Duration of influenza vaccine effectiveness in the elderly in Japan: A retrospective cohort study using large-scale population-based registry data |
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| Affiliation: | 1. Department of Biostatistics & Bioinformatics, Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan;2. Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;3. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;4. Department of Clinical Epidemiology & Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;1. Instituto Biomédico, Universidade Federal Fluminense, Alameda Barros Terra, s/n. São Domingos, Niterói, RJ 24020-150, Brazil;2. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho, 373 - bloco I, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ 21941-902, Brazil;1. George Washington University Hospital, Department of Obstetrics and Gynecology, 900 23rd ST NW, Washington, DC 20037, United States;2. George Washington University, School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States;3. Sarasota Memorial Hospital, 1700 S Tamiami Trail, Sarasota, FL 34239, United States;1. College of Chemistry and Material Sciences, School of Life Sciences, Heilongjiang University, Harbin, Heilongjiang 150080, China;2. Institute of Nanobiomaterials and Immunology, Zhejiang Provincial Key Laboratory of Plant Evolutionary Ecology and Conservation, School of Life Sciences, Taizhou University, Taizhou 318000, China;1. University Francisco Marroquin School of Medicine, Guatemala City, Guatemala;2. Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA;3. Center for Global Health, Colorado School of Public Health, Aurora, CO, USA;4. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA;5. Department of Infectious Diseases and Epidemiology, Children’s Hospital Colorado, Aurora, CO, USA |
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| Abstract: | BackgroundThe immune response to influenza vaccination in the elderly is likely to be lower than that in young adults. Clinical protection may not persist year-round in the elderly. However, the effectiveness of influenza vaccine in the elderly has not been adequately studied, especially in terms of the duration of effectiveness.MethodsWe used a linked database of healthcare administrative claims data and vaccination records maintained by the municipality of a city in Kanto region of Japan. We studied individuals who were aged 65 years or older at baseline and were followed up between April 1, 2014 to March 31, 2020. The duration of influenza vaccine effectiveness by age category was analyzed using a time-dependent piecewise Cox proportional hazard model with time-dependent vaccine status, prior season vaccination and covariates confirmed in the baseline period (age, sex, cancer, diabetes, chronic obstructive pulmonary diseases, asthma, chronic kidney diseases, and cardiovascular diseases).ResultsWe identified an analysis population of 83,146 individuals, of which 7,401 (8.9%) had experienced influenza and 270 (0.32%) underwent influenza-related hospitalization. Individuals who were vaccinated during the first season (n = 47,338) were older than non-vaccinated individuals (n = 35,808) (average age, 75.8 vs. 74.1 years, respectively). The multivariable analysis showed a lower incidence of influenza in vaccinated individuals (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.43–0.51; P < 0.001), while the incidence of hospitalization for influenza did not differ significantly by vaccination status (HR, 0.79; 95% CI, 0.53–1.18; P = 0.249). Protective effectiveness against incidence was maintained for 4 or 5 months after vaccination in those aged 65–69 and 80-years, 5 months in 70–79 years.ConclusionsOur study identified moderate vaccine effectiveness in preventing the incidence of influenza in the Japanese elderly. Vaccine effectiveness showed a trend of gradual attenuation. Clinicians should suspect influenza infection even in those vaccinated, especially in elderly individuals who had received vaccination more than 4 or 5 months previously. |
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| Keywords: | Cohort study Elderly Influenza vaccination Medical information database Time-dependent effectiveness CI" },{" #name" :" keyword" ," $" :{" id" :" k0035" }," $$" :[{" #name" :" text" ," _" :" Confidence Interval COVID-19" },{" #name" :" keyword" ," $" :{" id" :" k0045" }," $$" :[{" #name" :" text" ," _" :" Coronavirus Disease 2019 HR" },{" #name" :" keyword" ," $" :{" id" :" k005511" }," $$" :[{" #name" :" text" ," _" :" Hazard Ratio ICD-10" },{" #name" :" keyword" ," $" :{" id" :" k0065" }," $$" :[{" #name" :" text" ," _" :" International Classification of Diseases 10th revision United Kingdom" },{" #name" :" keyword" ," $" :{" id" :" k0075" }," $$" :[{" #name" :" text" ," _" :" UK |
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