Infectious Diseases Unit, Alfred Hospital, Melbourne, Victoria, Australia.
PLoS One. 2013 Jul 16;8(7):e68760. doi: 10.1371/journal.pone.0068760. Print 2013.
Immunisation programs are designed to reduce serious morbidity and mortality from influenza, but most evidence supporting the effectiveness of this intervention has focused on disease in the community or in primary care settings. We aimed to examine the effectiveness of influenza vaccination against hospitalisation with confirmed influenza. We compared influenza vaccination status in patients hospitalised with PCR-confirmed influenza with patients hospitalised with influenza-negative respiratory infections in an Australian sentinel surveillance system. Vaccine effectiveness was estimated from the odds ratio of vaccination in cases and controls. We performed both simple multivariate regression and a stratified analysis based on propensity score of vaccination. Vaccination status was ascertained in 333 of 598 patients with confirmed influenza and 785 of 1384 test-negative patients. Overall estimated crude vaccine effectiveness was 57% (41%, 68%). After adjusting for age, chronic comorbidities and pregnancy status, the estimated vaccine effectiveness was 37% (95% CI: 12%, 55%). In an analysis accounting for a propensity score for vaccination, the estimated vaccine effectiveness was 48.3% (95% CI: 30.0, 61.8%). Influenza vaccination was moderately protective against hospitalisation with influenza in the 2010 and 2011 seasons.
免疫计划旨在降低流感导致的严重发病率和死亡率，但大多数支持该干预措施有效性的证据都集中在社区或初级保健环境中的疾病上。我们旨在研究流感疫苗接种对因确诊流感住院的效果。我们在澳大利亚监测系统中比较了因 PCR 确诊流感住院的患者与因流感阴性呼吸道感染住院的患者的流感疫苗接种状况。通过病例和对照组的疫苗接种比值比来估计疫苗有效性。我们进行了简单的多变量回归分析和基于倾向评分的分层分析。在 598 例确诊流感患者中有 333 例和 1384 例检测阴性患者中有 785 例确定了疫苗接种状况。总体估计的原始疫苗有效性为 57%（41%，68%）。在调整年龄、慢性合并症和妊娠状态后，估计的疫苗有效性为 37%（95%CI：12%，55%）。在考虑疫苗接种倾向评分的分析中，估计的疫苗有效性为 48.3%（95%CI：30.0，61.8%）。在 2010 年和 2011 年的流感季节，流感疫苗接种对因流感住院有一定的保护作用。
