Abstract 11881: Association of Post-Vaccination Adverse Reactions After Influenza Vaccine With Mortality and Cardiopulmonary Outcomes in Patients With High-Risk Cardiovascular Disease: The INVESTED Trial

Abstract

Introduction: Influenza vaccination is associated with reduced cardiopulmonary morbidity and mortality among patients with heart failure or recent myocardial infarction. The immune response to vaccination frequently results in mild adverse reactions (AR), which leads to vaccine hesitancy. We assessed the association between vaccine-related AR and morbidity and mortality in patients with high-risk cardiovascular disease. Methods: The INVESTED trial randomized 5260 patients with recent acute myocardial infarction or heart failure hospitalization to high-dose trivalent or standard-dose quadrivalent inactivated influenza vaccine. We examined the association between vaccine-related AR and adverse clinical outcomes in propensity-adjusted models. Results: Overall, 1968 participants (37.4%) experienced a vaccine-related AR. Compared to those without AR, post-vaccination AR, most commonly injection site pain (60.3%), were associated with lower adjusted risk for the composite of all-cause death or cardiopulmonary hospitalization, cardiopulmonary hospitalizations, all-cause death, cardiovascular hospitalizations and non-cardiopulmonary hospitalizations (Figure 1; Table 1). Conclusions: Post-vaccination reactions after influenza vaccine were associated with reduced risk of cardiopulmonary hospitalizations and all-cause mortality in patients with high-risk cardiovascular disease in propensity adjusted models, and may be a marker of a better immune response or overall health status, and should not deter future vaccinations.