Pang Yuanjie, Liu Xiaofan, Liu Guangqi, Lv Min, Lu Ming, Wu Jiang, Huang Yangmu
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Department of Biostatistics, Yale School of Public Health, New Haven, CT.
Int J Infect Dis. 2022 Sep;122:162-168. doi: 10.1016/j.ijid.2022.05.059. Epub 2022 May 30.
There is limited evidence on the effectiveness of influenza vaccination on hospitalization outcomes by cardiovascular disease (CVD) subtypes or comorbidities.
This study involved 713,488 records of hospitalization of adults ≥60 years with CVD from the Beijing Urban Employee Basic Medical Insurance database. Logistic regression with generalized estimating equations was conducted to estimate the effectiveness of influenza vaccination on in-hospital death and recurrent hospitalization, adjusting for unmeasured confounders.
The coverage of influenza vaccination was only 13.3% among older adults hospitalized for CVD. Influenza vaccination was associated with 15% (odds ratios 0.85 [0.74, 0.99]) lower risk of in-hospital death among patients with CVD, with stronger associations in patients with stroke. Influenza vaccination was associated with 6% (0.94 [0.88, 0.99]) and 28% (0.72 [0.56, 0.93]) lower risks of recurrent hospitalization for ischemic heart disease (IHD) and respiratory disease in patients with IHD, but there were no clear associations in patients with stroke. For in-hospital death, the protective association of influenza vaccination was stronger in patients with fewer comorbidities and was similar to that of joint vaccinations of influenza and pneumococcal vaccinations.
The protective association of influenza vaccination on CVD hospitalization outcomes serves as the evidence base to increase the uptake of influenza vaccination among older adults in China.
关于流感疫苗接种对心血管疾病（CVD）亚型或合并症住院结局有效性的证据有限。
本研究纳入了来自北京市城镇职工基本医疗保险数据库的713488例≥60岁患有CVD的成年人住院记录。采用广义估计方程进行逻辑回归，以估计流感疫苗接种对院内死亡和再次住院的有效性，并对未测量的混杂因素进行调整。
因CVD住院的老年人中流感疫苗接种覆盖率仅为13.3%。流感疫苗接种使CVD患者院内死亡风险降低15%（比值比0.85[0.74,0.99]），在中风患者中关联更强。流感疫苗接种使缺血性心脏病（IHD）患者因IHD和呼吸系统疾病再次住院的风险分别降低6%（0.94[0.88,0.99]）和28%（0.72[0.56,0.93]），但在中风患者中无明显关联。对于院内死亡，流感疫苗接种的保护关联在合并症较少的患者中更强，且与流感疫苗和肺炎球菌疫苗联合接种的保护关联相似。
流感疫苗接种对CVD住院结局的保护关联为提高中国老年人流感疫苗接种率提供了证据基础。
