| アブストラクト | OBJECTIVES: We aimed to estimate the real-world effectiveness of the influenza vaccine against myocardial infarction (MI) and influenza in the decade since adults aged >/= 65 years were first recommended the vaccine. STUDY DESIGN AND SETTING: We identified annual cohorts, 1997 to 2011, of adults aged >/= 65 years, without previous influenza vaccination, from UK general practices, registered with the Clinical Practice Research Datalink. Using a quasi-experimental study design to control for confounding bias, we estimated influenza vaccine effectiveness on hospitalization for MI, influenza, and antibiotic prescriptions for lower respiratory tract infections. RESULTS: Vaccination was moderately effective against influenza, the prior event rate ratio-adjusted hazard ratios ranging from 0.70 in 1999 to 0.99 in 2001. Prior event rate ratio-adjusted hazard ratios demonstrated a protective effect against MIs, varying between 0.40 in 2010 and 0.89 in 2001. Aggregated across the cohorts, influenza vaccination reduced the risk of MIs by 39% (95% confidence interval: 34%, 44%). CONCLUSION: Effectiveness of the flu vaccine in preventing MIs in older UK adults is consistent with the limited evidence from clinical trials. Similar trends in effectiveness against influenza and against MIs suggest the risk of influenza mediates the effectiveness against MIs, although divergence in some years implies the mechanism may be complex. |
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| 投稿者 | Streeter, Adam J; Rodgers, Lauren R; Hamilton, Fergus; Masoli, Jane A H; Ble, Alessandro; Hamilton, William T; Henley, William E |
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| 組織名 | Institute for Epidemiology and Social Medicine, University of Munster, Munster,;North Rhine-Westphalia, Germany; Medical Statistics, Faculty of Health,;University of Plymouth, Plymouth Science Park, Derriford, Plymouth, UK; Health;Statistics Group, University of Exeter Medical School, University of Exeter,;South Cloisters, St. Luke's Campus, Exeter, UK. Electronic address:;streeter@exchange.wwu.de.;Health Statistics Group, University of Exeter Medical School, University of;Exeter, South Cloisters, St. Luke's Campus, Exeter, UK.;MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2PS, UK.;College of Medicine and Health, University of Exeter Medical School, St. Luke's;Campus, Exeter, UK; Healthcare for Older People, Royal Devon and Exeter NHS;Foundation Trust, Exeter, UK.;Campus, Exeter, UK. |
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