Fourth Division, Centers for Disease Control, Taiwan, ROC.
Vaccine. 2013 Jan 11;31(4):632-8. doi: 10.1016/j.vaccine.2012.11.055. Epub 2012 Dec 1.
Since 1998, an influenza vaccination program has been implemented by the Taiwan government targeting people aged ≥65 years. However, the evidence of the effectiveness of this program in preventing influenza, which is based on the nation-wide database, is lacking. This study attempted to estimate the effectiveness of the influenza vaccination program in preventing influenza- and pneumonia-associated outpatient visits and hospitalization in the elderly.
Randomly sampled data of 1 million claims from the National Health Insurance Research Database compiled into seven consecutive cohorts were used to perform this analysis. Elderly claimants aged ≥65 years were included in each cohort. To decrease potential bias between vaccinated and unvaccinated subjects, the propensity score method was applied. Logistic regression and zero-inflated negative binominal regression were used to examine the effectiveness of vaccination in preventing influenza- and pneumonia-associated outpatient visits and hospitalization.
A significant decrease in both the risk and frequency of hospitalization was observed in elderly people who received influenza vaccination compared with those who did not. No similar decrease was observed in the risk and frequency of outpatient visits for influenza and pneumonia.
Vaccination against influenza reduced hospitalization for influenza and pneumonia in elderly Taiwanese people. These results are meaningful for the promotion of vaccination policy. Annual influenza vaccination of the elderly should be encouraged.
自 1998 年以来,台湾政府针对 65 岁及以上人群实施了流感疫苗接种计划。然而,由于缺乏基于全国性数据库的证据,该计划在预防流感方面的效果仍不清楚。本研究旨在评估流感疫苗接种计划在预防老年人流感和肺炎相关门诊就诊和住院方面的效果。
本研究使用国家健康保险研究数据库中随机抽取的 100 万份索赔数据,将其分为七个连续队列进行分析。每个队列都纳入了≥65 岁的老年索赔人。为了减少接种组和未接种组之间的潜在偏倚,应用了倾向评分法。采用逻辑回归和零膨胀负二项回归分析来评估接种疫苗预防流感和肺炎相关门诊就诊和住院的效果。
与未接种疫苗的老年人相比,接种疫苗的老年人的住院风险和频率均显著降低。流感和肺炎门诊就诊的风险和频率则没有类似的降低。
流感疫苗接种可降低台湾老年人群流感和肺炎的住院率。这些结果对于推广疫苗接种政策具有重要意义。应鼓励老年人每年接种流感疫苗。