Sun Huimin, Wang Yijing, Wei Yongyue, Hu Weihua, Zhou Junwen, Nama Nuosu, Ma Yujie, Liu Gang, Hao Yuantao
Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China.
Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.
Vaccines (Basel). 2025 Feb 8;13(2):164. doi: 10.3390/vaccines13020164.
BACKGROUND/OBJECTIVES: This study evaluated the impact of influenza vaccination on mortality using real-world data and compared the effect of current-season-only vaccination versus continuous two-season vaccination.
The 2017-2019 data from the Center for Disease Control and Prevention of Shenzhen, Guangdong, China, included 880,119 individuals aged ≥65 years. The participants were divided into vaccinated and unvaccinated groups and matched using propensity scores with a 1:4 nearest-neighbor approach. Vaccinated individuals were further divided into current-season-only and continuous two-season vaccination groups, matched 1:1. Cox's multivariable proportional hazards regression models were used to assess the effect of vaccination on all-cause mortality, with Firth's penalized likelihood method applied to correct for a few events. The Fine-Gray competing risk models were used to assess the effect of vaccination on cardio-cerebral vascular disease (CCVD) mortality. Sensitivity analyses, including caliper matching, a nested case-control design, and Poisson's regression, were performed to test the robustness of the results.
Influenza vaccination reduced all-cause mortality by 39% (HR = 0.61, 95% CI: 0.47-0.80) and 55% (HR = 0.45, 95% CI: 0.33-0.60) in 2017-2018 and 2018-2019, respectively. Current-season-only vaccination showed stronger protective effects than continuous two-season vaccination (HR = 0.56, 95% CI: 0.31-0.99). Influenza vaccination reduced CCVD mortality by 46% (HR = 0.54, 95% CI: 0.34-0.84) in 2018-2019. The results were consistent across the sensitivity analyses.
Influenza vaccination was associated with a reduced risk of all-cause and CCVD mortality in older adults, underscoring the importance of routine influenza vaccination in older populations. Stronger effects were observed for current-season-only vaccination, warranting further research to confirm the association and explore mechanisms.
背景/目的：本研究使用真实世界数据评估流感疫苗接种对死亡率的影响，并比较仅接种当季疫苗与连续两季接种疫苗的效果。
来自中国广东深圳疾病预防控制中心的2017 - 2019年数据，包括880,119名年龄≥65岁的个体。参与者被分为接种疫苗组和未接种疫苗组，并使用倾向得分以1:4最近邻法进行匹配。接种疫苗的个体进一步分为仅接种当季疫苗组和连续两季接种疫苗组，以1:1进行匹配。使用Cox多变量比例风险回归模型评估疫苗接种对全因死亡率的影响，并应用Firth惩罚似然法校正少量事件。使用Fine - Gray竞争风险模型评估疫苗接种对心脑血管疾病（CCVD）死亡率的影响。进行了敏感性分析，包括卡尺匹配、巢式病例对照设计和泊松回归，以检验结果的稳健性。
在2017 - 2018年和2018 - 2019年，流感疫苗接种分别使全因死亡率降低了39%（HR = 0.61，95%CI：0.47 - 0.80）和55%（HR = 0.45，95%CI：0.33 - 0.60）。仅接种当季疫苗显示出比连续两季接种疫苗更强的保护作用（HR = 0.56，95%CI：0.31 - 0.99）。在2018 - 2019年，流感疫苗接种使CCVD死亡率降低了46%（HR = 0.54，95%CI：0.34 - 0.84）。敏感性分析的结果一致。
流感疫苗接种与老年人全因死亡率和CCVD死亡率风险降低相关，强调了在老年人群中进行常规流感疫苗接种的重要性。仅接种当季疫苗观察到更强的效果，需要进一步研究以确认这种关联并探索其机制。
Zotero 插件