Andrea Poscia1, Agnese Collamati2, Angelo Carfì2, Eva Topinkova3, Tomas Richter3, Michael Denkinger4, Roberta Pastorino1, Francesco Landi2, Walter Ricciardi1,5, Roberto Bernabei2, Graziano Onder2. 1. Institute of Public Health, Università Cattolica del Sacro Cuore of Rome, Rome, Italy. 2. Department of Geriatrics, Neurosciences, and Orthopedics, Università Cattolica del Sacro Cuore of Rome, Rome, Italy. 3. Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic. 4. GAPLESION Bethesda Clinic, Competence Centre of Geriatrics, University of Ulm, Ulm, Germany. 5. National Institute of Health, Rome, Italy.
Abstract
Background: Influenza and pneumococcal vaccines have been proved to be effective and safe in preventing and controlling infection among elderly, reducing morbidity and mortality. However, some evidences raised health concerns related to these vaccinations. This study aims to identify prevalence and outcomes related to influenza and pneumococcal vaccinations in a large European population of frail old people living in nursing homes (NHs). Methods: We conducted a survival analysis of NH residents participating to the Services and Health for Elderly in Long-TERm project, a prospective cohort study collecting information on residents admitted to 57 NH in eight countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel). Clinical and demographical data were collected using the international resident assessement instrument for long-term care facilities. Incident mortality was recorded during 1-year follow-up. A shared-frailty Cox regression model was used to assess the impact of vaccination status on mortality. Results: Mean age of 3510 participants was 84.6 years (SD = 7.7). In total, 81.7 and 27.0% received influenza and pneumococcal vaccination, respectively. Overall, 727 (20.7%) residents died during the follow-up period. After adjusting for potential confounders, which included age, sex, number of diseases, depression, cognitive and functional status, influenza (HR = 0.80; 95% CI 0.66-0.97) and the combination of influenza and pneumococcal vaccination (HR = 0.72; 95% CI 0.57-0.91), but not pneumococcal vaccination alone (HR = 0.52; 95% CI 0.25-1.06), were associated with a statistically significant reduction in mortality in respect of no vaccinations. Conclusion: In a population of older adult living in NH influenza and the combination of influenza and pneumococcal vaccination were associated with a reduction in all-cause mortality respect to no vaccination.
Background: Influenza and pneumococcal vaccines have been proved to be effective and safe in preventing and controlling infection among elderly, reducing morbidity and mortality. However, some evidences raised health concerns related to these vaccinations. This study aims to identify prevalence and outcomes related to influenza and pneumococcal vaccinations in a large European population of frail old people living in nursing homes (NHs). Methods: We conducted a survival analysis of NH residents participating to the Services and Health for Elderly in Long-TERm project, a prospective cohort study collecting information on residents admitted to 57 NH in eight countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel). Clinical and demographical data were collected using the international resident assessement instrument for long-term care facilities. Incident mortality was recorded during 1-year follow-up. A shared-frailty Cox regression model was used to assess the impact of vaccination status on mortality. Results: Mean age of 3510 participants was 84.6 years (SD = 7.7). In total, 81.7 and 27.0% received influenza and pneumococcal vaccination, respectively. Overall, 727 (20.7%) residents died during the follow-up period. After adjusting for potential confounders, which included age, sex, number of diseases, depression, cognitive and functional status, influenza (HR = 0.80; 95% CI 0.66-0.97) and the combination of influenza and pneumococcal vaccination (HR = 0.72; 95% CI 0.57-0.91), but not pneumococcal vaccination alone (HR = 0.52; 95% CI 0.25-1.06), were associated with a statistically significant reduction in mortality in respect of no vaccinations. Conclusion: In a population of older adult living in NH influenza and the combination of influenza and pneumococcal vaccination were associated with a reduction in all-cause mortality respect to no vaccination.
Authors: Reem T Mulla; Luke Andrew Turcotte; Nathalie Ih Wellens; Milou J Angevaare; Julie Weir; Micaela Jantzi; Paul C Hébert; George A Heckman; Hein van Hout; Nigel Millar; John P Hirdes Journal: BMJ Open Date: 2022-04-18 Impact factor: 3.006
Authors: Janet K Sluggett; Samanta Lalic; Sarah M Hosking; Brett Ritchie; Jennifer McLoughlin; Terry Shortt; Leonie Robson; Tina Cooper; Kelly A Cairns; Jenni Ilomäki; Renuka Visvanathan; J Simon Bell Journal: Int J Environ Res Public Health Date: 2020-05-08 Impact factor: 3.390