Centro Superior de Investigación en Salud Pública CSISP, Valencia, Spain. puig
Vaccine. 2012 Aug 24;30(39):5714-20. doi: 10.1016/j.vaccine.2012.07.006. Epub 2012 Jul 20.
We estimated influenza vaccine effectiveness (IVE) to prevent laboratory-confirmed influenza-related hospitalizations in patients 18 years old or older during the 2010-2011 influenza season.
We conducted a prospective case-control study in five hospitals, in Valencia, Spain. Study subjects were consecutive emergency hospitalizations for predefined conditions associated with an influenza-like illness episode <8 days before admission. Patients were considered immunized if vaccinated ≥14 days before influenza-like illness onset. Cases were those with a real time reverse transcriptase polymerase chain reaction (RT-PCR) positive for influenza and controls were RT-PCR positive for other respiratory viruses. Adjusted IVE was estimated as 100×(1-adjusted odds ratio). To account for indication bias we computed adjusted IVE for respiratory syncytial virus related hospitalizations.
Of 826 eligible hospitalized patients, 102 (12%) were influenza positive and considered cases, and 116 (14%) were positive for other respiratory viruses and considered controls. Adjusted IVE was 54% (95% confidence interval, 11-76%). By subgroup, adjusted IVE was 53% (4-77%) for those with high-risk conditions, 59% (16-79%) for those ≥60 years of age, and, 54% (4-79%) for those ≥60 years of age with high-risk conditions. No influenza vaccine effect was observed against respiratory syncytial virus related hospitalization.
Influenza vaccination was associated with a significant reduction on the risk of confirmed influenza hospitalization, irrespective of age and high-risk conditions.
我们评估了在 2010-2011 年流感季节中,18 岁及以上患者接种流感疫苗预防实验室确诊的流感相关住院的效果(疫苗效果,IVE)。
我们在西班牙巴伦西亚的五家医院进行了一项前瞻性病例对照研究。研究对象为因预先设定的与流感样疾病发作前<8 天相关的疾病而连续住院的患者。如果患者在流感样疾病发作前≥14 天接种了疫苗,则被认为是已免疫者。病例为实时逆转录聚合酶链反应(RT-PCR)检测出流感阳性的患者,对照为 RT-PCR 检测出其他呼吸道病毒阳性的患者。调整后的 IVE 估计为 100×(调整后的比值比)。为了考虑指示偏倚,我们计算了与呼吸道合胞病毒相关住院的调整后的 IVE。
在 826 名符合条件的住院患者中,有 102 名(12%)流感 RT-PCR 阳性,被认为是病例,有 116 名(14%)其他呼吸道病毒 RT-PCR 阳性,被认为是对照。调整后的 IVE 为 54%(95%置信区间,11-76%)。按亚组分析,高危人群的调整后 IVE 为 53%(4-77%),年龄≥60 岁的调整后 IVE 为 59%(16-79%),年龄≥60 岁且有高危因素的调整后 IVE 为 54%(4-79%)。未观察到流感疫苗对呼吸道合胞病毒相关住院的影响。
无论年龄和高危因素如何,流感疫苗接种都与确诊流感住院风险的显著降低相关。