Effectiveness of influenza vaccination in working-age adults with diabetes: a population-based cohort study.
Identifieur interne : 000384 ( Main/Exploration ); précédent : 000383; suivant : 000385Effectiveness of influenza vaccination in working-age adults with diabetes: a population-based cohort study.
Auteurs : Darren Lau [Canada] ; Dean T. Eurich ; Sumit R. Majumdar ; Alan Katz ; Jeffrey A. JohnsonSource :
- Thorax [ 1468-3296 ] ; 2013.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Diabète (épidémiologie), Facteurs temps (MeSH), Femelle (MeSH), Grippe humaine (complications), Grippe humaine (prévention et contrôle), Grippe humaine (épidémiologie), Humains (MeSH), Jeune adulte (MeSH), Manitoba (épidémiologie), Morbidité (tendances), Mâle (MeSH), Pronostic (MeSH), Sujet âgé (MeSH), Surveillance de la population (méthodes), Taux de survie (tendances), Vaccination (méthodes), Vaccins antigrippaux (administration et posologie), Études de suivi (MeSH), Études rétrospectives (MeSH).
- MESH :
- administration et posologie : Vaccins antigrippaux.
- méthodes : Surveillance de la population, Vaccination.
- prévention et contrôle : Grippe humaine.
- tendances : Morbidité, Taux de survie.
- épidémiologie : Diabète, Grippe humaine, Manitoba.
- Adolescent, Adulte, Adulte d'âge moyen, Facteurs temps, Femelle, Humains, Jeune adulte, Mâle, Pronostic, Sujet âgé, Études de suivi, Études rétrospectives.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Diabetes Mellitus (epidemiology), Female (MeSH), Follow-Up Studies (MeSH), Humans (MeSH), Influenza Vaccines (administration & dosage), Influenza, Human (complications), Influenza, Human (epidemiology), Influenza, Human (prevention & control), Male (MeSH), Manitoba (epidemiology), Middle Aged (MeSH), Morbidity (trends), Population Surveillance (methods), Prognosis (MeSH), Retrospective Studies (MeSH), Survival Rate (trends), Time Factors (MeSH), Vaccination (methods), Young Adult (MeSH).
- MESH :
- chemical , administration & dosage : Influenza Vaccines.
- geographic , epidemiology : Manitoba.
- complications : Influenza, Human.
- epidemiology : Diabetes Mellitus, Influenza, Human.
- methods : Population Surveillance, Vaccination.
- prevention & control : Influenza, Human.
- trends : Morbidity, Survival Rate.
- Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Time Factors, Young Adult.
Abstract
BACKGROUND
Guidelines recommend influenza vaccinations in all diabetic adults, but there is limited evidence to support vaccinating working-age adults (<65 years) with diabetes. We examined the effectiveness of influenza vaccine in this subgroup, compared with elderly adults (≥ 65 years) for whom vaccination recommendations are well accepted.
METHODS
We identified all adults with diabetes, along with a sample of age-matched and sex-matched comparison subjects without diabetes, from 2000 to 2008, using administrative data from Manitoba, Canada. With multivariable Poisson regression, we estimated vaccine effectiveness (VE) on influenza-like illnesses (ILIs), pneumonia and influenza (PI) hospitalisations and all-cause (ALL) hospitalisations during periods of known circulating influenza. Analyses were replicated outside of influenza season to rule out residual confounding.
RESULTS
We included 543 367 person-years of follow-up, during which 223 920 ILI, 5422 PI and 94 988 ALL occurred. The majority (58%) of adults with diabetes were working age. In this group, influenza vaccination was associated with relative reductions in PI (43%, 95% CI 28% to 54%) and ALL (28%, 95% CI 24% to 32%) but not ILI (-1%, 95% CI -3% to 1%). VE was similar in elderly adults for ALL (33-34%) and PI (45-55%), although not ILI (12-13%). However, similar estimates of effectiveness were also observed for all three groups during non-influenza control periods.
CONCLUSIONS
Working-age adults with diabetes experience similar benefits from vaccination as elderly adults, supporting current diabetes-specific recommendations. However, these benefits were also manifest outside of influenza season, suggesting residual bias. Vaccination recommendations in all high-risk adults would benefit from randomised trial evidence.
DOI: 10.1136/thoraxjnl-2012-203109
PubMed: 23535212
PubMed Central: PMC3711373
Affiliations:
Links toward previous steps (curation, corpus...)
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Eurich</name></author><author><name sortKey="Majumdar, Sumit R" sort="Majumdar, Sumit R" uniqKey="Majumdar S" first="Sumit R" last="Majumdar">Sumit R. Majumdar</name></author><author><name sortKey="Katz, Alan" sort="Katz, Alan" uniqKey="Katz A" first="Alan" last="Katz">Alan Katz</name></author><author><name sortKey="Johnson, Jeffrey A" sort="Johnson, Jeffrey A" uniqKey="Johnson J" first="Jeffrey A" last="Johnson">Jeffrey A. Johnson</name></author></analytic><series><title level="j">Thorax</title><idno type="eISSN">1468-3296</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Diabetes Mellitus (epidemiology)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Humans (MeSH)</term><term>Influenza Vaccines (administration & dosage)</term><term>Influenza, Human (complications)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (prevention & control)</term><term>Male (MeSH)</term><term>Manitoba (epidemiology)</term><term>Middle Aged (MeSH)</term><term>Morbidity (trends)</term><term>Population Surveillance (methods)</term><term>Prognosis (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Survival Rate (trends)</term><term>Time Factors (MeSH)</term><term>Vaccination (methods)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Diabète (épidémiologie)</term><term>Facteurs temps (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (complications)</term><term>Grippe humaine (prévention et contrôle)</term><term>Grippe humaine (épidémiologie)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Manitoba (épidémiologie)</term><term>Morbidité (tendances)</term><term>Mâle (MeSH)</term><term>Pronostic (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Surveillance de la population (méthodes)</term><term>Taux de survie (tendances)</term><term>Vaccination (méthodes)</term><term>Vaccins antigrippaux (administration et posologie)</term><term>Études de suivi (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Manitoba</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Diabetes Mellitus</term><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Population Surveillance</term><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Surveillance de la population</term><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Morbidité</term><term>Taux de survie</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Morbidity</term><term>Survival Rate</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Diabète</term><term>Grippe humaine</term><term>Manitoba</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prognosis</term><term>Retrospective Studies</term><term>Time Factors</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Pronostic</term><term>Sujet âgé</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Guidelines recommend influenza vaccinations in all diabetic adults, but there is limited evidence to support vaccinating working-age adults (<65 years) with diabetes. We examined the effectiveness of influenza vaccine in this subgroup, compared with elderly adults (≥ 65 years) for whom vaccination recommendations are well accepted.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We identified all adults with diabetes, along with a sample of age-matched and sex-matched comparison subjects without diabetes, from 2000 to 2008, using administrative data from Manitoba, Canada. With multivariable Poisson regression, we estimated vaccine effectiveness (VE) on influenza-like illnesses (ILIs), pneumonia and influenza (PI) hospitalisations and all-cause (ALL) hospitalisations during periods of known circulating influenza. Analyses were replicated outside of influenza season to rule out residual confounding.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We included 543 367 person-years of follow-up, during which 223 920 ILI, 5422 PI and 94 988 ALL occurred. The majority (58%) of adults with diabetes were working age. In this group, influenza vaccination was associated with relative reductions in PI (43%, 95% CI 28% to 54%) and ALL (28%, 95% CI 24% to 32%) but not ILI (-1%, 95% CI -3% to 1%). VE was similar in elderly adults for ALL (33-34%) and PI (45-55%), although not ILI (12-13%). However, similar estimates of effectiveness were also observed for all three groups during non-influenza control periods.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Working-age adults with diabetes experience similar benefits from vaccination as elderly adults, supporting current diabetes-specific recommendations. However, these benefits were also manifest outside of influenza season, suggesting residual bias. Vaccination recommendations in all high-risk adults would benefit from randomised trial evidence.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23535212</PMID><DateCompleted><Year>2013</Year><Month>09</Month><Day>03</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-3296</ISSN><JournalIssue CitedMedium="Internet"><Volume>68</Volume><Issue>7</Issue><PubDate><Year>2013</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Thorax</Title><ISOAbbreviation>Thorax</ISOAbbreviation></Journal><ArticleTitle>Effectiveness of influenza vaccination in working-age adults with diabetes: a population-based cohort study.</ArticleTitle><Pagination><MedlinePgn>658-63</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/thoraxjnl-2012-203109</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Guidelines recommend influenza vaccinations in all diabetic adults, but there is limited evidence to support vaccinating working-age adults (<65 years) with diabetes. We examined the effectiveness of influenza vaccine in this subgroup, compared with elderly adults (≥ 65 years) for whom vaccination recommendations are well accepted.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We identified all adults with diabetes, along with a sample of age-matched and sex-matched comparison subjects without diabetes, from 2000 to 2008, using administrative data from Manitoba, Canada. With multivariable Poisson regression, we estimated vaccine effectiveness (VE) on influenza-like illnesses (ILIs), pneumonia and influenza (PI) hospitalisations and all-cause (ALL) hospitalisations during periods of known circulating influenza. Analyses were replicated outside of influenza season to rule out residual confounding.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We included 543 367 person-years of follow-up, during which 223 920 ILI, 5422 PI and 94 988 ALL occurred. The majority (58%) of adults with diabetes were working age. In this group, influenza vaccination was associated with relative reductions in PI (43%, 95% CI 28% to 54%) and ALL (28%, 95% CI 24% to 32%) but not ILI (-1%, 95% CI -3% to 1%). VE was similar in elderly adults for ALL (33-34%) and PI (45-55%), although not ILI (12-13%). However, similar estimates of effectiveness were also observed for all three groups during non-influenza control periods.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Working-age adults with diabetes experience similar benefits from vaccination as elderly adults, supporting current diabetes-specific recommendations. However, these benefits were also manifest outside of influenza season, suggesting residual bias. Vaccination recommendations in all high-risk adults would benefit from randomised trial evidence.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lau</LastName><ForeName>Darren</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Public Health Sciences, University of Alberta, Edmonton, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eurich</LastName><ForeName>Dean T</ForeName><Initials>DT</Initials></Author><Author ValidYN="Y"><LastName>Majumdar</LastName><ForeName>Sumit R</ForeName><Initials>SR</Initials></Author><Author ValidYN="Y"><LastName>Katz</LastName><ForeName>Alan</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Johnson</LastName><ForeName>Jeffrey A</ForeName><Initials>JA</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Canadian Institutes of Health Research</Agency><Country>Canada</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>03</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Thorax</MedlineTA><NlmUniqueID>0417353</NlmUniqueID><ISSNLinking>0040-6376</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003920" MajorTopicYN="N">Diabetes Mellitus</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008350" MajorTopicYN="N" Type="Geographic">Manitoba</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009017" MajorTopicYN="N">Morbidity</DescriptorName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011159" MajorTopicYN="N">Population Surveillance</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName><QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Clinical Epidemiology</Keyword><Keyword MajorTopicYN="N">Viral infection</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>3</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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Eurich</name><name sortKey="Johnson, Jeffrey A" sort="Johnson, Jeffrey A" uniqKey="Johnson J" first="Jeffrey A" last="Johnson">Jeffrey A. Johnson</name><name sortKey="Katz, Alan" sort="Katz, Alan" uniqKey="Katz A" first="Alan" last="Katz">Alan Katz</name><name sortKey="Majumdar, Sumit R" sort="Majumdar, Sumit R" uniqKey="Majumdar S" first="Sumit R" last="Majumdar">Sumit R. Majumdar</name></noCountry><country name="Canada"><region name="Alberta"><name sortKey="Lau, Darren" sort="Lau, Darren" uniqKey="Lau D" first="Darren" last="Lau">Darren Lau</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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