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[意大利弗留利-威尼斯朱利亚大区老年人流感疫苗接种效果评估]

[Evaluation of the effectiveness of influenza vaccination among the elderly in Friuli-Venezia Giulia (Italy)].

作者信息

Valent Francesca, Schiava Flavio, Gnesutta Daniela, Brianti Giorgio, Barbone Fabio

机构信息

Istituto di igiene ed epidemiologia, Policlinico universitario a gestione diretta, Udine

出版信息

Epidemiol Prev. 2005 May-Aug;29(3-4):195-203.

Abstract

OBJECTIVES

To evaluate the effectiveness of the influenza vaccination in reducing medical visits, hospital admissions, and deaths among the population > or =65 years of age in Friuli-Venezia Giulia.

DESIGN

We conducted a retrospective and a prospective cohort study. For the retrospective study, we used data from the regional health electronic database. For the prospective study, we integrated this source of data with data provided by a sample of general practitioners.

SETTING

The Friuli-Venezia Giulia region, Northeastern Italy.

PARTICIPANTS

The population > or =65 years of age assisted by the Regional Health Service.

MAIN OUTCOME MEASURES

Mortality from any cause, deaths, hospital admissions, and medical visits due to influenza, heart disease, and respiratory disease, also stratified by age and comorbidity.

RESULTS

With the exception of some population subgroups, the retrospective study showed that the vaccination was not effective in reducing the risk of hospital admission and death. On the contrary, the vaccination was associated with an increase in hospital admissions due to influenza, heart disease, and respiratory disease (increased by 7%, 13%, and 17%, respectively). On the other hand, the prospective study showed an association between the vaccination and a 26% reduction in the risk of admissions for respiratory disease and a 21% reduction in the risk of all-cause death, whereas visits due to respiratory disease were increased by 55%.

CONCLUSIONS

Overall, the influenza vaccination appeared to have a low impact on the study cohorts. The vaccination was more effective in subjects <85 years of age and in those affected by comorbidity.

摘要

目的

评估流感疫苗接种在降低弗留利-威尼斯朱利亚地区65岁及以上人群就医、住院和死亡风险方面的有效性。

设计

我们开展了一项回顾性和前瞻性队列研究。回顾性研究使用了地区卫生电子数据库中的数据。前瞻性研究则将该数据源与全科医生样本提供的数据相结合。

地点

意大利东北部的弗留利-威尼斯朱利亚地区。

参与者

接受地区卫生服务机构协助的65岁及以上人群。

主要观察指标

任何原因导致的死亡率、流感、心脏病和呼吸道疾病导致的死亡、住院和就医情况,还按年龄和合并症进行了分层。

结果

除了一些人群亚组外,回顾性研究表明疫苗接种在降低住院和死亡风险方面无效。相反,疫苗接种与流感、心脏病和呼吸道疾病导致的住院人数增加有关(分别增加了7%、13%和17%)。另一方面,前瞻性研究表明疫苗接种与呼吸道疾病住院风险降低26%以及全因死亡风险降低21%有关,而呼吸道疾病导致的就医次数增加了55%。

结论

总体而言,流感疫苗接种对研究队列的影响似乎较低。疫苗接种在85岁以下人群和合并症患者中更有效。

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