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Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study

BACKGROUND: Studies have shown that influenza vaccines are effective in preventing influenza-associated acute respiratory illnesses in older adults. However, the influenza vaccine effectiveness (IVE) against influenza-associated pneumonia in this age group has not been established. No study has form...

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Autores principales: Suzuki, Motoi, Dhoubhadel, Bhim Gopal, Katsurada, Naoko, Sando, Eiichiro, Ishifuji, Tomoko, Kaneko, Norihiro, Yaegashi, Makito, Hosokawa, Naoto, Aoshima, Masahiro, Ariyoshi, Koya, Morimoto, Konosuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630872/
http://dx.doi.org/10.1093/ofid/ofx163.1153
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author Suzuki, Motoi
Dhoubhadel, Bhim Gopal
Katsurada, Naoko
Sando, Eiichiro
Ishifuji, Tomoko
Kaneko, Norihiro
Yaegashi, Makito
Hosokawa, Naoto
Aoshima, Masahiro
Ariyoshi, Koya
Morimoto, Konosuke
author_facet Suzuki, Motoi
Dhoubhadel, Bhim Gopal
Katsurada, Naoko
Sando, Eiichiro
Ishifuji, Tomoko
Kaneko, Norihiro
Yaegashi, Makito
Hosokawa, Naoto
Aoshima, Masahiro
Ariyoshi, Koya
Morimoto, Konosuke
author_sort Suzuki, Motoi
collection PubMed
description BACKGROUND: Studies have shown that influenza vaccines are effective in preventing influenza-associated acute respiratory illnesses in older adults. However, the influenza vaccine effectiveness (IVE) against influenza-associated pneumonia in this age group has not been established. No study has formally investigated the IVE against pneumococcal pneumonia. METHODS: This study was conducted as part of a multicenter prospective investigation of adult pneumonia by the Adult Pneumonia Study Group-Japan (APSG-J). All community-onset pneumonia patients aged 65 years or older who visited a community-based hospital in Chiba, central Japan were enrolled to the study from December 2012 to January 2014. Sputum samples were tested for 13 viruses and 6 bacteria by multiplex PCR assays. Patients were diagnosed as influenza-associated pneumonia if sputum PCR assays were positive for influenza A or B. Patients were diagnosed as pneumococcal pneumonia if sputum culture yielded pneumococcus, sputum PCR assays were positive for both ply and lytA genes, or a urinary antigen test showed a positive result. Patients were considered vaccinated if they had received at least one dose of seasonal inactivated influenza vaccine in the 12 months before the hospital visit. A test-negative design was applied to estimate the IVE for influenza-associated pneumonia and pneumococcal pneumonia. IVEs were calculated as (1 – odds ratio) × 100%. RESULTS: A total of 1044 patients were enrolled to the study. Among them, 49 (4.7%) were influenza-associated pneumonia, and 168 (16.1%) were pneumococcal pneumonia. The adjusted IVE against influenza-associated pneumonia was 57.2% (95% CI, 17.9% to 76.8%). The adjusted IVE against pneumococcal pneumonia was 31.7% (0.6% to 53.1%); the estimate did not change before and after controlling for pneumococcal vaccination history. CONCLUSION: Influenza vaccines effectively prevent influenza-associated pneumonia in older adults. Influenza vaccines are also associated with decreased risk of pneumococcal pneumonia in this age group, while some residual confounding may remain. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-56308722017-11-07 Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study Suzuki, Motoi Dhoubhadel, Bhim Gopal Katsurada, Naoko Sando, Eiichiro Ishifuji, Tomoko Kaneko, Norihiro Yaegashi, Makito Hosokawa, Naoto Aoshima, Masahiro Ariyoshi, Koya Morimoto, Konosuke Open Forum Infect Dis Abstracts BACKGROUND: Studies have shown that influenza vaccines are effective in preventing influenza-associated acute respiratory illnesses in older adults. However, the influenza vaccine effectiveness (IVE) against influenza-associated pneumonia in this age group has not been established. No study has formally investigated the IVE against pneumococcal pneumonia. METHODS: This study was conducted as part of a multicenter prospective investigation of adult pneumonia by the Adult Pneumonia Study Group-Japan (APSG-J). All community-onset pneumonia patients aged 65 years or older who visited a community-based hospital in Chiba, central Japan were enrolled to the study from December 2012 to January 2014. Sputum samples were tested for 13 viruses and 6 bacteria by multiplex PCR assays. Patients were diagnosed as influenza-associated pneumonia if sputum PCR assays were positive for influenza A or B. Patients were diagnosed as pneumococcal pneumonia if sputum culture yielded pneumococcus, sputum PCR assays were positive for both ply and lytA genes, or a urinary antigen test showed a positive result. Patients were considered vaccinated if they had received at least one dose of seasonal inactivated influenza vaccine in the 12 months before the hospital visit. A test-negative design was applied to estimate the IVE for influenza-associated pneumonia and pneumococcal pneumonia. IVEs were calculated as (1 – odds ratio) × 100%. RESULTS: A total of 1044 patients were enrolled to the study. Among them, 49 (4.7%) were influenza-associated pneumonia, and 168 (16.1%) were pneumococcal pneumonia. The adjusted IVE against influenza-associated pneumonia was 57.2% (95% CI, 17.9% to 76.8%). The adjusted IVE against pneumococcal pneumonia was 31.7% (0.6% to 53.1%); the estimate did not change before and after controlling for pneumococcal vaccination history. CONCLUSION: Influenza vaccines effectively prevent influenza-associated pneumonia in older adults. Influenza vaccines are also associated with decreased risk of pneumococcal pneumonia in this age group, while some residual confounding may remain. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5630872/ http://dx.doi.org/10.1093/ofid/ofx163.1153 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Suzuki, Motoi
Dhoubhadel, Bhim Gopal
Katsurada, Naoko
Sando, Eiichiro
Ishifuji, Tomoko
Kaneko, Norihiro
Yaegashi, Makito
Hosokawa, Naoto
Aoshima, Masahiro
Ariyoshi, Koya
Morimoto, Konosuke
Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study
title Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study
title_full Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study
title_fullStr Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study
title_full_unstemmed Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study
title_short Influenza Vaccine Effectiveness Against Influenza-Associated Pneumonia and Pneumococcal Pneumonia in Older Adults: A Prospective Test-Negative Design Study
title_sort influenza vaccine effectiveness against influenza-associated pneumonia and pneumococcal pneumonia in older adults: a prospective test-negative design study
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630872/
http://dx.doi.org/10.1093/ofid/ofx163.1153
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