年龄对美国≥65 岁 Medicare 受益人群中高剂量与标准剂量流感疫苗相对有效性的影响。
Effect of Age on Relative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccines Among US Medicare Beneficiaries Aged ≥65 Years.
机构信息
Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland.
Acumen, Burlingame, Stanford University, Stanford, California.
出版信息
J Infect Dis. 2019 Sep 26;220(9):1511-1520. doi: 10.1093/infdis/jiz360.
BACKGROUND
Studies have found that the high-dose influenza vaccine has a higher relative vaccine effectiveness (RVE) versus standard-dose vaccines in some seasons. We evaluated the effect of age on the RVE of high-dose versus standard-dose influenza vaccines among Medicare beneficiaries.
METHODS
A 6-season retrospective cohort study from 2012 to 2018 among Medicare beneficiaries aged ≥65 years was performed. Poisson regression was used to evaluate the effect of age on the RVE of high-dose versus standard-dose influenza vaccines in preventing influenza-related hospitalizations.
RESULTS
The study included >19 million vaccinated beneficiaries in a community pharmacy setting. The Poisson models indicated a slightly increasing trend in RVE with age in all seasons. The high-dose vaccine was more effective than standard-dose vaccines in preventing influenza-related hospital encounters (ie, influenza-related inpatient stays and emergency department visits) in the 2012-2013 (RVE, 23.1%; 95% confidence interval [CI], 17.6%-28.3%), 2013-2014 (RVE, 15.3%; 95% CI, 7.8%-22.3%), 2014-2015 (RVE, 8.9%; 95% CI, 5.6%-12.1%), and 2016-2017 (RVE, 12.6%; 95% CI, 6.3%-18.4%) seasons and was at least as effective in all other seasons. We also found that the high-dose vaccine was consistently more effective than standard-dose vaccines across all seasons for people aged ≥85 years. Similar trends were observed for influenza-related inpatient stays.
CONCLUSIONS
The RVE of high-dose versus standard-dose influenza vaccines increases with age.
背景
研究发现，在某些季节，高剂量流感疫苗相对于标准剂量疫苗具有更高的相对疫苗效力（RVE）。我们评估了年龄对医疗保险受益人中高剂量与标准剂量流感疫苗的 RVE 的影响。
方法
这是一项在 2012 年至 2018 年期间进行的针对 6 个季节的回顾性队列研究，参与者为年龄≥65 岁的医疗保险受益人。使用泊松回归评估年龄对高剂量与标准剂量流感疫苗预防流感相关住院的 RVE 的影响。
结果
本研究纳入了社区药房环境中超过 1900 万接种疫苗的受益人。泊松模型表明，所有季节的 RVE 均随年龄略有增加。在 2012-2013 年（RVE，23.1%；95%置信区间[CI]，17.6%-28.3%）、2013-2014 年（RVE，15.3%；95% CI，7.8%-22.3%）、2014-2015 年（RVE，8.9%；95% CI，5.6%-12.1%）和 2016-2017 年（RVE，12.6%；95% CI，6.3%-18.4%）季节，高剂量疫苗在预防流感相关住院方面比标准剂量疫苗更有效，并且在所有其他季节也至少同样有效。我们还发现，在所有季节，高剂量疫苗对≥85 岁人群的效果均优于标准剂量疫苗。对于流感相关住院患者，也观察到类似的趋势。
结论
高剂量与标准剂量流感疫苗的 RVE 随年龄增长而增加。
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