Epiconcept, Paris, France.
Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
Influenza Other Respir Viruses. 2021 Jul;15(4):429-438. doi: 10.1111/irv.12839. Epub 2021 Jan 22.
Claims of influenza vaccination increasing COVID-19 risk are circulating. Within the I-MOVE-COVID-19 primary care multicentre study, we measured the association between 2019-20 influenza vaccination and COVID-19.
We conducted a multicentre test-negative case-control study at primary care level, in study sites in five European countries, from March to August 2020. Patients presenting with acute respiratory infection were swabbed, with demographic, 2019-20 influenza vaccination and clinical information documented. Using logistic regression, we measured the adjusted odds ratio (aOR), adjusting for study site and age, sex, calendar time, presence of chronic conditions. The main analysis included patients swabbed ≤7 days after onset from the three countries with <15% of missing influenza vaccination. In secondary analyses, we included five countries, using multiple imputation with chained equations to account for missing data.
We included 257 COVID-19 cases and 1631 controls in the main analysis (three countries). The overall aOR between influenza vaccination and COVID-19 was 0.93 (95% CI: 0.66-1.32). The aOR was 0.92 (95% CI: 0.58-1.46) and 0.92 (95% CI: 0.51-1.67) among those aged 20-59 and ≥60 years, respectively. In secondary analyses, we included 6457 cases and 69 272 controls. The imputed aOR was 0.87 (95% CI: 0.79-0.95) among all ages and any delay between swab and symptom onset.
There was no evidence that COVID-19 cases were more likely to be vaccinated against influenza than controls. Influenza vaccination should be encouraged among target groups for vaccination. I-MOVE-COVID-19 will continue documenting influenza vaccination status in 2020-21, in order to learn about effects of recent influenza vaccination.
有关流感疫苗会增加 COVID-19 风险的说法正在流传。在 I-MOVE-COVID-19 初级保健多中心研究中,我们测量了 2019-20 年流感疫苗接种与 COVID-19 之间的关联。
我们在 2020 年 3 月至 8 月在五个欧洲国家的研究地点进行了一项初级保健层面的多中心病例对照研究。对出现急性呼吸道感染的患者进行拭子取样,并记录人口统计学、2019-20 年流感疫苗接种和临床信息。我们使用逻辑回归测量了调整后的优势比(aOR),并根据研究地点和年龄、性别、日历时间、是否存在慢性疾病进行了调整。主要分析包括在三个国家中发病后 ≤7 天且流感疫苗接种缺失率<15%的患者。在二次分析中,我们纳入了五个国家,使用链式方程进行多重插补来处理缺失数据。
我们在主要分析(三个国家)中纳入了 257 例 COVID-19 病例和 1631 例对照。流感疫苗接种与 COVID-19 之间的总体 aOR 为 0.93(95%CI:0.66-1.32)。在年龄 20-59 岁和≥60 岁的人群中,aOR 分别为 0.92(95%CI:0.58-1.46)和 0.92(95%CI:0.51-1.67)。在二次分析中,我们纳入了 6457 例病例和 69272 例对照。所有年龄段和拭子与症状出现之间任何延迟的插补 aOR 均为 0.87(95%CI:0.79-0.95)。
没有证据表明 COVID-19 病例比对照更有可能接种流感疫苗。应鼓励目标人群接种流感疫苗。I-MOVE-COVID-19 将继续记录 2020-21 年的流感疫苗接种情况,以便了解最近流感疫苗接种的效果。