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. |