Influenza Vaccine Effectiveness in Preventing Outpatient, Inpatient, and Severe Cases of Laboratory-Confirmed Influenza
Por:
Castilla, J, Godoy, P, Dominguez, A, Martinez-Baz, I, Astray, J, Martin, V, Delgado-Rodriguez, M, Baricot, M, Soldevila, N, Mayoral, JM, Quintana, JM, Galan, JC, Castro, A, Gonzalez-Candelas, F, Garin, O, Saez, M, Tamames, S, Pumarola, T, Bonfill X., López-Contreras J., Pomar V., Puig T., CIBERESP Cases Controls Influenza
Publicada:
15 jul 2013
Resumen:
Background. In most seasons, the influenza vaccine is effective in preventing influenza, but it is not clear whether it is equally effective in preventing mild and severe cases. We designed a case-control study to compare the effectiveness of the influenza vaccine in preventing outpatient, inpatient, and severe or fatal cases of laboratory-confirmed influenza.
Methods. Hospitalized patients (n = 691) with laboratory-confirmed influenza in the 2010-2011 season recruited in 29 Spanish hospitals were individually matched by age, admission/visit date, and province with an outpatient with laboratory-confirmed influenza and an outpatient control. Severe cases were considered those patients admitted to intensive care units or who died in the hospital (n = 177). We compared the influenza vaccine status of controls and outpatient cases, inpatient cases, and severe cases using conditional logistic regression adjusted for potential confounding factors. Severe and nonsevere inpatient influenza cases were compared using unconditional logistic regression. Vaccine effectiveness was (1 - odds ratio) x 100.
Results. Vaccine effectiveness was 75% (adjusted odds ratio [AOR], 0.25; 95% confidence interval [CI],.16-.39) in preventing influenza outpatient cases, 60% (AOR, 0.40; 95% CI,.25-.63) in preventing influenza-associated hospitalizations, and 89% (AOR, 0.11; 95% CI,.04-.37) in preventing severe cases. In inpatients, influenza vaccination was associated with a lower risk of severe influenza (AOR, 0.42; 95% CI,.22-.80).
Conclusions. Influenza vaccination prevented influenza cases and hospitalizations and was associated with a better prognosis in inpatients with influenza. The combined effect of these 2 mechanisms would explain the high effectiveness of the vaccine in preventing severe cases due to influenza.
Filiaciones:
Castilla, J:
Inst Salud Publ Navarra, Pamplona 31003, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Godoy, P:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Generalitat Catalonia, Dept Salut, Barcelona, Spain
Dominguez, A:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Barcelona, Barcelona, Spain
Martinez-Baz, I:
Inst Salud Publ Navarra, Pamplona 31003, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Astray, J:
Comunidad Madrid, Area Epidemiol, Madrid, Spain
Martin, V:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Leon, Inst Biomed, E-24071 Leon, Spain
Delgado-Rodriguez, M:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Jaen, Jaen, Spain
Baricot, M:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Soldevila, N:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Mayoral, JM:
Serv Vigilancia Andalucia, Seville, Spain
Quintana, JM:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Hosp Galdakao Usansolo, Unidad Invest, Guipuzcoa, Spain
Galan, JC:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Hosp Univ Ramon y Cajal, Madrid, Spain
Castro, A:
CIBER Enfermedades Resp, Madrid, Spain
Gonzalez-Candelas, F:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Valencia, Ctr Super Invest Salud Publ, E-46003 Valencia, Spain
Garin, O:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Hosp del Mar Res Inst, IMIM, Barcelona, Spain
Saez, M:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Girona, Res Grp Stat Econometr & Hlth, Girona, Spain
Tamames, S:
Direcc Gen Salud Publ Invest Desarrollo & Innovac, Valladolid, Spain
Pumarola, T:
Red Espanola Invest Patol Infecciosa, Barcelona, Spain
Bonfill X.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
López-Contreras J.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Pomar V.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Puig T.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
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