scholarly journals Projected Population Benefit of Increased Effectiveness and Coverage of Influenza Vaccination on Influenza Burden in the United States

2019 ◽  
Vol 70 (12) ◽  
pp. 2496-2502 ◽  
Author(s):  
Michelle M Hughes ◽  
Carrie Reed ◽  
Brendan Flannery ◽  
Shikha Garg ◽  
James A Singleton ◽  
...  
Keyword(s):  
United States ◽  
Mathematical Model ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Vaccine Coverage ◽  
Age Groups ◽  
The United States ◽  
Absolute Increase ◽  
Policy Agendas ◽  
Research And Policy

Abstract Background Vaccination is the best way to prevent influenza; however, greater benefits could be achieved. To help guide research and policy agendas, we aimed to quantify the magnitude of influenza disease that would be prevented through targeted increases in vaccine effectiveness (VE) or vaccine coverage (VC). Methods For 3 influenza seasons (2011–12, 2015–16, and 2017–18), we used a mathematical model to estimate the number of prevented influenza-associated illnesses, medically attended illnesses, and hospitalizations across 5 age groups. Compared with estimates of prevented illness during each season, given observed VE and VC, we explored the number of additional outcomes that would have been prevented from a 5% absolute increase in VE or VC or from achieving 60% VE or 70% VC. Results During the 2017–18 season, compared with the burden already prevented by influenza vaccination, a 5% absolute VE increase would have prevented an additional 1 050 000 illnesses and 25 000 hospitalizations (76% among those aged ≥65 years), while achieving 60% VE would have prevented an additional 190 000 hospitalizations. A 5% VC increase would have resulted in 785 000 fewer illnesses (56% among those aged 18–64 years) and 11 000 fewer hospitalizations; reaching 70% would have prevented an additional 39 000 hospitalizations. Conclusions Small, attainable improvements in effectiveness or VC of the influenza vaccine could lead to substantial additional reductions in the influenza burden in the United States. Improvements in VE would have the greatest impact in reducing hospitalizations in adults aged ≥65 years, and VC improvements would have the largest benefit in reducing illnesses in adults aged 18–49 years.

scholarly journals Influenza vaccine effectiveness against hospitalization in the United States, 2019-2020

2020 ◽  
Author(s):  
Mark W Tenforde ◽  
H Keipp Talbot ◽  
Christopher H Trabue ◽  
Manjusha Gaglani ◽  
Tresa M McNeal ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Respiratory Illness ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Influenza Viruses ◽  
Current Season ◽  
Hospital Resources ◽  
Negative Controls

Abstract Background Influenza causes significant morbidity and mortality and stresses hospital resources during periods of increased circulation. We evaluated the effectiveness of the 2019-2020 influenza vaccine against influenza-associated hospitalizations in the United States. Methods We included adults hospitalized with acute respiratory illness at 14 hospitals and tested for influenza viruses by reserve transcription polymerase chain reaction. Vaccine effectiveness (VE) was estimated by comparing the odds of current-season influenza vaccination in test-positive influenza cases versus test-negative controls, adjusting for confounders. VE was stratified by age and major circulating influenza types along with A(H1N1)pdm09 genetic subgroups. Results 3116 participants were included, including 18% (553) influenza-positive cases. Median age was 63 years. Sixty-seven percent (2079) received vaccination. Overall adjusted VE against influenza viruses was 41% (95% confidence interval [CI]: 27-52). VE against A(H1N1)pdm09 viruses was 40% (95% CI: 24-53) and 33% against B viruses (95% CI: 0-56). Of the two major A(H1N1)pdm09 subgroups (representing 90% of sequenced H1N1 viruses), VE against one group (5A+187A,189E) was 59% (95% CI: 34-75) whereas no significant VE was observed against the other group (5A+156K) [-1%, 95% CI: -61-37]. Conclusions In a primarily older population, influenza vaccination was associated with a 41% reduction in risk of hospitalized influenza illness.

scholarly journals Prevalence of and Sociodemographic Disparities in Influenza Vaccination Among Adults With Diabetes in the United States

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Priyanka Bhugra ◽  
Reed Mszar ◽  
Javier Valero-Elizondo ◽  
Gowtham R Grandhi ◽  
Salim S Virani ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Medical Expenditure Panel Survey ◽  
Vaccine Coverage ◽  
The United States ◽  
Sociodemographic Factors ◽  
Medical Expenditure ◽  
Sociodemographic Characteristics ◽  
Black Race ◽  
Patients With Diabetes

Abstract National estimates describing the overall prevalence of and disparities in influenza vaccination among patients with diabetes mellitus (DM) in United States are not well described. Therefore, we analyzed the prevalence of influenza vaccination among adults with DM, overall and by sociodemographic characteristics, using the Medical Expenditure Panel Survey database from 2008 to 2016. Associations between sociodemographic factors and lack of vaccination were examined using adjusted logistic regression. Among adults with DM, 36% lacked influenza vaccination. Independent predictors of lacking influenza vaccination included age 18 to 39 years (odds ratio [OR] 2.54; 95% confidence interval [CI], 2.14-3.00), Black race/ethnicity (OR 1.29; 95% CI, 1.14-1.46), uninsured status (OR 1.88; 95% CI, 1.59-2.21), and no usual source of care (OR 1.61; 95% CI, 1.39-1.85). Nearly 64% individuals with ≥ 4 higher-risk sociodemographic characteristics lacked influenza vaccination (OR 3.50; 95% CI 2.79-4.39). One-third of adults with DM in the United States lack influenza vaccination, with younger age, Black race, and lower socioeconomic status serving as strong predictors. These findings highlight the continued need for focused public health interventions to increase vaccine coverage and utilization among disadvantaged communities.

scholarly journals 1650. Knowledge and Attitudes Toward Influenza Vaccination Among Hispanics: A Survey Conducted in Latin American Consulates in South Florida

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S603-S603
Author(s):  
Maria L Soler Hidalgo ◽  
John M Abbamonte ◽  
Laura Regalini ◽  
Mariana Schlesinger ◽  
Maria L Alcaide ◽  
...  
Keyword(s):  
United States ◽  
Health Insurance ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Latin American ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
South Florida ◽  
Knowledge And Attitudes ◽  
Hispanic Community

Abstract Background Each year Influenza causes between 12,000 and 56,000 deaths, and over half a million of hospitalizations in the United States. Despite the widespread availability of vaccination, immunization coverage is low. Less than half of American adults receive the influenza vaccine, and there is a disparity between Hispanic and non-Hispanics, with only 35.9% of Hispanic compared with 45.9% of white non-Hispanics receiving the vaccine. In Miami, South Florida, over two-thirds of the population is Hispanic, and rates of influenza vaccination are low. This study aims to identify the knowledge and attitudes toward influenza vaccination among members of the adult Hispanic community in Miami, and to identify barriers to vaccination in this population. Methods This is a cross-sectional study conducted during the influenza season in 2017 and 2019 (October to December). A survey was administered in the waiting rooms of participating Latin American Consulates (Argentina, Colombia, Ecuador, Guatemala, Honduras, Mexico, Peru, and Uruguay) in Miami. Participants included were older than 18 years, Hispanic, and with residence in the United States for more than 6 months. The participants accepted the inform consent orally. The survey was voluntary and anonymous. Results We enrolled 970 adults. The median age was 43 years, 50% were male, 60% had health insurance, and 67% had completed education of high school or higher. Knowledge regarding influenza and vaccination was low (78% believed asymptomatic individuals could transmit influenza, 14% knew that vaccination is recommended during the winter months, 50% felt not everyone should be vaccinated, 25% believed the vaccine causes influenza, and 7% autism). About one quarter (27%) received the influenza vaccine annually, 35% sometimes, and 38% never. Using multinomial logistic regression, we identified age χ2(2) = 19.38, P < 0.001, consulate χ2(6) = 160.21, P < 0.001, and insurance status χ2(2) = 23.04, P < 0.001 as predictors of receiving vaccination. Neither gender, nor education level found to be associated with vaccination behavior. Conclusion Immunization rates in the adult Hispanic population are low. Interventions to improve vaccination among Hispanics who are older and lack of health insurance are urgently needed in the diverse Hispanic community. Disclosures All authors: No reported disclosures.

scholarly journals Disparities in Influenza Vaccine Coverage in the United States, 2008

2010 ◽  
Vol 58 (7) ◽  
pp. 1333-1340 ◽  
Author(s):  
Shauna T. Linn ◽  
Jack M. Guralnik ◽  
Kushang V. Patel
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Vaccine Coverage ◽  
The United States

scholarly journals Effects of Influenza Vaccination in the United States During the 2018–2019 Influenza Season

2020 ◽  
Vol 71 (8) ◽  
pp. e368-e376 ◽  
Author(s):  
Jessie R Chung ◽  
Melissa A Rolfes ◽  
Brendan Flannery ◽  
Pragati Prasad ◽  
Alissa O’Halloran ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Influenza Season ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Influenza Viruses ◽  
Monte Carlo Algorithm ◽  
Medical Visits ◽  
The Us

Abstract Background Multivalent influenza vaccine products provide protection against influenza A(H1N1)pdm09, A(H3N2), and B lineage viruses. The 2018–2019 influenza season in the United States included prolonged circulation of A(H1N1)pdm09 viruses well-matched to the vaccine strain and A(H3N2) viruses, the majority of which were mismatched to the vaccine. We estimated the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the season. Methods We used a mathematical model and Monte Carlo algorithm to estimate numbers and 95% uncertainty intervals (UIs) of influenza-associated outcomes prevented by vaccination in the United States. The model incorporated age-specific estimates of national 2018–2019 influenza vaccine coverage, influenza virus–specific vaccine effectiveness from the US Influenza Vaccine Effectiveness Network, and disease burden estimated from population-based rates of influenza-associated hospitalizations through the Influenza Hospitalization Surveillance Network. Results Influenza vaccination prevented an estimated 4.4 million (95%UI, 3.4 million–7.1 million) illnesses, 2.3 million (95%UI, 1.8 million–3.8 million) medical visits, 58 000 (95%UI, 30 000–156 000) hospitalizations, and 3500 (95%UI, 1000–13 000) deaths due to influenza viruses during the US 2018–2019 influenza season. Vaccination prevented 14% of projected hospitalizations associated with A(H1N1)pdm09 overall and 43% among children aged 6 months–4 years. Conclusions Influenza vaccination averted substantial influenza-associated disease including hospitalizations and deaths in the United States, primarily due to effectiveness against A(H1N1)pdm09. Our findings underscore the value of influenza vaccination, highlighting that vaccines measurably decrease illness and associated healthcare utilization even in a season in which a vaccine component does not match to a circulating virus.

scholarly journals Prevalence and Predictors of Influenza Vaccination Among Adults with High-Risk Conditions, United States, 2019

2021 ◽  
Vol 2 (3) ◽  
pp. 137-145
Author(s):  
Saji Gopalan ◽  
Devi Mishra ◽  
Ashis Das
Keyword(s):  
United States ◽  
High Risk ◽  
Influenza Vaccination ◽  
Family Income ◽  
Influenza Infection ◽  
Insurance Coverage ◽  
Age Groups ◽  
The United States ◽  
Medical Conditions ◽  
To Receive

Introduction: Influenza could be associated with illnesses, severe complications, hospitalizations, and deaths among adults with high-risk medical conditions. Influenza vaccination reduces the risks and complications associated with influenza infection in high-risk conditions. We assessed the prevalence and predictors of influenza vaccination in a national sample of adults with high-risk medical conditions in the United States. Methods: Using the nationally representative National Health Interview Survey of 2019, we estimated the prevalence of influenza vaccination among adults with high-risk conditions. We tested the associations between receipt of vaccination and socio-demographic predictors. Results: Out of 15,258 adults with high-risk conditions, 56% reported receiving an influenza vaccine over the previous 12 months. Multivariable regressions show that respondents from older age groups, females, married, higher annual family income, having health insurance and those with more than two high-risk conditions are more likely to receive the vaccine. However, adults from non-Hispanic Black race/ethnicity and living in the Southern census region are less likely to receive the vaccination. Education levels and living in a metro show no associations with vaccination status. Conclusions: State authorities and providers have important roles in sensitizing and reminding individuals with high-risk conditions to receive timely vaccination. Affordability needs to be enhanced for influenza vaccination including better insurance coverage and reduced co-payment.

scholarly journals Vaccine waning and mumps re-emergence in the United States

2017 ◽  
Author(s):  
Joseph A. Lewnard ◽  
Yonatan H. Grad
Keyword(s):  
United States ◽  
Vaccine Coverage ◽  
Age Distribution ◽  
Age Groups ◽  
The United States ◽  
Epidemiological Studies ◽  
Mumps Virus ◽  
Live Attenuated Vaccine ◽  
Virus Genotypes ◽  
Heterologous Virus

AbstractFollowing decades of declining mumps incidence amid widespread vaccination, the United States and other high-income countries have experienced a resurgence in mumps cases over the last decade. Outbreaks affecting vaccinated individuals—and communities with high vaccine coverage—have prompted concerns about the effectiveness of the live attenuated vaccine currently in use: it is unclear if immune protection wanes, or if the vaccine protects inadequately against mumps virus lineages currently circulating. Synthesizing data from epidemiological studies, we estimate that vaccine-derived protection wanes at a timescale of 27 (95%CI: 16 to 51) years. After accounting for this waning, we identify no evidence of changes in vaccine effectiveness over time associated with the emergence of heterologous virus genotypes. Moreover, a mathematical model of mumps transmission validates our findings about the central role of vaccine waning in the re-emergence of cases: outbreaks from 2006 to the present among young adults, and outbreaks occurring in the late 1980s and early 1990s among adolescents, align with peaks in the susceptibility of these age groups attributable to loss of vaccine-derived protection. In contrast, evolution of mumps virus strains escaping pressure would be expected to cause a higher proportion of cases among children. Routine use of a third dose at age 18y, or booster dosing throughout adulthood, may enable mumps elimination and should be assessed in clinical trials.One Sentence SummaryThe estimated waning rate of vaccine-conferred immunity against mumps predicts observed changes in the age distribution of mumps cases in the United States since 1967.

scholarly journals 2062. Improving Antibiotic Prescribing in the Ambulatory Care Setting—Stewardship through Influenza Vaccination, US Flu VE Network 2013–2014 Through 2017–2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S695-S695
Author(s):  
Emily Smith ◽  
Alicia M. Fry ◽  
Lauri Hicks ◽  
Katherine E Fleming-Dutra ◽  
Emily T Martin ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Vaccine Coverage ◽  
Improve Patient Safety ◽  
Respiratory Illness ◽  
Antibiotic Use ◽  
The United States ◽  
Antibiotic Prescribing ◽  
Ambulatory Care Setting

Abstract Background Improving antibiotic use is a key strategy to combat antibiotic resistance and improve patient safety. Acute respiratory illness (ARI) is a common cause of outpatient visits and accounts for ~41% of antibiotics used in the United States. We sought to determine the proportion of antibiotic prescriptions (Rx) prescribed among outpatients with ARI that can be potentially averted through influenza vaccination. Methods From 2013–2014 through 2017–2018 influenza seasons, we enrolled patients aged ≥6 months with ARI in the US Influenza Vaccine Effectiveness (VE) Network of >50 outpatient clinics. Antibiotic Rx and diagnosis codes were collected from medical records. Study influenza test results were not available to treating clinicians at most sites, and clinical influenza testing was infrequently performed (a), prevalence of influenza among unvaccinated ARI patients (b), prevalence of antibiotic Rx among unvaccinated influenza-positive ARI patients (c) and prevalence of antibiotic Rx among ARI patients overall (d), we derived estimates of the proportion of ARI antibiotic Rx that can be averted by influenza vaccination [(a × b × c)/d]. Results Among 37487 outpatients with ARI, 13,316 (36%) were prescribed an antibiotic and 9,689 (26%) tested positive for influenza. Of those positive, 2,496 (26%) were prescribed an antibiotic. Adjusted VE against influenza-associated ARI was 35% (95% confidence interval (CI), 32 to 39). Among unvaccinated patients with ARI, 30% were influenza-positive and 24% received antibiotics. Based on these estimates, we determined that influenza vaccination may prevent 10.6% of all ARI syndromes and may avert 1 in 14 or 7.3% of antibiotic Rx among ARI patients. Conclusion By preventing influenza-associated ARI syndromes, influenza vaccination may substantially reduce antibiotic prescribing. Increasing influenza vaccine coverage and improving protection may facilitate national goals to improve antibiotic use and reduce the global threat of antibiotic resistance. Disclosures All authors: No reported disclosures.

scholarly journals Effects of Influenza Vaccination in the United States During the 2017–2018 Influenza Season

2019 ◽  
Vol 69 (11) ◽  
pp. 1845-1853 ◽  
Author(s):  
Melissa A Rolfes ◽  
Brendan Flannery ◽  
Jessie R Chung ◽  
Alissa O’Halloran ◽  
Shikha Garg ◽  
...  
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Influenza A ◽  
Influenza Season ◽  
Influenza Virus Infection ◽  
The United States ◽  
Influenza B ◽  
Medical Visits ◽  
Influenza A H1n1

Abstract Background The severity of the 2017–2018 influenza season in the United States was high, with influenza A(H3N2) viruses predominating. Here, we report influenza vaccine effectiveness (VE) and estimate the number of vaccine-prevented influenza-associated illnesses, medical visits, hospitalizations, and deaths for the 2017–2018 influenza season. Methods We used national age-specific estimates of 2017–2018 influenza vaccine coverage and disease burden. We estimated VE against medically attended reverse-transcription polymerase chain reaction–confirmed influenza virus infection in the ambulatory setting using a test-negative design. We used a compartmental model to estimate numbers of influenza-associated outcomes prevented by vaccination. Results The VE against outpatient, medically attended, laboratory-confirmed influenza was 38% (95% confidence interval [CI], 31%–43%), including 22% (95% CI, 12%–31%) against influenza A(H3N2), 62% (95% CI, 50%–71%) against influenza A(H1N1)pdm09, and 50% (95% CI, 41%–57%) against influenza B. We estimated that influenza vaccination prevented 7.1 million (95% CrI, 5.4 million–9.3 million) illnesses, 3.7 million (95% CrI, 2.8 million–4.9 million) medical visits, 109 000 (95% CrI, 39 000–231 000) hospitalizations, and 8000 (95% credible interval [CrI], 1100–21 000) deaths. Vaccination prevented 10% of expected hospitalizations overall and 41% among young children (6 months–4 years). Conclusions Despite 38% VE, influenza vaccination reduced a substantial burden of influenza-associated illness, medical visits, hospitalizations, and deaths in the United States during the 2017–2018 season. Our results demonstrate the benefit of current influenza vaccination and the need for improved vaccines.

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