tetano
Editor, Senior Moderator
Hum Vaccin Immunother
. 2021 Jan 7;1-9.
doi: 10.1080/21645515.2020.1845525. Online ahead of print.
Preventive effects of influenza and pneumococcal vaccination in the elderly - results from a population-based retrospective cohort study
Norman Rose[SUP] 1 [/SUP], Josephine Storch[SUP] 2 3 [/SUP], Anna Mikolajetz[SUP] 4 [/SUP], Thomas Lehmann[SUP] 5 [/SUP], Konrad Reinhart[SUP] 1 4 6 [/SUP], Mathias W Pletz[SUP] 7 [/SUP], Christina Forstner[SUP] 7 8 [/SUP], Horst Christian Vollmar[SUP] 2 9 [/SUP], Antje Freytag[SUP] 2 [/SUP], Carolin Fleischmann-Struzek[SUP] 1 [/SUP]
Affiliations
Abstract
Influenza and pneumococcal vaccinations are recommended in the elderly to reduce life-threatening complications like sepsis. Protection may be reduced with increasing age. We aimed to assess the effectiveness of both vaccines in the elderly by performing a retrospective cohort study of 138,877 individuals aged ≥60 y in Germany, who were insured in a large statutory health insurance (AOK PLUS). We used longitudinal claims data to classify individuals according to vaccination status 2008-2014, and assessed vaccine effectiveness (VE) in 2015 and 2016. Inverse probability weighting based on generalized propensity scores was used to adjust for systematic between-group differences. Influenza vaccination was associated with a reduction of hospital treatment in laboratory-confirmed influenza in 2015 (VE = 41.32 [95%CI 0.85, 65.26]), but had no significant impact on the overall influenza incidence. Complications of influenza (pneumonia and sepsis) were reduced in 2016. We found a rise in influenza-like illness and acute respiratory infections in both years and an increased 90-d mortality after hospital-treated pneumonia in vaccinees in 2015. Pneumococcal vaccination was effective in preventing hospital-treated pneumonia within the first and second year after vaccination (VE = 52.45 [13.31, 73.92] and 46.04 [5.46, 69.21], respectively), but had no impact on sepsis incidence or pneumonia mortality. Influenza and pneumococcal vaccination can prevent severe complications from influenza and hospital-treated pneumonia in the elderly, respectively. Vaccine effects differ between years and seasons and are partly difficult to interpret. Despite extensive efforts to adjust for between-group differences, residual bias cannot be ruled out, possibly explaining signals like increased ILI or pneumonia mortality.
Keywords: Vaccine effectiveness; influenza; pneumococci; pneumonia; sepsis.
. 2021 Jan 7;1-9.
doi: 10.1080/21645515.2020.1845525. Online ahead of print.
Preventive effects of influenza and pneumococcal vaccination in the elderly - results from a population-based retrospective cohort study
Norman Rose[SUP] 1 [/SUP], Josephine Storch[SUP] 2 3 [/SUP], Anna Mikolajetz[SUP] 4 [/SUP], Thomas Lehmann[SUP] 5 [/SUP], Konrad Reinhart[SUP] 1 4 6 [/SUP], Mathias W Pletz[SUP] 7 [/SUP], Christina Forstner[SUP] 7 8 [/SUP], Horst Christian Vollmar[SUP] 2 9 [/SUP], Antje Freytag[SUP] 2 [/SUP], Carolin Fleischmann-Struzek[SUP] 1 [/SUP]
Affiliations
- PMID: 33412080
- DOI: 10.1080/21645515.2020.1845525
Abstract
Influenza and pneumococcal vaccinations are recommended in the elderly to reduce life-threatening complications like sepsis. Protection may be reduced with increasing age. We aimed to assess the effectiveness of both vaccines in the elderly by performing a retrospective cohort study of 138,877 individuals aged ≥60 y in Germany, who were insured in a large statutory health insurance (AOK PLUS). We used longitudinal claims data to classify individuals according to vaccination status 2008-2014, and assessed vaccine effectiveness (VE) in 2015 and 2016. Inverse probability weighting based on generalized propensity scores was used to adjust for systematic between-group differences. Influenza vaccination was associated with a reduction of hospital treatment in laboratory-confirmed influenza in 2015 (VE = 41.32 [95%CI 0.85, 65.26]), but had no significant impact on the overall influenza incidence. Complications of influenza (pneumonia and sepsis) were reduced in 2016. We found a rise in influenza-like illness and acute respiratory infections in both years and an increased 90-d mortality after hospital-treated pneumonia in vaccinees in 2015. Pneumococcal vaccination was effective in preventing hospital-treated pneumonia within the first and second year after vaccination (VE = 52.45 [13.31, 73.92] and 46.04 [5.46, 69.21], respectively), but had no impact on sepsis incidence or pneumonia mortality. Influenza and pneumococcal vaccination can prevent severe complications from influenza and hospital-treated pneumonia in the elderly, respectively. Vaccine effects differ between years and seasons and are partly difficult to interpret. Despite extensive efforts to adjust for between-group differences, residual bias cannot be ruled out, possibly explaining signals like increased ILI or pneumonia mortality.
Keywords: Vaccine effectiveness; influenza; pneumococci; pneumonia; sepsis.