The Potential Benefits of the Influenza Vaccination on COVID-19 Mortality Rate—A Retrospective Analysis of Patients in Poland

In this study, we used publicly available data from the Centrum e-Zdrowia (CeZ) Polish Databank proposing a possible correlation between influenza vaccination and mortality due to COVID-19. We limited our search to the patients with positive COVID‑19 laboratory tests from 1 January 2020 to 31 March 2021 and who filled a prescription for any influenza vaccine during the 2019–2020 influenza season. In total, we included 116,277 patients and used a generalized linear model to analyze the data. We found out that patients aged 60+ who received an influenza vaccination have a lower probability of death caused by COVID-19 in comparison to unvaccinated, and the magnitude of this difference grows with age. For people below 60 years old, we did not observe an influence of the vaccination. Our results suggest a potential protective effect of the influenza vaccine on COVID-19 mortality of the elderly. Administration of the influenza vaccine before the influenza season would reduce the burden of increased influenza incidence, the risk of influenza and COVID‑19 coinfection and render the essential medical resources accessible to cope with another wave of COVID-19. To our knowledge, this is the first study showing a correlation between influenza vaccination and the COVID-19 mortality rate in Poland.

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Influenza vaccination knowledge, attitudes, and practices among Tunisian elderly with chronic diseases

BMC Geriatrics ◽

10.1186/s12877-021-02667-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ghassen Kharroubi ◽

Ines Cherif ◽

Leila Bouabid ◽

Adel Gharbi ◽

Aicha Boukthir ◽

...

Keyword(s):

Side Effects ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Chronic Diseases ◽

Influenza Season ◽

The Elderly ◽

Health Care Facilities ◽

Vaccine Uptake ◽

Health Concern ◽

To Receive

Abstract Background Generally, seasonal influenza does not cause severe infection in healthy adults, but for the elderly, an infection can pose a serious health concern. Although several measures can help prevent influenza, vaccination is considered the most effective. This study aimed to assess influenza vaccine uptake among elderly with chronic diseases in Tunisia during the 2018–2019 influenza season, and to identify knowledge, attitudes and barriers associated with influenza vaccine uptake. Methods During influenza season of 2018–2019, we conducted a national cross-sectional study among elderly with chronic disease who were attending primary and secondary health care facilities in Tunisia. We collected data regarding practices, general knowledge and attitudes related to influenza and influenza vaccine, using a standardized questionnaire. A multivariate analysis by logistic regression was performed to assess the factors influencing willingness to receive influenza vaccine. Results Among the 1191 surveyed elderly, 19.4% (95%CI 14.1–21.9) were vaccinated during the 2018–2019 influenza season and 64.7% (61.9–67.3) expressed willingness to be vaccinated in the next season regardless of vaccination status in the 2018–2019 season. Previous vaccination in the 2018–2019 influenza season was the most significantly associated factor with willingness to receive influenza vaccine (adjusted OR = 16.5 [3.7–72.4]). Significant associations were also observed between knowledge of influenza severity for the elderly as well as for those with chronic diseases and willingness to be vaccinated (p < 0.01). Likewise, participants who were convinced by flu vaccine effectiveness and those who were not concerned about vaccine side effects were more likely to be vaccinated (p < 0.001). The main reason that may lead to vaccine acceptance was a doctor’s recommendation (41.1%), while the two main reasons that may lead to vaccine refusal were concerns about side effects (71.5%) and a belief that vaccine was ineffective in averting influenza illness (33.9%). Doctors were the most trusted source for information about influenza vaccine (91.5%). Conclusion Our study revealed low influenza vaccination coverage among Tunisian elderly with chronic diseases believed to be at higher risk for severe acute respiratory infections and death if infected with influenza. Treating physicians’ role in promoting influenza vaccination in this high-risk group seems to be crucial.

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22. Description of Hospitalized Patients with Influenza Vaccine Failure

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.067 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S35-S35

Author(s):

Joanna Kimball ◽

Yuwei Zhu ◽

Dayna Wyatt ◽

Helen Talbot

Keyword(s):

Logistic Regression ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Older Patients ◽

Influenza A ◽

Influenza Season ◽

Hospitalized Patients ◽

Vaccine Failure ◽

Increased Risk ◽

Immunosuppressed Patients

Abstract Background Despite influenza vaccination, some patients develop illness and require hospitalization. Many factors contribute to vaccine failure, including mismatch of the vaccine and circulating strains, waning immunity, timing of influenza season, age and patient comorbidities such as immune function. This study compared vaccinated, hospitalized patients with and without influenza. Methods This study used 2015–2019 Tennessee data from the US Hospitalized Adult Influenza Vaccine Effectiveness Network database. Enrolled patients were ≥ 18 years vaccinated for the current influenza season and admitted with an acute respiratory illness. Patient or surrogate interviews and medical chart abstractions were performed, and influenza vaccinations were confirmed by vaccine providers. Influenza PCR testing was performed in a research lab. Statistical analyses were performed with STATA and R using Pearson’s chi-squared, Kruskal-Wallis and Wilcoxon rank-sum tests and multivariate logistic regression. Results 1236 patients met study criteria, and 235 (19%) tested positive for influenza. Demographics, vaccines and comorbidities were similar between the two groups (Table 1) except for morbid obesity, which was more common in influenza negative patients (13% vs 8%, p = 0.04), and immunosuppression, which was more common in the influenza positive (63% vs 54%, p = 0.01). Logistic regression analysis demonstrated older patients (OR 1.47, 95% CI 1.03–2.10) and immunosuppressed patients (OR 1.56, 1.15–2.12) were at increased risk for influenza (Table 2 and Figure 1). Immunosuppression also increased the risk for influenza A/H3N2 (OR 1.86, 95% CI 1.25–2.75). A sensitivity analysis was performed on patients who self-reported influenza vaccination for the current season without vaccine verification and demonstrated increased risk of influenza in older adults (OR 1.66, 95% CI 1.16–2.39). Table 1: Demographics of influenza positive versus influenza negative patients in influenza vaccinated, hospitalized patients. Table 2: Logistic regression analyses of vaccinated, hospitalized influenza positive patients; vaccinated, hospitalized patients with influenza A subtypes and self-reported vaccinated, hospitalized influenza positive patients. Figure 1: Predicted Probability of Hospitalization with Influenza, Influenza A/H1N1 and Influenza A/H3N2 in Vaccinated Patients by Age. Conclusion Our study demonstrated an increased risk of influenza vaccine failure in older patients and immunosuppressed patients. These groups are also at increased risk for influenza complications. To improve protection of these patients against future influenza illnesses, more effective vaccines are needed, and more research on ring vaccination should be pursued. Disclosures All Authors: No reported disclosures

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Mortality due to respiratory diseases in the elderly after influenza vaccination campaigns in the Federal District, Brazil, 1996-2009

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000200011 ◽

2013 ◽

Vol 39 (2) ◽

pp. 198-204 ◽

Cited By ~ 2

Author(s):

Francisca Magalhães Scoralick ◽

Luciana Paganini Piazzolla ◽

Liana Laura Pires ◽

Cleudsom Neri ◽

Wladimir Kummer de Paula

Keyword(s):

Mortality Rate ◽

Influenza Vaccination ◽

Respiratory Diseases ◽

Positive Impact ◽

Vaccination Campaign ◽

Age Groups ◽

Federal District ◽

The Elderly ◽

Analysis Data ◽

Proportional Mortality

OBJECTIVE: To compare mortality rates due to respiratory diseases among elderly individuals residing in the Federal District of Brasília, Brazil, prior to and after the implementation of a national influenza vaccination campaign. METHODS: This was an ecological time series analysis. Data regarding the population of individuals who were over 60 years of age between 1996 and 2009 were obtained from official databases. The variables of interest were the crude mortality rate (CMR), the mortality rate due to the respiratory disease (MRRD), and the proportional mortality ratio (PMR) for respiratory diseases. We performed a qualitative analysis of the data for the period prior to and after the implementation of the vaccination campaign (1996-1999 and 2000-2009, respectively). RESULTS: The CMR increased with advancing age. Over the course of the study period, we observed reductions in the CMR in all of the age brackets studied, particularly among those aged 80 years or older. Reductions in the MRRD were also found in all of the age groups, especially in those aged 80 years or older. In addition, there was a decrease in the PMR for respiratory diseases in all age groups throughout the study period. The most pronounced decrease in the PMR for respiratory diseases in the ≥ 70 year age bracket occurred in 2000 (immediately following the implementation of the national vaccination campaign); in 2001, that rate increased in all age groups, despite the greater adherence to the vaccination campaign in comparison with that recorded for 2000. CONCLUSIONS: Influenza vaccination appears to have a positive impact on the prevention of mortality due to respiratory diseases, particularly in the population aged 70 or over.

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The impact of the 2009 influenza A(H1N1) pandemic on attitudes of healthcare workers toward seasonal influenza vaccination 2010/11

Eurosurveillance ◽

10.2807/ese.16.17.19854-en ◽

2011 ◽

Vol 16 (17) ◽

Author(s):

C Brandt ◽

H F Rabenau ◽

S Bornmann ◽

R Gottschalk ◽

S Wicker

Keyword(s):

Medical Students ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Healthcare Workers ◽

Influenza A ◽

Influenza Season ◽

University Hospital ◽

The Public ◽

Influenza A H1n1 ◽

The Impact

The emergence of the influenza A(H1N1)2009 virus provided a major challenge to health services around the world. However, vaccination rates for the public and for healthcare workers (HCWs) have remained low. We performed a study to review the reasons put forward by HCWs to refuse immunisation with the pandemic vaccine in 2009/10 and characterise attitudes in the influenza season 2010/11 due to the emergence of influenza A(H1N1)2009. A survey among HCWs and medical students in the clinical phase of their studies was conducted, using an anonymous questionnaire, at a German university hospital during an influenza vaccination campaign. 1,366 of 3,900 HCWs (35.0%) were vaccinated in the 2010/11 influenza season. Of the vaccinated HCWs, 1,323 (96.9%) completed the questionnaire in addition to 322 vaccinated medical students. Of the 1,645 vaccinees who completed the questionnaire, 712 had not been vaccinated against the influenza A(H1N1)2009 virus in the 2009/10 season. The main reason put forward was the objection to the AS03 adjuvants (239/712, 33.6%). Of the HCWs and students surveyed, 270 of 1,645 (16.4%) stated that the pandemic had influenced their attitude towards vaccination in general. Many German HCWs remained unconvinced of the safety of the pandemic (adjuvanted) influenza vaccine. For this reason, effective risk communication should focus on educating the public and HCWs about influenza vaccine safety and the benefits of vaccination.

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Seasonal Influenza Vaccination and Recommendation: The Difference between General Practitioners and Public Health Workers in China

Vaccines ◽

10.3390/vaccines8020265 ◽

2020 ◽

Vol 8 (2) ◽

pp. 265 ◽

Cited By ~ 1

Author(s):

Hongguo Rong ◽

Xiaozhen Lai ◽

Xiaochen Ma ◽

Zhiyuan Hou ◽

Shunping Li ◽

...

Keyword(s):

Public Health ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

General Practitioners ◽

Seasonal Influenza ◽

Health Workers ◽

The Elderly ◽

Vaccine Uptake ◽

Knowledge And Attitudes ◽

Public Health Workers

Seasonal influenza vaccination for healthcare workers (HCWs) is critical to the protection of HCWs and their patients. This study examined whether the separation of public health workers and general practitioners could affect the influenza vaccine uptake and recommendation behaviors among HCWs in China. A survey was conducted from August to October 2019, and HCWs from 10 provinces in China were recruited. A self-administered and anonymous questionnaire was used to assess HCWs’ demographic information, knowledge, and attitudes toward influenza vaccination, as well as vaccine uptake and recommendation behaviors. The primary outcome was HCWs’ vaccination and recommendation status of seasonal influenza vaccine. Multivariate logistic regression models were used to identify the influence factors of influenza vaccine uptake and recommendation among HCWs. Of the 1159 HCWs in this study, 25.3% were vaccinated against influenza in the previous season. “No need to get vaccinated” was the primary reason for both unvaccinated public health workers and general practitioners. Multivariate logistic regression showed that public health workers were more likely to get vaccinated against influenza (OR = 2.20, 95% CI 1.59–3.05) and recommend influenza vaccination to children (OR = 2.10, 95% CI 1.57–2.80) and the elderly (OR = 1.69, 95% CI 1.26–2.25) than general practitioners. Besides, the knowledge and perceived risk of influenza can give rise to HCWs’ vaccination and recommendation behaviors, and HCWs who got vaccinated in the past year were more likely to recommend it to children and the elderly in their work. The influenza vaccine coverage and recommendation among HCWs are still relatively low in China, especially for general practitioners. Further efforts are needed to improve the knowledge and attitudes toward influenza and influenza vaccination among HCWs, and coherent training on immunization for both public health workers and general practitioners might be effective in the face of separated public health and clinical services in China.

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

Clinical Infectious Diseases ◽

10.1093/cid/ciz1244 ◽

2020 ◽

Vol 71 (8) ◽

pp. e368-e376 ◽

Cited By ~ 7

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.

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Determinants of influenza vaccine uptake and willingness to be vaccinated by pharmacists among the active adult population in Hungary: a cross-sectional exploratory study

BMC Public Health ◽

10.1186/s12889-021-10572-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Githa Fungie Galistiani ◽

Mária Matuz ◽

Nikolett Matuszka ◽

Péter Doró ◽

Krisztina Schváb ◽

...

Keyword(s):

Logistic Regression ◽

Risk Factor ◽

Influenza Vaccine ◽

Health Risk ◽

Influenza Vaccination ◽

Influenza Season ◽

Adult Population ◽

Vaccine Uptake ◽

Cross Sectional ◽

Vaccination Uptake

Abstract Background Many studies have addressed influenza vaccine uptake in risk-group populations (e.g. the elderly). However, it is also necessary to assess influenza vaccine uptake in the active adult population, since they are considered to be a high-transmitter group. In several countries pharmacists are involved in adult vaccination in order to increase uptake. This study therefore aimed to investigate the determinants of influenza vaccination uptake and examine the willingness to be vaccinated by pharmacists. Methods A cross-sectional study was conducted among Hungarian adults using a self-administered online questionnaire distributed via social media (Facebook). The questionnaire included five domains: demographics, vaccine uptake, factors that motivated or discouraged vaccination, knowledge and willingness of participants to accept pharmacists as influenza vaccine administrators. Descriptive statistics were applied and logistic regression was conducted to assess the possible determinants of vaccination uptake. Results Data from 1631 participants who completed the questionnaires were analysed. Almost 58% of respondents (944/1631) had occupational and/or health risk factors for influenza. Just over one-tenth (12.3%;200/1631) of participants were vaccinated during the 2017/18 influenza season, 15.4% (145/944) of whom had a risk factor for influenza. Approximately half of the participants (47.4%) believed that influenza vaccination can cause flu, and just over half of them (51.6%), were not knowledgeable about the safety of influenza vaccine ingredients. Logistic regression found that age, sex, health risk factor and knowledge on influenza/influenza vaccination were associated with influenza vaccination uptake (p < 0.05). The most frequently cited reason for having an influenza vaccination was self-protection (95.0%). The most common reason given for refusing the influenza vaccine was that the respondent stated they rarely had an infectious disease (67.7%). The number of participants who were willing to be vaccinated by pharmacists was two-times higher than the number of participants who were actually vaccinated during the 2017/18 influenza season. Conclusion Influenza vaccine uptake in the active adult population is low in Hungary. Public awareness and knowledge about influenza vaccination and influenza disease should be increased. The results also suggest a need to extend the role played by pharmacists in Hungary.

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Effectiveness of influenza vaccine among health care personnel in Thailand, 2018/19 season

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1096 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T Eamchotchawalit ◽

P Piyaraj ◽

P Narongdej ◽

S Charoensakulchai ◽

C Chanthowong

Keyword(s):

Health Care ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Influenza Season ◽

Influenza Infection ◽

Vaccine Effectiveness ◽

Health Care Personnel ◽

Seasonal Influenza Vaccine ◽

Influenza Like Illness

Abstract Background Influenza vaccination is the most effective way of preventing influenza infections and it is recommended for the entire health care personnel in Thailand. However, the evidence of influenza vaccine effectiveness (VE) among health care personnel is lacking in Thailand. The objective of this study was to estimate influenza vaccine effectiveness (VE) against laboratory confirmed medically attended influenza illness for the 2018/9 season among health care personnel who at risk for influenza infection in Bangkok, the capital of Thailand. Methods Throat swab specimens were collected from patients with influenza-like illness (ILI) presenting to outpatient clinics and tested for influenza virus by RT-PCR, between October 2018 and September 2019. A test-negative case-control design was used to estimate influenza VE against medically-attended laboratory-confirmed influenza in outpatient settings. Cases were influenza-like illness (ILI) patients who tested positive for influenza, and controls were influenza negative patients. Results During the 2018/19 season 373 samples were collected; 57 (15.3%) were positive for influenza, 70.2% A un-subtyped and 29.8% B. Adjusted VE against all influenza viruses for this influenza season was -31.7% (95% confidence interval (CI): -40.2 to 66.4), against influenza A un-subtyped, it was 43.9% (95% CI: -30.6 to 75.9) and against influenza B, it was 52.0% (95% CI: (-73.9 to 86.8). Conclusions The seasonal influenza vaccine was moderately effective against medically attended lab-confirmed influenza infection in health care personnel in Bangkok, Thailand in the 2018-19 influenza season. Key messages The seasonal influenza vaccine was moderately effective against medically attended lab-confirmed influenza infection in health care personnel in Bangkok. Increasing seasonal influenza vaccination among health care personnel in Thailand may decrease medically attended influenza-associated ILI cases in this population.

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Early season estimate of influenza vaccination effectiveness against influenza hospitalisation in children, Hong Kong, winter influenza season 2018/19

Eurosurveillance ◽

10.2807/1560-7917.es.2019.24.5.1900056 ◽

2019 ◽

Vol 24 (5) ◽

Cited By ~ 14

Author(s):

Susan S Chiu ◽

Mike YW Kwan ◽

Shuo Feng ◽

Eunice LY Chan ◽

Huiying Chua ◽

...

Keyword(s):

Hong Kong ◽

Confidence Interval ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Influenza A ◽

Influenza Season ◽

Public Hospitals ◽

Early Season ◽

Influenza A H1n1

The winter 2018/19 influenza season in Hong Kong has been predominated by influenza A(H1N1)pdm09 as at January 2019. We enrolled 2,016 children in three public hospitals in Hong Kong between 2 September 2018 and 11 January 2019. Using the test-negative approach, we estimated high early season effectiveness of inactivated influenza vaccine against influenza A or B of 90% (95% confidence interval (CI): 80–95%) and 92% (95% CI: 82–96%) against influenza A(H1N1)pdm09.

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Serologic antibody response to quadrivalent influenza vaccination in Polish elderly patients

European Journal of Public Health ◽

10.1093/eurpub/ckz187.158 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

P Dubiel ◽

M Ganczak ◽

M Drozd-Dąbrowska ◽

E Hallmann-Szelińska ◽

K Szymański ◽

...

Keyword(s):

Antibody Response ◽

Influenza Vaccine ◽

Elderly Patients ◽

Influenza Vaccination ◽

Geometric Mean ◽

Primary Care Clinic ◽

The Elderly ◽

Study Objective ◽

Care Clinic ◽

Quadrivalent Influenza Vaccine

Abstract Background The effectiveness of immunization with subunit inactivated quadrivalent influenza vaccine (QIV) in the elderly has not been sufficiently estimated. The study objective was to evaluate QIV-induced antibody response and influencing determinants in Polish elderly patients. Methods Consecutive patients ≥55 years old attending the Primary Care Clinic in Gryfino, Poland, received QIV (A/Michigan/45/2015 [A/H1N1/pdm09], A/Singapore/INFIMH-16-0019/2016 [A/H3N2/], B/Colorado/06/2017 [Victoria lineage], B/Phuket/3073/2013 [Yamagata lineage]) between October-December 2018. Hemagglutination-inhibition assays measured antibody response to vaccine strains before/after vaccination. Geometric mean titer (GMT)/titers ratio (GMTR), protection (PR) and response (RR) rates were calculated. Results Among 108 participants (45.4% females; age 55-85, median 67 years) the highest GMTR after vaccination was observed for A/H3N2/(61.5-fold) followed by Victoria lineage (10.3-fold), A/H1N1/pdm09 (8.4-fold) and Yamagata lineage (3.0-fold). Most participants had a post-QIV protection for A/H3N2/and Yamagata lineage vaccine strains (64.8%, 70.4% respectively); lower PR were observed for Victoria lineage (57.4%) and A/H1N1/pdm09 (41.8%). The RR was high for A/H3N2/(91.7%) and Victoria lineage (68.5%), however, not satisfactory for A/H1N1/pdm09 and Yamagata lineage (59.3%, 52.8% respectively). Patients who received influenza vaccination in the previous year presented lower response to the both B strains compared to those who did not (p < 0.0001 and p = 0.03 respectively). Conclusions Although vaccine-induced antibody response in the elderly Polish population was more effective against A/H3N2/and B Victoria, this introductory study supports the use of QIV. Prior season vaccination was associated with lower antibody response to the current vaccination; this was not consistent to vaccine strains. Further research to better investigate QIV effectiveness determinants in the elderly would be of value. Key messages Subunit inactivated quadrivalent influenza vaccine (QIV) is effective in elderly people and should be used. The response to vaccination is not consistent and depends on the strain of influenza virus.

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