A/H3N2, and against deaths with COPD as the underlying cause. CONCLUSIONS: These results support the importance of influenza vaccination in older adults, who account for most influenza-associated deaths annually. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/33354709/Influenza_Vaccine_Effectiveness_Against_All_Cause_Mortality_Following_Laboratory_Confirmed_Influenza_in_Older_Adults_2010_2011_to_2015_2016_Seasons_in_Ontario_Canada_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciaa1862 DB - PRIME DP - Unbound Medicine ER -