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Clin Infect Dis. 2018 Sep 15. doi: 10.1093/cid/ciy792. [Epub ahead of print]
Clinical effectiveness of influenza vaccination after allogeneic hematopoietic stem cell transplantation: A cross-sectional prospective observational study.
Pi?ana JL1,2, P?rez A3, Montoro J1,2, Gim?nez E4, Dolores G?mez M5, Lorenzo I1, Madrid S4, Gonz?lez EM5, Vinuesa V4, Hern?ndez-Boluda JC5, Salavert M6, Sanz G1,2, Solano C5,7, Sanz J1,2, Navarro D4,8.
Author information
Abstract
Background:
Allogeneic hematopoietic stem cell recipients (allo-HSCT) are at high risk for morbidity and mortality from influenza respiratory virus infection (RVI). Vaccination is the primary method for preventing influenza RVI. Although the influenza vaccine is able to achieve serological response in some allo-HSCT recipients, its clinical benefit is still uncertain.
Methods:
In this prospective cross-sectional study, we retrospectively analyzed the effect of inactivated trivalent influenza vaccination status on the prevalence of influenza RVI in a consecutive cohort of 136 allo-HSCT adult recipients who developed 161 RVI over 5 flu seasons (from 2013 to 2018). Respiratory virus in upper and/or lower respiratory tract specimens were tested using multiplex PCR panel assays.
Results:
Overall, we diagnosed 74 episodes (46%) of Influenza RVI in 70 allo-HSCT recipients. Influenza RVI occurred in 51% of the non-vaccinated compared to 36% of the vaccinated recipients (p= 0.036). Multivariate analysis showed that influenza vaccination was associated with lower prevalence of influenza RVI (OR 0.39, p= 0.01). Multivariate risk factor analysis of lower respiratory tract disease (LRTD) identified two conditions associated with the probability of influenza RVI progression; influenza vaccination (OR 0.12, 95% C.I. 0.014-1, p= 0.05) and high-risk immunodeficiency score index (OR 36, 95% C.I. 2.26-575, p= 0.011). Influenza vaccination was also associated with lower likelihood of influenza-related hospital admission (14% vs 2%, p= 0.04).
Conclusion:
This study shows that influenza vaccination may have a clinical benefit in allo-HSCT recipients with virologicallly confirmed RVI, in terms of lower influenza RVI prevalence, LRTD progression and hospital admission.
PMID: 30239624 DOI: 10.1093/cid/ciy792
Clinical effectiveness of influenza vaccination after allogeneic hematopoietic stem cell transplantation: A cross-sectional prospective observational study.
Pi?ana JL1,2, P?rez A3, Montoro J1,2, Gim?nez E4, Dolores G?mez M5, Lorenzo I1, Madrid S4, Gonz?lez EM5, Vinuesa V4, Hern?ndez-Boluda JC5, Salavert M6, Sanz G1,2, Solano C5,7, Sanz J1,2, Navarro D4,8.
Author information
Abstract
Background:
Allogeneic hematopoietic stem cell recipients (allo-HSCT) are at high risk for morbidity and mortality from influenza respiratory virus infection (RVI). Vaccination is the primary method for preventing influenza RVI. Although the influenza vaccine is able to achieve serological response in some allo-HSCT recipients, its clinical benefit is still uncertain.
Methods:
In this prospective cross-sectional study, we retrospectively analyzed the effect of inactivated trivalent influenza vaccination status on the prevalence of influenza RVI in a consecutive cohort of 136 allo-HSCT adult recipients who developed 161 RVI over 5 flu seasons (from 2013 to 2018). Respiratory virus in upper and/or lower respiratory tract specimens were tested using multiplex PCR panel assays.
Results:
Overall, we diagnosed 74 episodes (46%) of Influenza RVI in 70 allo-HSCT recipients. Influenza RVI occurred in 51% of the non-vaccinated compared to 36% of the vaccinated recipients (p= 0.036). Multivariate analysis showed that influenza vaccination was associated with lower prevalence of influenza RVI (OR 0.39, p= 0.01). Multivariate risk factor analysis of lower respiratory tract disease (LRTD) identified two conditions associated with the probability of influenza RVI progression; influenza vaccination (OR 0.12, 95% C.I. 0.014-1, p= 0.05) and high-risk immunodeficiency score index (OR 36, 95% C.I. 2.26-575, p= 0.011). Influenza vaccination was also associated with lower likelihood of influenza-related hospital admission (14% vs 2%, p= 0.04).
Conclusion:
This study shows that influenza vaccination may have a clinical benefit in allo-HSCT recipients with virologicallly confirmed RVI, in terms of lower influenza RVI prevalence, LRTD progression and hospital admission.
PMID: 30239624 DOI: 10.1093/cid/ciy792