Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Department of Global Health, School of Public Health, Peking University, Beijing, China.
Hum Vaccin Immunother. 2021 Dec 2;17(12):5522-5528. doi: 10.1080/21645515.2021.2007012. Epub 2022 Feb 8.
Influenza vaccination in a single season protects against hospitalization outcomes among older adults hospitalized for cardiovascular or respiratory diseases, but the effectiveness of repeated influenza vaccination is less clear. Four hospitalization outcomes (in-hospital death, re-admission, length of stay, and direct medical costs) were extracted from the Beijing Urban Employee Basic Medical Insurance database in 2015-2016 for adults aged ≥60 years hospitalized for cardiovascular or respiratory diseases. Vaccination status during three influenza seasons (2013/2014-2015/2016) was ascertained through linkages to the Beijing Elderly Influenza Vaccination database. The summer months (June-August) were used as a reference period to control unmeasured confounders during the influenza season. There were 99,135 periods of observation in the analysis, with 8.3% participants receiving influenza vaccination in all three seasons. After adjusting for confounders, influenza vaccination in all three seasons was associated with a lower risk of re-admission among patients with cardiovascular diseases (odds ratio 0.71 [95% CI 0.53-0.96]) and a lower risk of death among patients with respiratory diseases (0.68 [0.46-0.98]) compared with those unvaccinated in any season. Among patients with cardiovascular diseases, influenza vaccination in all three seasons was also associated with a non-significant lower risk of death (0.66 [0.44-1.03]) in addition to shorter hospital stays and lower direct medical costs. When stratified by history of vaccination, the effectiveness of current season vaccination was similar among patients with cardiovascular or respiratory diseases (-value for heterogeneity all >0.05). Repeated influenza vaccination protected against hospitalization outcomes among older adults with cardiovascular or respiratory diseases.
在一个流感季节接种疫苗可以预防因心血管或呼吸系统疾病住院的老年人的住院结局，但重复接种流感疫苗的效果不太清楚。从 2015-2016 年北京市城镇职工基本医疗保险数据库中提取了 4 个住院结局（住院期间死亡、再入院、住院时间和直接医疗费用），这些结局适用于因心血管或呼吸系统疾病住院的年龄≥60 岁的成年人。通过与北京市老年人流感疫苗接种数据库的链接确定了三个流感季节（2013/2014-2015/2016）期间的接种情况。夏季（6-8 月）被用作流感季节的参考期，以控制未测量的混杂因素。在分析中共有 99135 个观察期，8.3%的参与者在所有三个季节都接种了流感疫苗。在调整混杂因素后，与所有三个季节均未接种疫苗的患者相比，所有三个季节接种流感疫苗的患者因心血管疾病再入院的风险较低（比值比 0.71[95%CI 0.53-0.96]），因呼吸系统疾病死亡的风险也较低（0.68[0.46-0.98]）。在心血管疾病患者中，与所有三个季节均未接种疫苗的患者相比，所有三个季节接种流感疫苗还与非致命性死亡风险较低相关（0.66[0.44-1.03]），此外还与住院时间缩短和直接医疗费用降低相关。在按疫苗接种史分层时，心血管或呼吸系统疾病患者中当前季节疫苗接种的有效性相似（-值的异质性均>0.05）。重复接种流感疫苗可以预防心血管或呼吸系统疾病老年患者的住院结局。
