tetano
Editor, Senior Moderator
Clin Infect Dis
. 2023 Mar 21;ciad148.
doi: 10.1093/cid/ciad148. Online ahead of print.
Evaluating the impact of statin use on influenza vaccine effectiveness and influenza infection in older adults
Hannah Chung[SUP] 1 [/SUP], Michael A Campitelli[SUP] 1 [/SUP], Sarah A Buchan[SUP] 1 2 3 [/SUP], Aaron Campigotto[SUP] 4 5 [/SUP], Branson Chen[SUP] 1 [/SUP], Natasha S Crowcroft[SUP] 1 3 6 7 [/SUP], Vinita Dubey[SUP] 3 8 [/SUP], Jonathan B Gubbay[SUP] 2 4 7 [/SUP], Timothy Karnauchow[SUP] 9 10 [/SUP], Kevin Katz[SUP] 11 [/SUP], Allison J McGeer[SUP] 3 7 12 [/SUP], J Dayre McNally[SUP] 9 [/SUP], Samira Mubareka[SUP] 13 [/SUP], Michelle Murti[SUP] 2 3 [/SUP], David C Richardson[SUP] 14 [/SUP], Laura C Rosella[SUP] 1 2 3 [/SUP], Kevin L Schwartz[SUP] 1 2 3 [/SUP], Marek Smieja[SUP] 15 [/SUP], George Zahariadis[SUP] 5 16 [/SUP], Jeffrey C Kwong[SUP] 1 2 3 6 17 18 [/SUP]
Affiliations
Abstract
Background: Older adults are recommended to receive influenza vaccination annually and many use statins. Statins have immunomodulatory properties that might modify influenza vaccine effectiveness (VE) and alter influenza infection risk.
Methods: Using the test-negative design and linked laboratory and health administrative databases in Ontario, Canada, we estimated VE against laboratory-confirmed influenza among community-dwelling statin users and non-users aged ≥66 years during the 2010-2011 to 2018-2019 influenza seasons. We also estimated the odds ratio (OR) for influenza infection between statin users and non-users by vaccination status.
Results: Among subjects tested for influenza across the 9 seasons, 54,243 had continuous statin exposure prior to testing and 48,469 were deemed unexposed. VE against laboratory-confirmed influenza was similar between statin users and non-users (17% [95%CI, 13-20%] and 17% [95%CI, 13-21%] respectively; test for interaction, p=0.87). In both vaccinated and unvaccinated subjects, statin users had higher odds of laboratory-confirmed influenza than non-users (OR for vaccinated =1.15; 95%CI, 1.10-1.21; OR for unvaccinated=1.15; 95%CI, 1.10-1.20). These findings were consistent by mean daily dose and statin type. VE did not differ between users and non-users of other cardiovascular drugs, except for beta-blockers. We did not observe that vaccinated and unvaccinated users of these drugs had increased odds of influenza, except for unvaccinated beta-blocker users.
Conclusions: Influenza VE did not differ between statin users and non-users. Statin use was associated with increased odds of laboratory-confirmed influenza in vaccinated and unvaccinated subjects, but these associations might be impacted by residual confounding.
Keywords: Influenza; older adults; statins; vaccine effectiveness.
. 2023 Mar 21;ciad148.
doi: 10.1093/cid/ciad148. Online ahead of print.
Evaluating the impact of statin use on influenza vaccine effectiveness and influenza infection in older adults
Hannah Chung[SUP] 1 [/SUP], Michael A Campitelli[SUP] 1 [/SUP], Sarah A Buchan[SUP] 1 2 3 [/SUP], Aaron Campigotto[SUP] 4 5 [/SUP], Branson Chen[SUP] 1 [/SUP], Natasha S Crowcroft[SUP] 1 3 6 7 [/SUP], Vinita Dubey[SUP] 3 8 [/SUP], Jonathan B Gubbay[SUP] 2 4 7 [/SUP], Timothy Karnauchow[SUP] 9 10 [/SUP], Kevin Katz[SUP] 11 [/SUP], Allison J McGeer[SUP] 3 7 12 [/SUP], J Dayre McNally[SUP] 9 [/SUP], Samira Mubareka[SUP] 13 [/SUP], Michelle Murti[SUP] 2 3 [/SUP], David C Richardson[SUP] 14 [/SUP], Laura C Rosella[SUP] 1 2 3 [/SUP], Kevin L Schwartz[SUP] 1 2 3 [/SUP], Marek Smieja[SUP] 15 [/SUP], George Zahariadis[SUP] 5 16 [/SUP], Jeffrey C Kwong[SUP] 1 2 3 6 17 18 [/SUP]
Affiliations
- PMID: 36942534
- DOI: 10.1093/cid/ciad148
Abstract
Background: Older adults are recommended to receive influenza vaccination annually and many use statins. Statins have immunomodulatory properties that might modify influenza vaccine effectiveness (VE) and alter influenza infection risk.
Methods: Using the test-negative design and linked laboratory and health administrative databases in Ontario, Canada, we estimated VE against laboratory-confirmed influenza among community-dwelling statin users and non-users aged ≥66 years during the 2010-2011 to 2018-2019 influenza seasons. We also estimated the odds ratio (OR) for influenza infection between statin users and non-users by vaccination status.
Results: Among subjects tested for influenza across the 9 seasons, 54,243 had continuous statin exposure prior to testing and 48,469 were deemed unexposed. VE against laboratory-confirmed influenza was similar between statin users and non-users (17% [95%CI, 13-20%] and 17% [95%CI, 13-21%] respectively; test for interaction, p=0.87). In both vaccinated and unvaccinated subjects, statin users had higher odds of laboratory-confirmed influenza than non-users (OR for vaccinated =1.15; 95%CI, 1.10-1.21; OR for unvaccinated=1.15; 95%CI, 1.10-1.20). These findings were consistent by mean daily dose and statin type. VE did not differ between users and non-users of other cardiovascular drugs, except for beta-blockers. We did not observe that vaccinated and unvaccinated users of these drugs had increased odds of influenza, except for unvaccinated beta-blocker users.
Conclusions: Influenza VE did not differ between statin users and non-users. Statin use was associated with increased odds of laboratory-confirmed influenza in vaccinated and unvaccinated subjects, but these associations might be impacted by residual confounding.
Keywords: Influenza; older adults; statins; vaccine effectiveness.