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The Clinical Efficacy of Seasonal Influenza Vaccination - Characteristics of two Outbreaks of Influenza A(H1n1) in Immunocompromised Patients

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  • The Clinical Efficacy of Seasonal Influenza Vaccination - Characteristics of two Outbreaks of Influenza A(H1n1) in Immunocompromised Patients

    J Hosp Infect. 2017 Dec 7. pii: S0195-6701(17)30652-7. doi: 10.1016/j.jhin.2017.12.003. [Epub ahead of print]
    The Clinical Efficacy of Seasonal Influenza Vaccination - Characteristics of two Outbreaks of Influenza A(H1n1) in Immunocompromised Patients.

    Helanter? I1, Janes R2, Anttila VJ3.
    Author information

    Abstract

    BACKGROUND:

    Influenza A(H1N1) causes serious complications in immunocompromised patients. The efficacy of seasonal vaccination in these patients has been questioned.
    AIMS:

    We describe two outbreaks of influenza A(H1N1) in immunocompromised patients.
    METHODS:

    Two outbreaks of influenza A(H1N1) occurred in our institution: on the kidney transplant ward in 2014 including patients early after kidney or simultaneous pancreas-kidney transplantation, and on the oncology ward in 2016 including patients receiving chemotherapy for malignant tumors. Factors leading to these outbreaks and the clinical efficacy of seasonal influenza vaccination were analyzed.
    FINDINGS:

    Altogether 86 patients were exposed to influenza A(H1N1) during the outbreaks, among whom the seasonal influenza vaccination status was unknown in ten. Only 3/38 vaccinated patients were infected with influenza A(H1N1), compared to 20/38 unvaccinated patients (P=0.02). 1/38 vaccinated patient died related to influenza, compared to 7/38 unvaccinated patients (P=0.06). Shared factors behind the two outbreaks included old fashioned facilities not designed for the treatment of immunosuppressed patients. Vaccination coverage among patients was low, between 40-70% despite vaccination being offered to all patients free of charge. Vaccination coverage of health care workers on the transplant ward was low (46%), but, despite high coverage on the oncology ward (92%) the outbreak occurred.
    CONCLUSIONS:

    Seasonal influenza vaccination was clinically effective with both a reduced risk of influenza infection and a trend towards reduced mortality in these immunocompromised patients. Several possible causes were identified behind these two outbreaks that require continuous awareness in health care professionals to prevent further outbreaks.
    Copyright ? 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.


    PMID: 29225054 DOI: 10.1016/j.jhin.2017.12.003
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