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Abstract

Introduction

When influenza vaccination is ineffective in preventing influenza virus infection, it may still reduce the severity of influenza-associated disease. Here, we estimate the effect of influenza vaccination in preventing severe outcomes e.g. intensive care unit (ICU) admission and death, even though it did not prevent influenza virus infection and subsequent hospitalisation.

Methods

An observational case–case epidemiological study was carried out in 12 sentinel hospitals in Catalonia (Spain) over six influenza seasons 2010/11–2015/16. Cases were individuals with severe laboratory-confirmed influenza virus infection and aged 18 years and older. For each reported case we collected demographic, virological and clinical characteristics. Logistic regression was used to estimate the crude, adjusted odd ratios (aOR) and 95% confidence intervals (CI).

Results

Of 1,727 hospitalised patients included in the study, 799 were female (46.7%), 591 (34.2%) were admitted to the ICU and 223 (12.9%) died. Influenza vaccination uptake was lower in cases that required ICU admission or died (21.2% vs 29.7%, p < 0.001). The adjusted influenza vaccination effectiveness in preventing ICU admission or death was 23% (95% CI: 1 to 40). In an analysis restricted to sex, age group and antiviral treatment, influenza vaccination had a positive effect on disease severity in all age groups and categories.

Conclusions

We found that influenza vaccination reduced the severity of disease even in cases where it did not prevent infection and influenza-associated hospitalisation. Therefore, increased vaccination uptake may reduce complications, ICU admission and death.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2018-10-25
2024-12-22
/content/10.2807/1560-7917.ES.2018.23.43.1700732
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Influenza vaccine effectiveness in reducing severe outcomes over six influenza seasons, a case-case analysis, Spain, 2010/11 to 2015/16
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Pere+Godoy&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Godoy Pere</a>, <a href="/search?value1=Arantxa+Romero&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Romero Arantxa</a>, <a href="/search?value1=N%C3%BAria+Soldevila&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Soldevila Núria</a>, <a href="/search?value1=Nuria+Torner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Torner Nuria</a>, <a href="/search?value1=Mireia+Jan%C3%A9&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jané Mireia</a>, <a href="/search?value1=Ana+Mart%C3%ADnez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martínez Ana</a>, <a href="/search?value1=Joan+A+Cayl%C3%A0&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Caylà Joan A</a>, <a href="/search?value1=Cristina+Rius&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rius Cristina</a>, <a href="/search?value1=Angela+Dom%C3%ADnguez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Domínguez Angela</a>, <a href="/search?value1=The+Working+Group+on+Surveillance+of+Severe+Influenza+Hospitalized+Cases+in+Catalonia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">The Working Group on Surveillance of Severe Influenza Hospitalized Cases in Catalonia</a></span>. Influenza vaccine effectiveness in reducing severe outcomes over six influenza seasons, a case-case analysis, Spain, 2010/11 to 2015/16. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(43):pii=1700732. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.43.1700732" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.43.1700732</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 30 Oct 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 06 Apr 2018 </span> </p>
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