High-dose (HD) influenza vaccine provided superior protection for seniors against influenza hospitalization during the 2016-17 influenza season in the Portland metropolitan area, a new study found. The differential vaccine effectiveness (VE) was assessed by a nested series of models across matching strata. For an exact match for high-dose and standard-dose seniors, matching elements included exact age, gender, residence type, race/ethnicity, provider bias, and residence area. Among the findings:
- A simple aggregate comparison of influenza hospitalization risk showed no added HD effectiveness.
- For nested models, adding strata increased VE in this study population.
- Among 23,712 matched pairs of HD to standard-dose vaccinated seniors, the HD vaccine was 30.7% more effective in preventing influenza-related hospitalization.
Robison SG, Thomas AR. Assessing the effectiveness of high-dose influenza vaccine in preventing hospitalization among seniors, and observations on the limitations of effectiveness study design. [Published online ahead of print October 1, 2018]. Vaccine. doi:10.1016/j.vaccine.2018.09.050.
This is a very important study. In this examination of a large US city and type of influenza vaccination and hospitalization, researchers found that the high dose vaccine was 30% more effective in seniors for preventing hospitalizations. Only about 70% of our senior citizens get vaccinated against influenza each year. For our patients that do elect to get vaccinated, we should try to get them the vaccine that is more effective for outcomes like hospitalizations. This real-world trial tried to eliminate biases like certain “healthy” patients get immunized more or that clinicians are more likely to encourage vaccination in their “sicker” patients. The ACIP does not give the high-dose influenza vaccine a preferential recommendation but at this point, should they? —John Russell, MD
This Week's Must Reads
HRRP & Patient Mortality in HF, AMI & Pneumonia, JAMA; 2018 Dec 25; Wadhera, et al
Hypertensive Diseases of Pregnancy & Risk of HF, Mayo Clin Proc; ePub 2018 Dec 19; Nizamuddin, et al
Clopidogrel + Aspirin Can Reduce Recurrent Stroke, BMJ; ePub 2018 Dec 18; Hao, Tampi, et al
Second-Line ADMs & CV Events in T2D, JAMA Netw Open; ePub 2018 Dec 21; O’Brien, et al
Health Care Utilization of a Dementia Care Program, JAMA Intern Med; ePub 2018 Dec 21; Jennings, et al
Must Reads in Vaccines
Acellular Pertussis Vaccine Is Safe & Effective, JAMA Pediatr; 2018 Nov; Wood, Nolan, et al
Influenza and Pertussis Vaccination in Pregnancy, Vaccine; ePub 2018 Nov 3; Wilcox, Bottrell, et al
Influenza Vaccine Efficacy in High-Risk Patients, Vaccine; ePub 2018 Nov 9; Shang, Chung, et al
Childhood Vaccination Coverage Rates Compared, J Paediatr Child Health; ePub 2018 Nov 13; Baumann, et al
Measles Immunity After Vaccination in Children with HIV, Clin Infect Dis; ePub 2018 Nov 12; Mutsaerts, et al