Cargando…

Safety of Influenza Vaccination Among Hospitalized Patients

BACKGROUND: Despite national recommendations, hospital influenza vaccination rates remain low. To address potential concerns regarding safety, we evaluated whether influenza vaccinatioqinPn during hospitalization increases utilization and/or evaluations for infection post-discharge. METHODS: This re...

Descripción completa

Detalles Bibliográficos
Autores principales: Tartof, Sara, Liu, In-Lu Amy, Qian, Lei, Lewin, Bruno, Sy, Lina S, Tseng, Hung Fu, Hechter, Rulin, Jacobsen, Steven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631380/
http://dx.doi.org/10.1093/ofid/ofx163.1150
_version_ 1783269454467039232
author Tartof, Sara
Liu, In-Lu Amy
Qian, Lei
Lewin, Bruno
Sy, Lina S
Tseng, Hung Fu
Hechter, Rulin
Jacobsen, Steven
author_facet Tartof, Sara
Liu, In-Lu Amy
Qian, Lei
Lewin, Bruno
Sy, Lina S
Tseng, Hung Fu
Hechter, Rulin
Jacobsen, Steven
author_sort Tartof, Sara
collection PubMed
description BACKGROUND: Despite national recommendations, hospital influenza vaccination rates remain low. To address potential concerns regarding safety, we evaluated whether influenza vaccinatioqinPn during hospitalization increases utilization and/or evaluations for infection post-discharge. METHODS: This retrospective cohort study was conducted among members of Kaiser Permanente Southern California aged ≥ 6 months who were hospitalized between September 1(st) and March 31(st), from 2011 to 2014. With inverse probability of treatment weighting to adjust for confounding, we assessed the association between inpatient influenza vaccination and: rates of readmission, emergency department (ED) visits, outpatient visits, fever (temperature ≥38.0°C) and laboratory evaluations for infection (urine, blood, and wound culture; complete blood count) ≤ 7 days post-discharge. We modeled risk using 3 comparison groups: a) never vaccinated throughout the influenza season, b) vaccinated prior to hospitalization, and c) vaccinated >7 days post-discharge. RESULTS: For the 3 models, 41,733 hospitalizations with inpatient vaccination and a) 78, 809, b) 142,479, and c) 21,570 hospitalizations without inpatient vaccination were included. In adjusted analyses, compared with those never vaccinated, those vaccinated during hospitalization had marginally increased risk of ED visits (RR=1.08, 95% CI: 1.02–1.14) and post-discharge infection work-ups (1.06: 1.03–1.10). Compared with those with either prior vaccination or those with vaccination >7 days post-discharge, patients vaccinated during hospitalization had decreased risk of re-admission (0.84: 0.76–0.93; 0.80: 0.73–0.87, respectively), post-discharge fever (0.76: 0.63–0.92; 0.56: 0.47–0.67), and post-discharge infection work-ups (0.92: 0.89–0.96; 0.90: 0.86–0.93). Risk of outpatient visits ≤7 days post-discharge varied for the prior, never, and later vaccination comparison groups (0.93: 0.90–0.95; 1.09: 1.06–1.11; 1.11: 1.08.-1.14, respectively). CONCLUSION: There was no substantial increased risk of study outcomes associated with influenza vaccination during hospitalization. Our data support the recommendation of vaccinating hospitalized patients against influenza. DISCLOSURES: H. F. Tseng, Novavax: Grant Investigator, Research grant
format Online
Article
Text
id pubmed-5631380
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-56313802017-11-07 Safety of Influenza Vaccination Among Hospitalized Patients Tartof, Sara Liu, In-Lu Amy Qian, Lei Lewin, Bruno Sy, Lina S Tseng, Hung Fu Hechter, Rulin Jacobsen, Steven Open Forum Infect Dis Abstracts BACKGROUND: Despite national recommendations, hospital influenza vaccination rates remain low. To address potential concerns regarding safety, we evaluated whether influenza vaccinatioqinPn during hospitalization increases utilization and/or evaluations for infection post-discharge. METHODS: This retrospective cohort study was conducted among members of Kaiser Permanente Southern California aged ≥ 6 months who were hospitalized between September 1(st) and March 31(st), from 2011 to 2014. With inverse probability of treatment weighting to adjust for confounding, we assessed the association between inpatient influenza vaccination and: rates of readmission, emergency department (ED) visits, outpatient visits, fever (temperature ≥38.0°C) and laboratory evaluations for infection (urine, blood, and wound culture; complete blood count) ≤ 7 days post-discharge. We modeled risk using 3 comparison groups: a) never vaccinated throughout the influenza season, b) vaccinated prior to hospitalization, and c) vaccinated >7 days post-discharge. RESULTS: For the 3 models, 41,733 hospitalizations with inpatient vaccination and a) 78, 809, b) 142,479, and c) 21,570 hospitalizations without inpatient vaccination were included. In adjusted analyses, compared with those never vaccinated, those vaccinated during hospitalization had marginally increased risk of ED visits (RR=1.08, 95% CI: 1.02–1.14) and post-discharge infection work-ups (1.06: 1.03–1.10). Compared with those with either prior vaccination or those with vaccination >7 days post-discharge, patients vaccinated during hospitalization had decreased risk of re-admission (0.84: 0.76–0.93; 0.80: 0.73–0.87, respectively), post-discharge fever (0.76: 0.63–0.92; 0.56: 0.47–0.67), and post-discharge infection work-ups (0.92: 0.89–0.96; 0.90: 0.86–0.93). Risk of outpatient visits ≤7 days post-discharge varied for the prior, never, and later vaccination comparison groups (0.93: 0.90–0.95; 1.09: 1.06–1.11; 1.11: 1.08.-1.14, respectively). CONCLUSION: There was no substantial increased risk of study outcomes associated with influenza vaccination during hospitalization. Our data support the recommendation of vaccinating hospitalized patients against influenza. DISCLOSURES: H. F. Tseng, Novavax: Grant Investigator, Research grant Oxford University Press 2017-10-04 /pmc/articles/PMC5631380/ http://dx.doi.org/10.1093/ofid/ofx163.1150 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
Tartof, Sara
Liu, In-Lu Amy
Qian, Lei
Lewin, Bruno
Sy, Lina S
Tseng, Hung Fu
Hechter, Rulin
Jacobsen, Steven
Safety of Influenza Vaccination Among Hospitalized Patients
title Safety of Influenza Vaccination Among Hospitalized Patients
title_full Safety of Influenza Vaccination Among Hospitalized Patients
title_fullStr Safety of Influenza Vaccination Among Hospitalized Patients
title_full_unstemmed Safety of Influenza Vaccination Among Hospitalized Patients
title_short Safety of Influenza Vaccination Among Hospitalized Patients
title_sort safety of influenza vaccination among hospitalized patients
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631380/
http://dx.doi.org/10.1093/ofid/ofx163.1150
work_keys_str_mv AT tartofsara safetyofinfluenzavaccinationamonghospitalizedpatients
AT liuinluamy safetyofinfluenzavaccinationamonghospitalizedpatients
AT qianlei safetyofinfluenzavaccinationamonghospitalizedpatients
AT lewinbruno safetyofinfluenzavaccinationamonghospitalizedpatients
AT sylinas safetyofinfluenzavaccinationamonghospitalizedpatients
AT tsenghungfu safetyofinfluenzavaccinationamonghospitalizedpatients
AT hechterrulin safetyofinfluenzavaccinationamonghospitalizedpatients
AT jacobsensteven safetyofinfluenzavaccinationamonghospitalizedpatients