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Vaccine. 2019 Oct 9. pii: S0264-410X(19)31349-0. doi: 10.1016/j.vaccine.2019.09.105. [Epub ahead of print] Comparative effectiveness of high dose versus adjuvanted influenza vaccine: A retrospective cohort study.
van Aalst R1, Gravenstein S2, Mor V3, Mahmud SM4, Wilschut J5, Postma M6, Chit A7.
Author information
1 Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Vaccine Epidemiology and Modelling, Sanofi Pasteur, Swiftwater, PA, USA. Electronic address: rob.vanaalst@sanofi.com. 2 Brown University, School of Public Health, Dept. Health Services, Policy and Practice, USA; Providence VA Medical Center, Center of Long-Term Services and Support, USA; Center for Gerontology & Healthcare Research, Providence, RI, USA; Warren Alpert Medical School of Brown University, Providence, RI, USA. 3 Brown University, School of Public Health, Dept. Health Services, Policy and Practice, USA; Providence VA Medical Center, Center of Long-Term Services and Support, USA. 4 Department of Community Health Sciences, College of Medicine, University of Manitoba, Winnipeg, MB, Canada; George & Fay Yee Center for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, MB, Canada. 5 Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 6 Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), University of Groningen, Department of Pharmacy, Groningen, the Netherlands; Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, the Netherlands. 7 Vaccine Epidemiology and Modelling, Sanofi Pasteur, Swiftwater, PA, USA; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND:
Adults 65 years and older (seniors) experience more complications following influenza infection than younger adults. We estimated the relative vaccine effectiveness (rVE) of a trivalent high dose (HD-IIV3) versus an adjuvanted trivalent influenza vaccine (aIIV3) in seniors for respiratory-related hospitalizations.
METHODS:
We conducted a retrospective cohort study using claims data from Optum's Clinformatics? Data Mart to compare outcome rates between seniors who received HD-IIV3 versus aIIV3 during the 2016/17 and 2017/18, predominantly A/H3N2 respiratory seasons. Rates were adjusted for demographic characteristics, comorbid conditions, previous influenza vaccination, and geography. We used the previous event rate ratio (PERR) approach to address bias by time-fixed unmeasured confounders.
RESULTS:
We identified 842,282 HD-IIV3 and 34,157 aIIV3 recipients for the 2016/17 season and 1,058,638 HD-IIV3 and 189,636 aIIV3 recipients for the 2017/18 season. The pooled rVE of HD-IIV3 versus aIIV3 for respiratory-related hospitalizations over both seasons was 12% (95% confidence interval: 3.3%-20%); 13% (-6.4% to 32%) for the 2016/17 season and 12% (2.1%-21%) for the 2017/18 season.
CONCLUSIONS:
Pooled over two predominantly A/H3N2 respiratory seasons, HD-IIV3 was associated with fewer respiratory hospital admissions than aIIV3 in senior members of large national managed health care company in the U.S.
Copyright ? 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.
KEYWORDS:
Adjuvanted; Comparative effectiveness; HD-IIV3; High-dose; Influenza vaccine; PERR; Previous event rate ratio; Relative vaccine effectiveness; Residual confounding; Unmeasured confounding factors; aIIV3; rVE
PMID: 31606249 DOI: 10.1016/j.vaccine.2019.09.105