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Preventive effects of influenza and pneumococcal vaccination in the elderly - results from a population-based retrospective cohort study.

Abstract：

:Influenza and pneumococcal vaccinations are recommended in the elderly to reduce life-threatening complications like sepsis. Protection may be reduced with increasing age. We aimed to assess the effectiveness of both vaccines in the elderly by performing a retrospective cohort study of 138,877 individuals aged ≥60 y in Germany, who were insured in a large statutory health insurance (AOK PLUS). We used longitudinal claims data to classify individuals according to vaccination status 2008-2014, and assessed vaccine effectiveness (VE) in 2015 and 2016. Inverse probability weighting based on generalized propensity scores was used to adjust for systematic between-group differences. Influenza vaccination was associated with a reduction of hospital treatment in laboratory-confirmed influenza in 2015 (VE = 41.32 [95%CI 0.85, 65.26]), but had no significant impact on the overall influenza incidence. Complications of influenza (pneumonia and sepsis) were reduced in 2016. We found a rise in influenza-like illness and acute respiratory infections in both years and an increased 90-d mortality after hospital-treated pneumonia in vaccinees in 2015. Pneumococcal vaccination was effective in preventing hospital-treated pneumonia within the first and second year after vaccination (VE = 52.45 [13.31, 73.92] and 46.04 [5.46, 69.21], respectively), but had no impact on sepsis incidence or pneumonia mortality. Influenza and pneumococcal vaccination can prevent severe complications from influenza and hospital-treated pneumonia in the elderly, respectively. Vaccine effects differ between years and seasons and are partly difficult to interpret. Despite extensive efforts to adjust for between-group differences, residual bias cannot be ruled out, possibly explaining signals like increased ILI or pneumonia mortality.

journal_name

Hum Vaccin Immunother

journal_title

Human vaccines & immunotherapeutics

authors

Rose N,Storch J,Mikolajetz A,Lehmann T,Reinhart K,Pletz MW,Forstner C,Vollmar HC,Freytag A,Fleischmann-Struzek C

doi

10.1080/21645515.2020.1845525

subject

Has Abstract

pub_date

2021-01-07 00:00:00

pages

1-9

eissn

2164-5515

issn

2164-554X

pub_type

杂志文章

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Preventive effects of influenza and pneumococcal vaccination in the elderly - results from a population-based retrospective cohort study.