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Feb 08, 2025;13 (2):

Effect of Current-Season-Only Versus Continuous Two-Season Influenza Vaccination on Mortality in Older Adults: A Propensity-Score-Matched Retrospective Cohort Study.

Huimin Sun, Yijing Wang, Yongyue Wei, Weihua Hu, Junwen Zhou, Nuosu Nama, Yujie Ma, Gang Liu, Yuantao Hao
Author Information
  1. Huimin Sun: Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China. ORCID
  2. Yijing Wang: Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.
  3. Yongyue Wei: Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China. ORCID
  4. Weihua Hu: Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China.
  5. Junwen Zhou: Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China.
  6. Nuosu Nama: Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China.
  7. Yujie Ma: Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China.
  8. Gang Liu: Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.
  9. Yuantao Hao: Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing 100191, China.
PMID: 40006711 DOI: 10.3390/vaccines13020164

Abstract

BACKGROUND/OBJECTIVES: This study evaluated the impact of influenza vaccination on mortality using real-world data and compared the effect of current-season-only vaccination versus continuous two-season vaccination.
METHODS: The 2017-2019 data from the Center for Disease Control and Prevention of Shenzhen, Guangdong, China, included 880,119 individuals aged ���65 years. The participants were divided into vaccinated and unvaccinated groups and matched using propensity scores with a 1:4 nearest-neighbor approach. Vaccinated individuals were further divided into current-season-only and continuous two-season vaccination groups, matched 1:1. Cox's multivariable proportional hazards regression models were used to assess the effect of vaccination on all-cause mortality, with Firth's penalized likelihood method applied to correct for a few events. The Fine-Gray competing risk models were used to assess the effect of vaccination on cardio-cerebral vascular disease (CCVD) mortality. Sensitivity analyses, including caliper matching, a nested case-control design, and Poisson's regression, were performed to test the robustness of the results.
RESULTS: Influenza vaccination reduced all-cause mortality by 39% (HR = 0.61, 95% CI: 0.47-0.80) and 55% (HR = 0.45, 95% CI: 0.33-0.60) in 2017-2018 and 2018-2019, respectively. Current-season-only vaccination showed stronger protective effects than continuous two-season vaccination (HR = 0.56, 95% CI: 0.31-0.99). Influenza vaccination reduced CCVD mortality by 46% (HR = 0.54, 95% CI: 0.34-0.84) in 2018-2019. The results were consistent across the sensitivity analyses.
CONCLUSIONS: Influenza vaccination was associated with a reduced risk of all-cause and CCVD mortality in older adults, underscoring the importance of routine influenza vaccination in older populations. Stronger effects were observed for current-season-only vaccination, warranting further research to confirm the association and explore mechanisms.

Keywords

cardio-cerebral vascular diseases influenza vaccination mortality older adults survival analysis

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Grants

  1. 82204162, 81973150/National Natural Science Foundation of China
  2. SZSM202311001/Sanming Project of Medicine in Shenzhen
Journal Article

Word Cloud

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