Journal Article

Influence of High-Risk Medical Conditions on the Effectiveness of Influenza Vaccination among Elderly Members of 3 Large Managed-Care Organizations

Eelko Hak, James Nordin, Feifei Wei, John Mullooly, Sung Poblete, Raymond Strikas and Kristin L Nichol

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 4, pages 370-377
Published in print August 2002 | ISSN: 1058-4838
Published online August 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/341403
Influence of High-Risk Medical Conditions on the Effectiveness of Influenza Vaccination among Elderly Members of 3 Large Managed-Care Organizations

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This serial cohort study assessed the risk of hospitalization or death associated with influenza and the effectiveness of influenza vaccination among subgroups of elderly members of 3 managed-care organizations in the United States. Data on baseline characteristics and outcomes were obtained from computerized databases. A total of 122,974 (1996–1997 season) and 158,454 (1997–1998 season) persons were included in the cohorts. Among unvaccinated persons, hospitalizations for pneumonia/influenza or death occurred in 8.2 of 1000 healthy and 38.4 of 1000 high-risk persons in year 1, and in 8.2 of 1000 healthy and 29.3 of 1000 high-risk persons in year 2. After adjustments, vaccination was associated with a 48% reduction in the incidence of hospitalization or death (95% confidence interval [CI], 42–52) in year 1 and 31% (95% CI, 26–37) in year 2. Effectiveness estimates were statistically significant and generally consistent across the healthy and high-risk subgroups. The absolute risk reduction, however, was 2.4- to 4.7-fold higher among high-risk than among healthy elderly persons. All elderly individuals may substantially benefit from vaccination. However, the impact of influenza is greater in persons with high-risk medical conditions

Journal Article.  4659 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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