Abstract
The burden of influenza is disproportionally higher among older adults. We evaluated the relative vaccine effectiveness (rVE) of adjuvanted trivalent (aIIV3) compared to high-dose trivalent influenza vaccine (HD-IIV3e) against influenza and cardio-respiratory disease (CRD)-related hospitalizations/ER visits among adults ≥65 years during the 2019–2020 influenza season. Economic outcomes were also compared. A retrospective cohort analysis was conducted using prescription, professional fee claims, and hospital data. Inverse probability of treatment weighting (IPTW) was used to adjust for confounding. IPTW-adjusted Poisson regression was used to evaluate the adjusted rVE of aIIV3 versus HD-IIV3e. All-cause and influenza-related healthcare resource utilization (HCRU) and costs were examined post-IPTW. Recycled predictions from generalized linear models were used to estimate adjusted costs. Adjusted analysis showed that aIIV3 (n = 798,987) was similarly effective compared to HD-IIV3e (n = 1,655,979) in preventing influenza-related hospitalizations/ER visits (rVE 3.1%; 95% CI: −2.8%; 8.6%), hospitalizations due to any cause (−0.7%; 95% CI: −1.6%; 0.3%), and any CRD-related hospitalization/ER visit (0.9%; 95% CI: 0.01%; 1.7%). Adjusted HCRU and annualized costs were also statistically insignificant between the two cohorts. The adjusted clinical and economic outcomes evaluated in this study were comparable between aIIV3 and HD-IIV3e during the 2019–2020 influenza season.
Highlights
Introduction conditions of the Creative CommonsOlder adults are at higher risk of infection with seasonal influenza and subsequent complications compared to younger adults [1,2]
This study used a retrospective observational cohort design. It was conducted among patients aged ≥65 years vaccinated with aIIV3 or HD-IIV3e during the 2019–2020 influenza season in the United States (US) using de-identified data from IQVIA’s New Data Warehouse: Professional Fee Claims (Dx), Prescription Claims (Rx), and Hospital Charge Data Master (CDM) databases
A few baseline characteristics were imbalanced with SMD ≥0.1 prior to Inverse probability of treatment weighting (IPTW)
Summary
Older adults (aged ≥ 65 years) are at higher risk of infection with seasonal influenza and subsequent complications compared to younger adults [1,2]. Immunosenescence and reduced vaccine effectiveness, with the risk of death nearly doubled in those aged ≥75 years compared with those aged 65–74 years [1,3]. AIIV3 and HD-IIV3e present opportunities to reduce influenza and related burden among older adults compared to standard influenza vaccines [1,6]. Effectiveness and immunogenicity of enhanced vaccines compared to standard dose vaccines have been demonstrated by several studies [1,6,7,8,9]. Details of the two enhanced vaccines are described in another study by the authors [10]
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