학술논문

Influenza Vaccination Modifies Disease Severity Among Community-dwelling Adults Hospitalized With Influenza
Document Type
article
Source
Clinical Infectious Diseases. 65(8)
Subject
Emerging Infectious Diseases
Immunization
Influenza
Clinical Research
Pneumonia & Influenza
Vaccine Related
Infectious Diseases
Prevention
Aging
Infection
Adolescent
Adult
Aged
Female
Humans
Influenza Vaccines
Influenza
Human
Male
Middle Aged
Propensity Score
Retrospective Studies
Severity of Illness Index
United States
Vaccination
Young Adult
Influenza vaccination
adults
disease severity
Biological Sciences
Medical and Health Sciences
Microbiology
Language
Abstract
BackgroundWe investigated the effect of influenza vaccination on disease severity in adults hospitalized with laboratory-confirmed influenza during 2013-14, a season in which vaccine viruses were antigenically similar to those circulating.MethodsWe analyzed data from the 2013-14 influenza season and used propensity score matching to account for the probability of vaccination within age strata (18-49, 50-64, and ≥65 years). Death, intensive care unit (ICU) admission, and hospital and ICU lengths of stay (LOS) were outcome measures for severity. Multivariable logistic regression and competing risk models were used to compare disease severity between vaccinated and unvaccinated patients, adjusting for timing of antiviral treatment and time from illness onset to hospitalization.ResultsInfluenza vaccination was associated with a reduction in the odds of in-hospital death among patients aged 18-49 years (adjusted odds ratios [aOR] = 0.21; 95% confidence interval [CI], 0.05 to 0.97), 50-64 years (aOR = 0.48; 95% CI, 0.24 to 0.97), and ≥65 years (aOR = 0.39; 95% CI, 0.17 to 0.66). Vaccination also reduced ICU admission among patients aged 18-49 years (aOR = 0.63; 95% CI, 0.42 to 0.93) and ≥65 years (aOR = 0.63; 95% CI, 0.48 to 0.81), and shortened ICU LOS among those 50-64 years (adjusted relative hazards [aRH] = 1.36; 95% CI, 1.06 to 1.74) and ≥65 years (aRH = 1.34; 95% CI, 1.06 to 1.73), and hospital LOS among 50-64 years (aRH = 1.13; 95% CI, 1.02 to 1.26) and ≥65 years (aRH = 1.24; 95% CI, 1.13 to 1.37).ConclusionsInfluenza vaccination during 2013-14 influenza season attenuated adverse outcome among adults that were hospitalized with laboratory-confirmed influenza.