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50至64岁在职成年人中流感样疾病负担及流感疫苗接种效果

Burden of influenza-like illness and effectiveness of influenza vaccination among working adults aged 50-64 years.

作者信息

Nichol Kristin L, D'Heilly Sarah J, Greenberg Michael E, Ehlinger Edward

机构信息

Research Service, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN 55417, USA.

出版信息

Clin Infect Dis. 2009 Feb 1;48(3):292-8. doi: 10.1086/595842.

Abstract

BACKGROUND

Uncertainties regarding influenza disease impact and benefits of vaccination may contribute to low vaccination rates among adults aged 50-64 years.

METHODS

This prospective cohort study assessed the burden of influenza-like illness (ILI) among working adults aged 50-64 years and the effectiveness of influenza vaccination in reducing the rate of ILI and productivity losses. Employees of the University of Minnesota (Minneapolis) were invited via e-mail to participate in the study during October 2006. The study data were collected using internet-based surveys at baseline (October 2006) and during the follow-up period (from November 2006 through April 2007). Months included in the 2006-2007 influenza season were identified retrospectively from Minnesota Department of Health surveillance data. Vaccine effectiveness for reducing the rate of ILI, ILI-associated health care use, the number of days of illness, work loss, and reduced on-the-job productivity during the influenza season were assessed using multivariable regression models after controlling for important confounders.

RESULTS

Four hundred ninety-seven persons were included in the study, 85 (17.1%) of whom experienced an ILI. Among unvaccinated participants, ILI was responsible for 45% of all days of illness during the influenza season, 39% of all illness-related work days lost, and 49% of all days with illness-related reduced on-the-job productivity. In the multivariable regression analyses, vaccination was associated with a significant reduction in the rate of ILI (adjusted odds ratio, 0.48; 95% confidence interval, 0.27-0.86) and fewer days of illness, absenteeism, and impaired on-the-job performance.

CONCLUSION

ILIs were common among our study participants, accounting for a large portion of illness, work loss, and impaired work performance during the influenza season. Vaccination was associated with substantial health and productivity benefits. Vaccine delivery should be improved for this high-priority group.

摘要

背景

关于流感疾病影响和疫苗接种益处的不确定性可能导致50 - 64岁成年人的疫苗接种率较低。

方法

这项前瞻性队列研究评估了50 - 64岁在职成年人中流感样疾病(ILI)的负担,以及流感疫苗接种在降低ILI发病率和生产力损失方面的有效性。明尼苏达大学(明尼阿波利斯)的员工于2006年10月通过电子邮件受邀参与该研究。研究数据通过基于网络的调查在基线时(2006年10月)以及随访期间(2006年11月至2007年4月)收集。2006 - 2007年流感季节所涵盖的月份是根据明尼苏达州卫生部的监测数据回顾性确定的。在控制了重要混杂因素后,使用多变量回归模型评估了流感季节期间疫苗接种在降低ILI发病率、与ILI相关的医疗保健使用、患病天数、工作损失以及在职生产力下降方面的有效性。

结果

497人纳入研究,其中85人(17.1%)经历了ILI。在未接种疫苗的参与者中,ILI占流感季节所有患病天数的45%,所有因病损失工作日的39%,以及所有因病导致在职生产力下降天数的49%。在多变量回归分析中,接种疫苗与ILI发病率显著降低(调整后的优势比为0.48;95%置信区间为0.27 - 0.86)以及患病天数、缺勤率和在职表现受损减少相关。

结论

ILI在我们的研究参与者中很常见,在流感季节占疾病、工作损失和工作表现受损的很大一部分。接种疫苗带来了显著的健康和生产力益处。对于这一高优先级群体,应改进疫苗接种服务。

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