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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2017
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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. |
format | Online Article Text |
id | pubmed-5630872 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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