Pelton Stephen I, Divino Victoria, Shah Drishti, Mould-Quevedo Joaquin, DeKoven Mitch, Krishnarajah Girishanthy, Postma Maarten J
Department of Pediatrics, Boston University Schools of Medicine, Boston, MA 02118, USA.
Maxwell Finland Laboratories, Boston Medical Center, Boston, MA 02118, USA.
Vaccines (Basel). 2020 Aug 7;8(3):446. doi: 10.3390/vaccines8030446.
The influenza-related disease burden is highest among the elderly. We evaluated the relative vaccine effectiveness (rVE) of adjuvanted trivalent influenza vaccine (aTIV) compared to other egg-based influenza vaccines (high-dose trivalent (TIV-HD), quadrivalent (QIVe-SD), and standard-dose trivalent (TIVe-SD)) against influenza-related and cardio-respiratory events among subjects aged ≥65 years for the 2017-2018 influenza season. This retrospective cohort analysis used prescription claims, professional fee claims, and hospital charge master data. Influenza-related hospitalizations/ER visits and office visits and cardio-respiratory events were assessed post-vaccination. Inverse probability of treatment weighting (IPTW) and Poisson regression were used to evaluate the adjusted rVE of aTIV compared to other vaccines. In an economic analysis, annualized follow-up costs were compared between aTIV and TIV-HD. The study was composed of 234,313 aTIV, 1,269,855 TIV-HD, 212,287 QIVe-SD, and 106,491 TIVe-SD recipients. aTIV was more effective in reducing influenza-related office visits and other respiratory-related hospitalizations/ER visits compared to the other vaccines. For influenza-related hospitalizations/ER visits, aTIV was associated with a significantly higher rVE compared to QIVe-SD and TIVe-SD and was comparable to TIV-HD. aTIV was also associated with a significantly higher rVE compared to TIVe-SD against hospitalizations/ER visits related to pneumonia and asthma/COPD/bronchial events. aTIV and TIV-HD were associated with comparable annualized all-cause and influenza-related costs. Adjusted analyses demonstrated a significant benefit of aTIV against influenza- and respiratory-related events compared to the other egg-based vaccines.
流感相关疾病负担在老年人中最高。我们评估了佐剂三价流感疫苗（aTIV）与其他基于鸡蛋的流感疫苗（高剂量三价（TIV-HD）、四价（QIVe-SD）和标准剂量三价（TIVe-SD））相比，在2017 - 2018流感季节针对≥65岁受试者的流感相关和心肺事件的相对疫苗效力（rVE）。这项回顾性队列分析使用了处方索赔、专业费用索赔和医院收费主数据。在接种疫苗后评估流感相关的住院/急诊就诊、门诊就诊和心肺事件。使用治疗权重的逆概率（IPTW）和泊松回归来评估aTIV与其他疫苗相比的调整后rVE。在一项经济分析中，比较了aTIV和TIV-HD之间的年化随访成本。该研究由234,313名aTIV接种者、1,269,855名TIV-HD接种者、212,287名QIVe-SD接种者和106,491名TIVe-SD接种者组成。与其他疫苗相比，aTIV在减少流感相关门诊就诊和其他呼吸道相关住院/急诊就诊方面更有效。对于流感相关的住院/急诊就诊，与QIVe-SD和TIVe-SD相比，aTIV的rVE显著更高，与TIV-HD相当。与TIVe-SD相比，aTIV在预防与肺炎和哮喘/慢性阻塞性肺疾病/支气管事件相关的住院/急诊就诊方面的rVE也显著更高。aTIV和TIV-HD的年化全因成本和流感相关成本相当。调整分析表明，与其他基于鸡蛋的疫苗相比，aTIV在预防流感和呼吸道相关事件方面具有显著益处。
