1171. Follow-up of vaccine preventable disease hospitalisations in the ageing population: onset of chronic comorbidities

BACKGROUND: Vaccine preventable diseases (VPD) such as influenza, pneumococcal infection, herpes zoster and pertussis pose a significant burden for adults 50 years and older. The disease burden beyond the acute phase (downstream effects) where a VPD can trigger or exacerbate comorbidities is less studied. METHODS: Using Optum’s de-identified Clinformatics Data Mart Database, a retrospective claims database study was conducted to assess the diagnosis of new comorbidities in older adults (50+) up to 365 days following an index hospitalisation with a VPD during the epidemiological years 2016 – 2018. A subset of outcomes is reported here, focusing on the new onset of myocardial infarction (MI) and congestive heart failure (CHF). Subjects hospitalised with a VPD were compared to matched controls without a VPD hospitalisation. Matching was conducted on the day of VPD hospitalisation based on baseline variables like demographics, insurance, comorbidities, and Charlson-Comorbidity Index (CCI) score. The study analysed the new onset of MI and CHF over 365 days following a VPD index hospitalisation stratified by age category and CCI score at baseline. Results are reported as mean change (95% confidence interval (CI)). RESULTS: At 365 days, there was a significant higher risk for a new MI observed in the VPD-hospitalised cohort compared to their matched controls (Figure 1) across all age groups and CCI categories. In particular, individuals without any comorbidity at baseline (CCI = 0) experienced an increased probability for a new MI diagnosis between 6% (4.9–7.4%, p< 0.001) and 13% (11.6% - 14.3%, p< 0.001). Furthermore, the VPD-hospitalised cohort also showed a significant higher risk for a new CHF diagnosis versus their non-VPD matched controls (Figure 2). Those without any comorbidity at baseline (CCI = 0) showed an increased proportion of new CHF diagnosis over 365 days between 12% (10–14%, p< 0.001) and 25% (24–27%, p< 0.001). [Figure: see text] [Figure: see text] CONCLUSION: Results suggest that individuals hospitalised for a VPD were more likely to experience a new MI or CHF compared to their matched controls. Limitations exist around direct associations between the VPD hospitalisation and the onset of a new MI or CHF diagnosis, but the findings support the hypothesis that downstream effects of VPDs could trigger or exacerbate a comorbidity. DISCLOSURES: Ahmed Salem, MSc, GSK: employee|GSK: Stocks/Bonds Maximilian Hartmann, PhD, GSK: Grant/Research Support Nathalie Servotte, PhD, GSK: employee|GSK: Stocks/Bonds Emmanuel Aris, PhD, GSK: employee|GSK: Stocks/Bonds T. Mark Doherty, PhD, GSK: employee|GSK: Stocks/Bonds Ekkehard Beck, PhD, GSK: employee|GSK: Stocks/Bonds