Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy.

Salvatore Mannino, Marco Villa, Giovanni Apolone, Noel S. Weiss, Nicola Groth, Ivana Aquino, Liana Boldori, Fausta Caramaschi, Antonio Gattinoni, Giancarlo Malchiodi, Kenneth J. Rothman

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Abstract

Although vaccination against influenza is recommended for elderly and high-risk patients in many countries, efficacy in the elderly has been suboptimal. The MF59 adjuvanted trivalent inactivated vaccine (ATIV) was developed to increase the immune response of elderly subjects to influenza vaccination, but its effectiveness has not yet been well documented. This prospective, observational study evaluated the relative effectiveness of ATIV versus nonadjuvanted trivalent inactivated vaccine (TIV) in individuals at least 65 years of age in Lombardy, northern Italy. Hospitalizations for influenza or pneumonia (International Classification of Diseases, Ninth Revision, Clinical Modification, codes 480-487) during the 2006-2007, 2007-2008, and 2008-2009 influenza seasons were identified from administrative databases. Stratified and regression analyses, including the propensity score to adjust for confounding, as well as generalized estimating equations to account for repeated vaccination, were used. Overall, 107,661 records were evaluated, contributing 170,988 person-seasons of observation. Since ATIV is preferentially recommended for more frail individuals, subjects vaccinated with ATIV were older and had more functional impairment and comorbidities. In the primary analysis, risk of hospitalization for influenza or pneumonia was 25% lower for ATIV relative to TIV (relative risk = 0.75, 95% confidence interval: 0.57, 0.98). To the extent that there is residual bias, ATIV is likely to be even more protective than this result suggests.

Original languageEnglish
Pages (from-to)527-533
Number of pages7
JournalAmerican Journal of Epidemiology
Volume176
Issue number6
Publication statusPublished - Sep 15 2012

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Inactivated Vaccines
Human Influenza
Italy
Vaccination
Pneumonia
Hospitalization
Propensity Score
International Classification of Diseases
Observational Studies
Comorbidity
Regression Analysis
Observation
Databases
Prospective Studies
Confidence Intervals

ASJC Scopus subject areas

  • Epidemiology

Cite this

Mannino, S., Villa, M., Apolone, G., Weiss, N. S., Groth, N., Aquino, I., ... Rothman, K. J. (2012). Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. American Journal of Epidemiology, 176(6), 527-533.

Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. / Mannino, Salvatore; Villa, Marco; Apolone, Giovanni; Weiss, Noel S.; Groth, Nicola; Aquino, Ivana; Boldori, Liana; Caramaschi, Fausta; Gattinoni, Antonio; Malchiodi, Giancarlo; Rothman, Kenneth J.

In: American Journal of Epidemiology, Vol. 176, No. 6, 15.09.2012, p. 527-533.

Research output: Contribution to journalArticle

Mannino, S, Villa, M, Apolone, G, Weiss, NS, Groth, N, Aquino, I, Boldori, L, Caramaschi, F, Gattinoni, A, Malchiodi, G & Rothman, KJ 2012, 'Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy.', American Journal of Epidemiology, vol. 176, no. 6, pp. 527-533.
Mannino, Salvatore ; Villa, Marco ; Apolone, Giovanni ; Weiss, Noel S. ; Groth, Nicola ; Aquino, Ivana ; Boldori, Liana ; Caramaschi, Fausta ; Gattinoni, Antonio ; Malchiodi, Giancarlo ; Rothman, Kenneth J. / Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. In: American Journal of Epidemiology. 2012 ; Vol. 176, No. 6. pp. 527-533.
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