Role Of Influenza Vaccination Research Articles

A recent experience on the role of influenza vaccination on cardiovascular events.

The purpose of this review is to update the recent information regarding the role of influenza vaccination (IV) as a strategy to reduce cardiovascular (CV) events. During the last 2 years, new meta-analysis, guidelines, and two randomized controlled trials (RCTs) were published. The IAMI trial added information regarding the safety and efficacy of IV right after an acute myocardial infarction hospitalization. A significant reduction in the primary endpoint-including mortality-was observed. More recently, the influenza vaccine to prevent vascular events trial (IVVE) trial did not meet the primary CV endpoint in patients with heart failure (HF). However, a significant reduction was observed during the seasonal peaks of Influenza circulation. COVID-19 pandemic provoked recruitment difficulties in these trials, as well as an altered influenza seasonality and incidence. Further analysis of IVVE trial is needed to clarify the precise role of IV in patients with HF. A recent meta-analysis of RCTs and observational studies indicated that IV was safe and effective to reduce CV events, and it was included in the most updated guideline. Despite these benefits, and the recommendations for its prescription by scientific societies and health regulatory agencies, the vaccination rate remains below than expected globally. The correct understanding of implementation barriers, which involve doctors, patients, and their context, is essential when continuous improvement strategies are planned, in order to improve the IV rate in at-risk subjects.

The role of influenza vaccination in the COVID-19 infection: Impact on incidence and severity in Iraq

The role of influenza vaccination in the COVID-19 infection: Impact on incidence and severity in Iraq

Perception, knowledge and attitude towards influenza vaccine during COVID-19 pandemic in Jordanian population.

IntroductionSeasonal influenza is considered as one of the major causes of morbidity and mortality worldwide. This needs solutions to decrease burdens on the healthcare systems especially during the Coronavirus Disease (COVID-19) pandemic. Population knowledge, perception and attitude towards influenza vaccine during COVID-19 pandemic could have a positive impact to decrease mortality, morbidity and burdens on the healthcare system. This study focuses on investigating knowledge, attitude and practice (KAP) of Jordanian adults towards influenza vaccine during COVID-19 pandemic.MethodsThis cross-sectional study recruited 1112 randomly selected Jordanian adults. A four-part questionnaire was designed and included questions about the demographic and clinical characteristics, perception about influenza, attitudes towards the role of influenza vaccine during COVID-19 pandemic and the factors that affect respondents’ practice towards influenza vaccine.Results73.1% population were not vaccinated, and most were not willing to be vaccinated during the COVID-19 pandemic. 55% of the population thought that influenza vaccine decreased the burden on the Jordanian healthcare system. The major refusal factor to be vaccinated was because influenza was not considered as a threat (41.3%). People mostly got their information about influenza vaccine from social media (64.3%). The role of the pharmacist and physician was neglected.ConclusionsThe reinforcement of the role of pharmacists, physician and media to educate people about the importance of influenza vaccine during the COVID-19 pandemic is needed. Furthermore, campaigns should be conducted to increase the population awareness towards the importance of influenza vaccine uptake and its importance.

1238Estimating the non-specific effects of seasonal influenza vaccine on RSV-hospitalisations in children

Abstract Background Seasonal influenza vaccine is effective against influenza hospitalisations, but little is known about non-specific effects on other respiratory pathogens with similar seasonal patterns. We aimed to assess the causal impact of seasonal influenza vaccine on laboratory-confirmed hospitalisations for respiratory syncytial virus (RSV) in children using an instrumental variable (IV) strategy. Methods We used population-based probabilistically linked data on births, childhood immunisations, deaths, hospitalisations, perinatal and statewide microbiology data (2000-2013) in Western Australia (WA). Our analysis cohort included children up to age 7 years. We exploited WA’s unique preschool influenza vaccination policy commencing in 2008 and used this as an instrument for vaccination status. We estimated a system of two simultaneous probit equations: determinants of influenza vaccine uptake, and determinants of RSV-confirmed hospitalisation. Results Influenza vaccine coverage was low prior to 2008 but increased to 33.7% in children aged 6-23 months in 2009. RSV-hospitalisations ranged from 3.5/1000 children (12-23 months) to 6.4/1000 (6-12 months). Receipt of seasonal influenza vaccine reduced RSV-hospitalisations in the population cohort of children aged <2 years by an average of 0.21% in the same year (p < 0.001). Conclusions To our knowledge, this is the first analysis utilising an IV estimation strategy to assess the impact of influenza vaccine on RSV-hospitalisations. We estimated a small, but highly statistically significant impact that warrants further investigation using contemporary data. Key messages RSV is a leading cause of childhood morbidity. The role of influenza vaccine offering cross protection to RSV could be further explored prior to RSV vaccines being commercially available.

Personal and vaccination history as factors associated with SARS-CoV-2 infection

Background and objectiveSARS-CoV-2 has been and is a major global Public Health challenge. Since the beginning of the pandemic, different comorbidities have been postulated and associated with spectra of increased severity and mortality. The objectives of this research are: 1) to analyse the factors associated with SARS-CoV-2 infection (COVID-19) in a health area in northern Spain; 2) to understand the possible role of influenza vaccination and pneumococcal vaccination in the development of COVID-19. Materials and methodA test-negative case-control study was conducted. Variables related to personal and vaccination history were considered. Although the epidemiological definition of the case varied over time, the reference definition was that corresponding to 31/01/2020 in Spain. A bivariate and multivariate analysis was performed. ResultsThe sample included 188 patients, of which 63 were cases and 125 controls. The results show that obesity increases the risk 2.4-fold of suffering this infection (IC 95% 1,301–4,521) and ARA-2 increases it 2.2-fold (95% CI 1,256–6,982). On the other hand, anti-pneumococcal vaccination of 13 serotypes showed results close to statistical significance (OR = 0.4; 95% CI 0.170–1,006). ConclusionObesity and the use of ARA-2 increases the risk of COVID-19. Scientific knowledge about factors associated with COVID-19 should be expanded. The authors consider that the present research raises the need further investigate the role of vaccines in this infection and their possible heterologous properties.

The Collaboration for Increasing Influenza Vaccination in Children (CIIVIC): a meeting report

The Collaboration for Increasing Influenza Vaccination in Children (CIIVIC): a meeting report

Antecedentes personales y vacunales como factores asociados a la infección por SARS-CoV-2

Background and objectiveSARS-CoV-2 has been and is a major global Public Health challenge. Since the beginning of the pandemic, different comorbidities have been postulated and associated with spectra of increased severity and mortality. The objectives of this research are: 1) to analyse the factors associated with SARS-CoV-2 infection (COVID-19) in a health area in northern Spain; 2) to understand the possible role of influenza vaccination and pneumococcal vaccination in the development of COVID-19. Materials and methodA test-negative case-control study was conducted. Variables related to personal and vaccination history were considered. Although the epidemiological definition of the case varied over time, the reference definition was that corresponding to 31/01/2020 in Spain. A bivariate and multivariate analysis was performed. ResultsThe sample included 188 patients, of which 63 were cases and 125 controls. The results show that obesity increases the risk 2.4-fold of suffering this infection (IC 95% 1,301-4,521) and ARA-2 increases it 2.2-fold (95% CI 1,256-6,982). On the other hand, anti-pneumococcal vaccination of 13 serotypes showed results close to statistical significance (OR = 0.4; 95% CI 0.170-1,006). ConclusionObesity and the use of ARA-2 increases the risk of COVID-19. Scientific knowledge about factors associated with COVID-19 should be expanded. The authors consider that the present research raises the need further investigate the role of vaccines in this infection and their possible heterologous properties.

The role of influenza vaccination in mitigating the adverse impact of ambient air pollution on lung function in children: New insights from the Seven Northeastern Cities Study in China

BackgroundAmbient air pollution exposure and influenza virus infection have been documented to be independently associated with reduced lung function previously. Influenza vaccination plays an important role in protecting against influenza-induced severe diseases. However, no study to date has focused on whether influenza vaccination may modify the associations between ambient air pollution exposure and lung function. MethodsWe undertook a cross-sectional study of 6740 children aged 7–14 years into Seven Northeast Cities (SNEC) Study in China during 2012–2013. We collected information from parents/guardians about sociodemographic factors and influenza vaccination status in the past three years. Lung function was measured using portable electronic spirometers. Machine learning methods were used to predict 4-year average ambient air pollutant exposures to nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter <1 μm (PM1), <2.5 μm (PM2.5) and <10 μm (PM10). Two-level linear and logistic regression models were used to assess interactions between influenza vaccination and long-term ambient air pollutants exposure on lung function reduction, controlling for potential confounding factors. ResultsAmbient air pollution were observed significantly associated with reductions in lung function among children. We found significant interactions between influenza vaccination and air pollutants on lung function, suggesting greater vulnerability to air pollution among unvaccinated children. For example, an interaction (pinteraction = 0.002) indicated a −283.44 mL (95% CI: −327.04, −239.83) reduction in forced vital capacity (FVC) per interquartile range (IQR) increase in PM1 concentrations among unvaccinated children, compared with the −108.24 mL (95%CI: −174.88, −41.60) reduction in FVC observed among vaccinated children. Results from logistic regression models also showed stronger associations between per IQR increase in PM1 and lung function reduction measured by FVC and peak expiratory flow (PEF) among unvaccinated children than the according ORs among vaccinated children [i.e., Odds Ratio (OR) for PM1 and impaired FVC: 2.33 (95%CI: 1.79, 3.03) vs 1.65 (95%CI: 1.20, 2.28); OR for PM2.5 and impaired PEF: 1.45 (95%CI: 1.12,1.87) vs 1.04 (95%CI: 0.76,1.43)]. The heterogeneity of the modification by influenza vaccination of the associations between air pollution exposure and lung function reduction appeared to be more substantial in girls than in boys. ConclusionOur results suggest that influenza vaccination may moderate the detrimental effects of ambient air pollution on lung function among children. This study provides new insights into the possible co-benefits of strengthening and promoting global influenza vaccination programs among children.

Influenza vaccination in preventing outbreaks in schools: A long-term ecological overview

Influenza vaccination is the most effective way to reduce the incidence of influenza infections. However, the role of influenza vaccination, such as school-based influenza vaccination, in preventing the influenza outbreaks in schools remains unclear now. In this study, a total of 286 school febrile outbreaks involving 6863 cases in the Beijing area from September 1, 2006 to March 31, 2017 were analyzed. We also tested 294 circulating strains isolated in Beijing during the same period and compared with that of vaccine strains identified every influenza season. The virological match/mismatch between vaccine strains and circulating strains, and the coverage of vaccination in schools were analyzed against outbreaks during the 11 years. It showed that over 80% school febrile outbreaks were caused by influenza A/B virus, the most frequent being A(H3N2) virus (53.25%), followed by A(H1N1)pdm09 virus (25.11%) and B virus (21.64%). More importantly, low vaccine coverage (in 2006-2007 influenza season) and vaccine mismatch (in 2014-2015 and 2015-2016 influenza season) were associated with an increased number of influenza school outbreaks. High vaccination coverage with a matched vaccine can significantly reduce influenza outbreaks in schools (OR: 0.111, p < .001). We have shown the effectiveness of school-based influenza vaccination in preventing outbreaks using trivalent inactivated influenza vaccine in schools. Thus the school-based vaccine policy should be paid more attention in China and other countries worldwide.

Relationship between pharmacist density and adult influenza vaccination after controlling for individual and neighborhood effects

ObjectivesSince 2009, all 50 states have passed legislation to allow pharmacists to administer influenza vaccinations. Pharmacies have become the second most common place for influenza vaccination, after a doctor’s office. The aim of this study was to provide nationally representative results on the relationship between pharmacist density and influenza vaccination after controlling for both individual- and county-level characteristics. DesignRetrospective data analysis with the use of merged individual data from the 2008-2012 Behavioral Risk Factor Surveillance System (BRFSS) and county data from the 2010 Area Health Resources Files. Sample-weighted multivariate logistic models were estimated to predict influenza vaccinations with the use of number of pharmacists per 1000 population as the key predictor. Setting and participantsBRFSS is a telephone-based national survey across 50 states. A nationally representative sample of 1,696,119 adults 18 years of age and older were included in this analysis. ResultsThe number of pharmacists per 1000 population was associated with higher odds of influenza vaccination (adjusted odds ratio [AOR] 1.13, 95% confidence interval [CI] 1.11-1.15) and was significant for non-Hispanic whites (AOR 1.06, 95% CI 1.04-1.08) and Hispanics (AOR 1.35, 95% CI 1.24-1.48). It varied across county types and employment status. The largest effects were found in urban counties (AOR 1.16, 95% CI 1.11-1.21) and among the self-employed (AOR 1.18, 95% CI 1.10-1.26), homemakers (AOR 1.18, 95% CI 1.10-1.26), and the retired (AOR 1.18, 95% CI, 1.14-1.22). ConclusionPharmacists play an important role in influenza vaccination and are an important alternative to traditional settings such as doctors’ offices and health clinics. Future research is needed to investigate reasons and barriers behind their different effects in different regions and population groups. By covering in-pharmacy vaccinations in health plans and removing other barriers, pharmacists can help to alleviate the shortage of other health care providers and help increase vaccination rates.

Change in settings for early-season influenza vaccination among US adults, 2012 to 2013.

Vaccination in non-medical settings is recommended as a strategy to increase access to seasonal influenza vaccine. To evaluate change in early-season influenza vaccination setting, we analyzed data from the National Internet Flu Survey. Bivariate comparison of respondent characteristics by location of vaccination was assessed using chi-square tests. Multinomial logistic regression was performed to compare the predicted probability of being vaccinated in medical, retail, and mobile settings in 2012 vs 2013. In both 2012 and 2013, vaccination in medical settings was more likely among elderly adults, those with chronic conditions, and adults with a high school education or less. Adults 18–64 without a chronic condition had a lower probability of vaccination in the medical setting, and higher probability of vaccination in a retail or mobile setting, in 2013 compared to 2012. Adults 18–64 with a chronic condition had no change in their location of flu vaccination. Elderly adults had a lower probability of vaccination in the medical setting, and higher probability of vaccination in a retail setting, in 2013 compared to 2012. Non-medical settings continue to play an increasing role in influenza vaccination of adults, particularly for adults without a chronic condition and elderly adults. Retail and mobile settings should continue to be viewed as important mechanisms to ensure broad access to influenza vaccination.

A study of an influenza A (H1N1)pdm09 outbreak in pregnant women in Rajasthan, India.

To describe the clinical and epidemiological factors of influenza A (H1N1)pdm09-infected patients who were pregnant or in the puerperal period during a recent influenza outbreak in Rajasthan, India. A retrospective, observational study was performed using hospital records of individuals with confirmed influenza A (H1N1)pdm09 infection admitted to a large tertiary care center in Rajasthan, India, between January 1 and March 15, 2015. The study cohort included 44 patients who were pregnant or in the puerperal period. The mean age was significantly lower in the study cohort than in other female patients treated for influenza A (H1N1)pdm09 infection at the hospital during the study period (25.45±3.45years vs 40.46±13.99 years; P<0.001). Mortality was significantly higher in the study cohort than in the comparison female patients (36% vs 17%; P=0.003). Factors found to be associated with mortality were delayed initiation of oseltamivir, poor oxygen saturation at admission, and more than 50% lung involvement under radiographic examination. None of the patients in the study cohort had received a vaccination against seasonal influenza. Influenza A (H1N1)pdm09 infection during pregnancy causes more severe illness. Early recognition and timely administration of antiviral therapy can improve outcomes. The role of influenza vaccination in this high-risk population cannot be overemphasized.

Virus etiology of SARI cases and protective role of influenza vaccination determined in sentinel surveillance system

Virus etiology of SARI cases and protective role of influenza vaccination determined in sentinel surveillance system

Relationship between local family physician supply and influenza vaccination after controlling for individual and neighborhood effects

Family physicians (FPs) play an important role in influenza vaccination. We investigated how local FP supply is associated with influenza vaccination, controlling for both individual-level and county-level characteristics. The 2008-2010 individual-level data from the Behavioral Risk Factor Surveillance System were merged with county-level data from the Area Resource File (n = 985,157). Multivariate logistic analyses were performed to predict influenza vaccination using the number of FPs per 1000 population as the key predictor, adjusting for individual-level demographic, socioeconomic, and health information, as well as county-level racial composition and income level. Additional analyses were performed across racial/ethnic and employment status categories. Increasing local FP supply was associated with higher odds (adjusted odds ratio [aOR], 1.58; 95% confidence interval [CI], 1.49-1.67) and varied across racial/ethnic groups (Hispanic: aOR, 2.05, 95% CI, 1.55-2.72; non-Hispanic white: aOR, 1.57, 95% CI, 1.48-1.66; non-Hispanic black: aOR, 1.49, 95% CI, 1.18-1.89), employment status categories, and county types. FP supply was significantly associated with influenza vaccination. The association was greatest among those who were Hispanic, residing in a rural area, or out of work. Our findings lend support to initiatives aimed at increasing the FP supply, particularly among disadvantaged populations.

Chicken anemia virus infection in broiler chickens vaccinated and not vaccinated for avian influenza in Iran

SUMMARY To study the role of influenza vaccination in inducing chicken anemia infection in broiler chickens in Iran, 25 flocks vaccinated for avian influenza (AI) and 25 nonvaccinated flocks were randomly selected. In this study, we attempted to select flocks with similar mortality and growing conditions. At the end of the rearing period, 15 thymus samples were taken, and after DNA extraction, a 713-bp viral protein 2 (VP2) gene of the chicken anemia virus (CAV) was amplified by specific primers. In addition, 20 batches belonging to 10 different commercial chicken vaccines were examined for evidence of CAV contamination. A total of 105 out of 375 chickens were vaccinated for AI (28%) and 135 out of 375 nonvaccinated chickens (36%) were infected with CAV. The frequency of CAV infection in the 750 studied chickens was 32% at slaughter age. The CAV VP2 gene was not detected in any commercial chicken vaccines. On the basis of statistical analyses, there were no significant correlations between vaccination for AI and CAV infection. Furthermore, comparison of the infection rate for CAV in AI-vaccinated and nonvaccinated chickens revealed no significant differences between these 2 groups. Vaccination against AI seems to play no role in increasing or reducing the prevalence of CAV.

The Role of Health System Pharmacy in Improving Influenza Vaccination Rates among Health Care Workers

The Director's Forum series is written and edited by Robert J. Weber and Scott M. Mark and is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. During the autumn months, health care professions and the media will advocate for immunizing all patients to prevent the occurrence and spread of influenza. A potential source of influenza in hospitalized patients is health care workers (HCWs) who have not been vaccinated. Pharmacists have long served as vaccine immunizers, advocates, and educators and may play an active role in improving vaccination rates among HCWs. Pharmacy directors should consider their department's role in influenza vaccination by becoming active partners in influenza prevention. By actively participating in making vaccines available in a variety of ways to HCWs, pharmacy directors can maximize the benefits of a hospital's employee vaccination program.

Faktoren, die mit Angaben zum Impfschutz gegen Influenza assoziiert sind – eine Querschnittuntersuchung bei älteren hausärztlichen Patienten

General practitioners (GPs) play an important role in influenza vaccination. However, reliable data on the influenza immunisation coverage rate in primary care patients are quite rare. Due to a lack of personal and time resources general practitioners cannot afford to collect such data by themselves. Hence fifth-year students have been involved in the scientific data collection during their practical placement in 118 GP practices. Using logistic regression analysis of a representative sample (n = 541) plausible factors associated with the influenza immunisation coverage rate have been identified. These factors were found to be both patient- and practice-specific. This practice-oriented study was conducted to improve the available data base on the influenza immunisation coverage rate among elderly patients in primary care settings.

Abstract 524: Influenza Vaccination Reduces The Risk Of Venous Thromboembolism

It is widely accepted that influenza vaccination reduces the risk of cardiovascular events in patients with coronary artery diseases. However, no information is available concerning the role of influenza vaccination in venous thromboembolism (VTE). Methods: A case-control study was conducted in 727 cases and 727 age and sex-matched controls from 11 centers in France (the FARIVE study). Cases were patients with a first documented episode of VTE and without any personal history of cancer within the last 5 years; controls were recruited in the same hospital and had no personal history of venous or arterial thrombosis. Results: Overall, 202 (28.2%) of cases and 233 (32.1%) of controls had influenza vaccination during the previous 12 months at the time of recruitment. Information was not available for only 12 subjects out of 1454. The crude odds ratio (OR) for VTE associated with influenza vaccination was 0.76 (95% CI 0.58–0.99). After adjustment for potential confounding variables (age, sex, inclusion date, BMI, educational levels and varicose veins), the OR for VTE associated with vaccination was 0.74 (95% CI 0.57–0.97). The protective effect of vaccination toward VTE was higher in the population below 52 years (median of age), with an OR of 0.52 (95% CI 0.32–0.85). In women below the age of 51, the crude OR for VTE associated with influenza vaccination was 0.50 (95% CI 0.24–1.05) and was significant after adjustment for confounding variables including oral contraceptives, with an OR of 0.41 (95% CI 0.19–0.92). The protective effect of vaccination was similar for different types of VTE (DVT or PE). There was no statistical differences in the protective effects when we compared provoked with unprovoked VTE events. Conclusion: This is the first study that demonstrates a protective effect of influenza vaccination in VTE. In vitro influenza induces activation of coagulation and inflammation but we cannot rule out that the protective effect of influenza vaccination was due to other unknown mechanisms, as the protective effect was similar within the different seasons of the year. Influenza vaccination may reduce the risk of VTE by 26%. This relationship between influenza vaccination and VTE and its underlying mechanism still need to be analyzed and confirmed in further studies.

Influenza Vaccination of Patients With Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA)

The role of influenza vaccination in patients suffering from autoimmune diseases, including systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), has long been a subject of discussion. The risk of exacerbation of the main disease following vaccination is of particular concern, and needs to be carefully evaluated against the risk of disease flares as a result of infections. Our study included 69 SLE patients and 54 RA patients, all in stable condition. We split the groups into two subgroups each: patients in SLE1 (23 patients) and RA1 (23 patients) received the flu vaccine (“Vaxigrip”, Aventis Pasteur) in November 2003. Patients in SLE2 (46 patients) and RA2 (31 patients) were not vaccinated. Throughout the following year, we studied parameters of disease activity and the occurrence of viral respiratory and bacterial infections in our patients. The vaccine was well tolerated in all cases. Vaccinated patients had significantly fewer occurrences of infections. Every viral and bacterial infection resulted in the worsening of the main disease. We believe that influenza vaccine is indicated for SLE and RA patients in stable condition. However, this decision must be made on a patient-by-patient basis. We plan to continue our study with the goal of formulating a better protocole for the clinical practice.

The Role of Influenza Vaccine in Healthcare Workers in the Era of Severe Acute Respiratory Syndrome

The new coronavirus responsible for severe acute respiratory syndrome (SARS) found its first victims in healthcare workers with attack rates of more than 50% before infection control measures were instituted; and this led to the near collapse of healthcare systems in some of the affected countries. In Singapore, healthcare workers accounted for 40% of the total number of SARS patients.