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Clin Infect Dis. 2018 Feb 9. doi: 10.1093/cid/ciy100. [Epub ahead of print]
Statin use and risks of influenza-related outcomes among older adults receiving standard-dose or high-dose influenza vaccines through Medicare during 2010-2015.
Izurieta HS1,2, Chillarige Y3, Kelman JA4, Forshee R1, Qiang Y5, Wernecke M3, Ferdinands JM6, Lu Y1, Wei Y3, Xu W3, Lu M3, Fry A6, Pratt D1, Shay DK6.
Author information
Abstract
Background:
Statins are used to reduce cardiovascular disease risk. Recent studies suggest that statin use may be associated with an increased influenza risk among influenza vaccinees. We used Medicare data to evaluate associations between statins and risks of influenza-related encounters among vaccinees.
Methods:
In this retrospective cohort study, we identified Medicare beneficiaries aged >65 years who received high-dose (HD) or standard-dose (SD) influenza vaccines at pharmacies from 2010-11 through 2014-15. Statin users were matched to non-users by vaccine type, demographics, prior medical encounters, and comorbidities. We used multivariable Poisson models to estimate associations between statin use around the time of vaccination and risk of influenza-related encounters. Study outcomes included influenza-related office visits with a rapid test followed by dispensing of oseltamivir, and influenza-related hospitalizations (including emergency room visits), during high influenza circulation periods.
Results:
The study included 1,403,651 statin users matched to non-users. Cohorts were well-balanced, with standardized mean differences ≤0.03 for all measured covariates. For statin users, compared to non-users, the adjusted relative risk was 1.086 (95% confidence interval [CI] 1.025-1.150) for influenza-related visits and 1.096 (95% CI 1.013-1.185) for influenza-related hospitalizations. The risk difference ranged from -0.02 to 0.23 for influenza-related visits and from -0.04 to 0.13 for hospitalizations, depending on season severity. Results were similar for HD and SD vaccinees, and for non-synthetic and synthetic statin users.
Conclusions:
Among 2.8 million Medicare beneficiaries, these results suggest that statin use around time of vaccination does not substantially affect the risk of influenza-related medical encounters among older adults.
KEYWORDS:
Statins; influenza hospitalization; influenza vaccination; outpatient
PMID: 29438483 DOI: 10.1093/cid/ciy100
Statin use and risks of influenza-related outcomes among older adults receiving standard-dose or high-dose influenza vaccines through Medicare during 2010-2015.
Izurieta HS1,2, Chillarige Y3, Kelman JA4, Forshee R1, Qiang Y5, Wernecke M3, Ferdinands JM6, Lu Y1, Wei Y3, Xu W3, Lu M3, Fry A6, Pratt D1, Shay DK6.
Author information
Abstract
Background:
Statins are used to reduce cardiovascular disease risk. Recent studies suggest that statin use may be associated with an increased influenza risk among influenza vaccinees. We used Medicare data to evaluate associations between statins and risks of influenza-related encounters among vaccinees.
Methods:
In this retrospective cohort study, we identified Medicare beneficiaries aged >65 years who received high-dose (HD) or standard-dose (SD) influenza vaccines at pharmacies from 2010-11 through 2014-15. Statin users were matched to non-users by vaccine type, demographics, prior medical encounters, and comorbidities. We used multivariable Poisson models to estimate associations between statin use around the time of vaccination and risk of influenza-related encounters. Study outcomes included influenza-related office visits with a rapid test followed by dispensing of oseltamivir, and influenza-related hospitalizations (including emergency room visits), during high influenza circulation periods.
Results:
The study included 1,403,651 statin users matched to non-users. Cohorts were well-balanced, with standardized mean differences ≤0.03 for all measured covariates. For statin users, compared to non-users, the adjusted relative risk was 1.086 (95% confidence interval [CI] 1.025-1.150) for influenza-related visits and 1.096 (95% CI 1.013-1.185) for influenza-related hospitalizations. The risk difference ranged from -0.02 to 0.23 for influenza-related visits and from -0.04 to 0.13 for hospitalizations, depending on season severity. Results were similar for HD and SD vaccinees, and for non-synthetic and synthetic statin users.
Conclusions:
Among 2.8 million Medicare beneficiaries, these results suggest that statin use around time of vaccination does not substantially affect the risk of influenza-related medical encounters among older adults.
KEYWORDS:
Statins; influenza hospitalization; influenza vaccination; outpatient
PMID: 29438483 DOI: 10.1093/cid/ciy100