High-dose influenza vaccines for the prevention of hospitalization due to cardiovascular events in older adults in the nursing home: Post-hoc analysis of a cluster-randomized trial期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

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High-dose influenza vaccines for the prevention of hospitalization due to cardiovascular events in older adults in the nursing home: Post-hoc analysis of a cluster-randomized trial

Institution:	1. University Hospitals Cleveland Medical Center, Cleveland, OH, United States;2. Case Western Reserve University, Cleveland, OH, United States;3. School of Public Health, Brown University, Providence, RI, United States;4. Center on Innovation in Long-Term Services and Supports, Veterans Administration Medical Center, Providence, RI, United States;5. Warren Alpert Medical School of Brown University, Providence, RI, United States;6. Insight Therapeutics, LLC, Norfolk, VA, United States;7. Veterans Administration Medical Center, Cleveland, OH, United States

Abstract:	Older adults are at high risk of major acute cardiovascular events (MACE) linked to influenza illness and preventable by influenza vaccination. It is unknown whether high-dose vaccine might incrementally reduce the risk of MACE. We conducted a post-hoc analysis of data collected from a pragmatic cluster randomized study of 823 nursing homes (NH) randomized to standard-dose (SD) or high-dose (HD) influenza vaccine in the 2013–14 season. Adults age 65 year or older who are Medicare-enrolled long-stay residents were included in the analysis. There were no statistically significant differences in hospitalization for MACE, acute coronary syndromes (ACS), stroke or heart failure between the HD and SD arms. However, in the fee-for-service group, participants in the HD arm had significantly decreased risk of hospitalization for respiratory problems, which was not observed in the Medicare Advantage group. High-dose influenza vaccine was not shown to be incrementally protective against MACE relative to standard-dose vaccine.

Keywords:	High-dose influenza vaccine Influenza vaccines/administration & dosage Influenza Nursing homes Outbreaks MACE"} {"#name":"keyword" "$":{"id":"pc_va4t6xnfsN"} "$$":[{"#name":"text" "_":"Major Acute Cardiovascular Event(s) NH"} {"#name":"keyword" "$":{"id":"pc_tDFCRegprn"} "$$":[{"#name":"text" "_":"Nursing Home(s) SD"} {"#name":"keyword" "$":{"id":"pc_kAg4Ezhh4p"} "$$":[{"#name":"text" "_":"Standard-Dose HD"} {"#name":"keyword" "$":{"id":"pc_zquNopC5yX"} "$$":[{"#name":"text" "_":"High-Dose CDC"} {"#name":"keyword" "$":{"id":"pc_9gilAfuh3N"} "$$":[{"#name":"text" "_":"Centers for Disease Control and Prevention IIV"} {"#name":"keyword" "$":{"id":"pc_RFMHvT26ok"} "$$":[{"#name":"text" "_":"inactivated Influenza Vaccine MA"} {"#name":"keyword" "$":{"id":"pc_H9uLmNi3G0"} "$$":[{"#name":"text" "_":"Medicare Advantage FFS"} {"#name":"keyword" "$":{"id":"pc_xkoYCgJIlO"} "$$":[{"#name":"text" "_":"Fee-for-service ADL"} {"#name":"keyword" "$":{"id":"pc_ITsRzZ9izh"} "$$":[{"#name":"text" "_":"Activities of Daily Living MDS"} {"#name":"keyword" "$":{"id":"pc_1IQqBzUzmp"} "$$":[{"#name":"text" "_":"Minimum Data Set CMS"} {"#name":"keyword" "$":{"id":"pc_M5Qd6b20QN"} "$$":[{"#name":"text" "_":"Centers for Medicare & Medicaid Services ICD-9"} {"#name":"keyword" "$":{"id":"pc_WgqJh2Vr3W"} "$$":[{"#name":"text" "_":"International Classification of Diseases 9th edition
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