tetano
Editor, Senior Moderator
J Clin Epidemiol
. 2022 Jul 8;S0895-4356(22)00169-X.
doi: 10.1016/j.jclinepi.2022.06.018. Online ahead of print.
Influenza vaccination reduced myocardial infarctions in UK older adults: a prior event rate ratio study
Adam J Streeter[SUP] 1 [/SUP], Lauren R Rodgers[SUP] 2 [/SUP], Fergus Hamilton[SUP] 3 [/SUP], Jane Ah Masoli[SUP] 4 [/SUP], Alessandro Ble[SUP] 5 [/SUP], William T Hamilton[SUP] 5 [/SUP], William E Henley[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: We aimed to estimate the real-world effectiveness of the influenza vaccine against myocardial infarction (MI) and influenza in the decade since adults aged ≥65y were first recommended the vaccine.
Study design and setting: We identified annual cohorts, 1997 to 2011, of adults aged ≥65y, without previous influenza vaccination, from UK general practices, registered with the Clinical Practice Research Datalink. Using a quasi-experimental study design to control for confounding bias, we estimated influenza vaccine effectiveness on hospitalisation for MI, influenza and antibiotic prescriptions for lower respiratory tract infections.
Results: Vaccination was moderately effective against influenza, the prior event rate ratio (PERR)-adjusted hazard ratios
ranging from 0.70 in 1999 to 0.99 in 2001. PERR-adjusted HRs demonstrated a protective effect against MIs, varying between 0.40 in 2010 to 0.89 in 2001. Aggregated across the cohorts, influenza vaccination reduced the risk of MIs by 39% (95%confidence interval: 34%, 44%) .
Conclusions: Effectiveness of the flu vaccine in preventing MIs in older UK adults is consistent with the limited evidence from clinical trials. Similar trends in effectiveness against influenza and against MIs suggest the risk of influenza mediates the effectiveness against MIs, although divergence in some years implies the mechanism may be complex.
Keywords: Real-world evidence; influenza; myocardial infarction; prior event rate ratio; unmeasured confounders; vaccine effectiveness.
. 2022 Jul 8;S0895-4356(22)00169-X.
doi: 10.1016/j.jclinepi.2022.06.018. Online ahead of print.
Influenza vaccination reduced myocardial infarctions in UK older adults: a prior event rate ratio study
Adam J Streeter[SUP] 1 [/SUP], Lauren R Rodgers[SUP] 2 [/SUP], Fergus Hamilton[SUP] 3 [/SUP], Jane Ah Masoli[SUP] 4 [/SUP], Alessandro Ble[SUP] 5 [/SUP], William T Hamilton[SUP] 5 [/SUP], William E Henley[SUP] 2 [/SUP]
Affiliations
- PMID: 35817230
- DOI: 10.1016/j.jclinepi.2022.06.018
Abstract
Objective: We aimed to estimate the real-world effectiveness of the influenza vaccine against myocardial infarction (MI) and influenza in the decade since adults aged ≥65y were first recommended the vaccine.
Study design and setting: We identified annual cohorts, 1997 to 2011, of adults aged ≥65y, without previous influenza vaccination, from UK general practices, registered with the Clinical Practice Research Datalink. Using a quasi-experimental study design to control for confounding bias, we estimated influenza vaccine effectiveness on hospitalisation for MI, influenza and antibiotic prescriptions for lower respiratory tract infections.
Results: Vaccination was moderately effective against influenza, the prior event rate ratio (PERR)-adjusted hazard ratios
ranging from 0.70 in 1999 to 0.99 in 2001. PERR-adjusted HRs demonstrated a protective effect against MIs, varying between 0.40 in 2010 to 0.89 in 2001. Aggregated across the cohorts, influenza vaccination reduced the risk of MIs by 39% (95%confidence interval: 34%, 44%) .
Conclusions: Effectiveness of the flu vaccine in preventing MIs in older UK adults is consistent with the limited evidence from clinical trials. Similar trends in effectiveness against influenza and against MIs suggest the risk of influenza mediates the effectiveness against MIs, although divergence in some years implies the mechanism may be complex.
Keywords: Real-world evidence; influenza; myocardial infarction; prior event rate ratio; unmeasured confounders; vaccine effectiveness.