BACKGROUND: Yearly influenza immunization is recommended for immunocompromised (IC) individuals, although immune responses are lower than that for the nonimmunocompromised and the data on vaccine effectiveness (VE) in the IC is scarce. We evaluated VE against influenza-associated hospitalization among IC adults. METHODS: We analyzed data from adults ≥ 18 years hospitalized with acute respiratory illness (ARI) during the 2017-2018 influenza season at 10 hospitals in the United States. IC adults were identified using prespecified case definitions using electronic medical record data. VE was evaluated with a test-negative case-control design using multivariable logistic regression with polymerase chain reaction-confirmed influenza as the outcome and vaccination status as the exposure, adjusting for age, enrolling site, illness onset date, race, days from onset to specimen collection, self-reported health, and self-reported hospitalizations. RESULTS: Of 3524 adults hospitalized with ARI, 1210 (34.3%) had an immunocompromising condition. IC adults were more likely to be vaccinated than non-IC (69.5% vs 65.2%) and less likely to have influenza (22% vs 27.8%). The mean age did not differ among IC and non-IC (61.4 vs 60.8 years of age). The overall VE against influenza hospitalization, including immunocompetent adults, was 33% (95% confidence interval [CI], 21-44). VE among IC vs non-IC adults was lower at 5% (95% CI, -29% to 31%) vs 41% (95% CI, 27-52) (P < .05 for interaction term). CONCLUSIONS: VE in 1 influenza season was very low among IC individuals. Future efforts should include evaluation of VE among the different immunocompromising conditions and whether enhanced vaccines improve the suboptimal effectiveness among the immunocompromised.
BACKGROUND: Yearly influenza immunization is recommended for immunocompromised (IC) individuals, although immune responses are lower than that for the nonimmunocompromised and the data on vaccine effectiveness (VE) in the IC is scarce. We evaluated VE against influenza-associated hospitalization among IC adults. METHODS: We analyzed data from adults ≥ 18 years hospitalized with acute respiratory illness (ARI) during the 2017-2018 influenza season at 10 hospitals in the United States. IC adults were identified using prespecified case definitions using electronic medical record data. VE was evaluated with a test-negative case-control design using multivariable logistic regression with polymerase chain reaction-confirmed influenza as the outcome and vaccination status as the exposure, adjusting for age, enrolling site, illness onset date, race, days from onset to specimen collection, self-reported health, and self-reported hospitalizations. RESULTS: Of 3524 adults hospitalized with ARI, 1210 (34.3%) had an immunocompromising condition. IC adults were more likely to be vaccinated than non-IC (69.5% vs 65.2%) and less likely to have influenza (22% vs 27.8%). The mean age did not differ among IC and non-IC (61.4 vs 60.8 years of age). The overall VE against influenza hospitalization, including immunocompetent adults, was 33% (95% confidence interval [CI], 21-44). VE among IC vs non-IC adults was lower at 5% (95% CI, -29% to 31%) vs 41% (95% CI, 27-52) (P < .05 for interaction term). CONCLUSIONS: VE in 1 influenza season was very low among IC individuals. Future efforts should include evaluation of VE among the different immunocompromising conditions and whether enhanced vaccines improve the suboptimal effectiveness among the immunocompromised.
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Authors: Charles R Beck; Bruce C McKenzie; Ahmed B Hashim; Rebecca C Harris; Jonathan S Nguyen-Van-Tam Journal: J Infect Dis Date: 2012-08-16 Impact factor: 5.226
Authors: Michaela K Nichols; Melissa K Andrew; Todd F Hatchette; Ardith Ambrose; Guy Boivin; William Bowie; Ayman Chit; Gael Dos Santos; May ElSherif; Karen Green; Francois Haguinet; Scott A Halperin; Barbara Ibarguchi; Jennie Johnstone; Kevin Katz; Phillipe Lagacé-Wiens; Joanne M Langley; Jason LeBlanc; Mark Loeb; Donna MacKinnon-Cameron; Anne McCarthy; Janet E McElhaney; Allison McGeer; Andre Poirier; Jeff Powis; David Richardson; Anne Schuind; Makeda Semret; Vivek Shinde; Stephanie Smith; Daniel Smyth; Grant Stiver; Geoffrey Taylor; Sylvie Trottier; Louis Valiquette; Duncan Webster; Lingyun Ye; Shelly A McNeil Journal: Vaccine Date: 2018-03-13 Impact factor: 3.641
Authors: Min Z Levine; Emily T Martin; Joshua G Petrie; Adam S Lauring; Crystal Holiday; Stacie Jefferson; William J Fitzsimmons; Emileigh Johnson; Jill M Ferdinands; Arnold S Monto Journal: J Infect Dis Date: 2019-05-24 Impact factor: 5.226
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Authors: Peter J Embi; Matthew E Levy; Allison L Naleway; Palak Patel; Manjusha Gaglani; Karthik Natarajan; Kristin Dascomb; Toan C Ong; Nicola P Klein; I-Chia Liao; Shaun J Grannis; Jungmi Han; Edward Stenehjem; Margaret M Dunne; Ned Lewis; Stephanie A Irving; Suchitra Rao; Charlene McEvoy; Catherine H Bozio; Kempapura Murthy; Brian E Dixon; Nancy Grisel; Duck-Hye Yang; Kristin Goddard; Anupam B Kharbanda; Sue Reynolds; Chandni Raiyani; William F Fadel; Julie Arndorfer; Elizabeth A Rowley; Bruce Fireman; Jill Ferdinands; Nimish R Valvi; Sarah W Ball; Ousseny Zerbo; Eric P Griggs; Patrick K Mitchell; Rachael M Porter; Salome A Kiduko; Lenee Blanton; Yan Zhuang; Andrea Steffens; Sarah E Reese; Natalie Olson; Jeremiah Williams; Monica Dickerson; Meredith McMorrow; Stephanie J Schrag; Jennifer R Verani; Alicia M Fry; Eduardo Azziz-Baumgartner; Michelle A Barron; Mark G Thompson; Malini B DeSilva Journal: MMWR Morb Mortal Wkly Rep Date: 2021-11-05 Impact factor: 17.586