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Clin Infect Dis. 2016 Nov 15;63(10):1304-1311. Epub 2016 Aug 2.

Case-Control Study of Vaccine Effectiveness in Preventing Laboratory-Confirmed Influenza Hospitalizations in Older Adults, United States, 2010-2011.

Author information

1
Influenza Division, Centers for Disease Control and Prevention.
2
Battelle Memorial Institute.
3
Emory University School of Medicine.
4
VA Medical Center, Atlanta, Georgia.
5
Maryland Department of Health and Mental Hygiene, Baltimore.
6
Connecticut Emerging Infections Program, Yale School of Public Health, New Haven.
7
California Emerging Infections Program, Oakland.
8
University of Rochester School of Medicine and Dentistry, New York.
9
Minnesota Department of Health, St Paul.
10
Colorado Department of Public Health and Environment, Denver.
11
Oregon Public Health Division, Portland.
12
Vanderbilt University School of Medicine, Nashville, Tennessee.
13
New York State Department of Health, Albany.
14
New Mexico Department of Health, Santa Fe.

Abstract

BACKGROUND:

 Older adults are at increased risk of influenza-associated complications, including hospitalization, but influenza vaccine effectiveness (VE) data are limited for this population. We conducted a case-control study to estimate VE to prevent laboratory-confirmed influenza hospitalizations among adults aged ≥50 years in 11 US Emerging Infections Program hospitalization surveillance sites.

METHODS:

 Cases were influenza infections (confirmed by reverse-transcription polymerase chain reaction) in adults aged ≥50 years hospitalized during the 2010-2011 influenza season, identified through Emerging Infections Program surveillance. Community controls, identified through home telephone lists, were matched by age group (±5 years), county, and month of hospitalization for case patients. Vaccination status was determined by self-report (with location and date) or medical records. Conditional logistic regression models were used to calculate adjusted VE (aVE) estimates (100 × [1 - adjusted odds ratio]), adjusting for sex, race, socioeconomic factors, smoking, chronic medical conditions, recent hospitalization for a respiratory condition, and functional status.

RESULTS:

 Among case patients, 205 of 368 (55%) were vaccinated, compared with 489 of 773 controls (63%). Case patients were more likely to be of nonwhite race and more likely to have ≥2 chronic health conditions, a recent hospitalization for a respiratory condition, an income <$35 000, and a lower functional status score (P < .01 for all). The aVE was 56.8% (95% confidence interval, 34.1%-71.7%) and was similar across age groups, including adults ≥75 years (aVE, 57.3%; 15.9%-78.4%).

CONCLUSIONS:

 During 2010-2011, influenza vaccination was associated with a significant reduction in the risk of laboratory-confirmed influenza hospitalization among adults aged ≥50 years, regardless of age group.

KEYWORDS:

influenza vaccination; influenza vaccine effectiveness; influenza-associated hospitalization; older adults

PMID:
27486114
DOI:
10.1093/cid/ciw512
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