I1. Adult Vaccines
Oral Abstract Submission
Lauren Beacham, MA
Statistician
Centers for Disease Control and Prevention
Atlanta, GA
Disclosure: Nothing to disclose
Carmen S. Arriola, DVM, PhD
Epidemiologist
Centers for Disease Control and Prevention
Atlanta, GA
Disclosure: Nothing to disclose
Art Reingold, MD
Professor and Division Head, Epidemiology
University of California, Berkeley
Berkeley, CA
Disclosure: Nothing to disclose
Nisha B. Alden, MPH
Respiratory and Invasive Bacterial Disease Program Manager
Colorado Department of Public Health and Environment
Denver, Colorado
Disclosure: CDC: Grant/Research Support
Kim Yousey-Hindes, MPH, CPH
Epidemiologist 3
Connecticut Emerging Infections Program
New Haven, Connecticut
Disclosure: Nothing to disclose
Evan J. Anderson, MD
Infectious Diseases Physician
Emory University, Atlanta VA Medical Center
Atlanta, Georgia
Disclosure: AbbVie: Consultant
MedImmune: Scientific Research Study Investigator
Merck: Scientific Research Study Investigator
Micron Biomedical: Scientific Research Study Investigator
Novavax: Grant/Research Support
PaxVax: Scientific Research Study Investigator
Pfizer: Grant/Research Support, Advisor or Review Panel member
Regeneron: Scientific Research Study Investigator
Sanofi Pasteur: Scientific Research Study Investigator
Maya Monroe, MPH
Epidemiologist
Maryland Department of Health and Mental Hygiene
Baltimore, Maryland
Disclosure: Nothing to disclose
Sue Kim, MPH
Epidemiologist
Michigan Department of Health and Human Services
Lansing, Michigan
Disclosure: Nothing to disclose
Ruth Lynfield, MD
State Epidemiologist
Minnesota Department of Health
St. Paul, Minnesota
Disclosure: Nothing to disclose
Lourdes Irizarry, MD
Infectious Diseases Physician
New Mexico Department of Health
Santa Fe, NM
Disclosure: Nothing to disclose
Alison Muse, MPH
Epidemiologist
New York State Department of Health
Albany, New York
Disclosure: Nothing to disclose
Nancy M. Bennett, MD
Professor of Medicine and Public Health Sciences
University of Rochester School of Medicine and Dentistry
Rochester, NY
Disclosure: Nothing to disclose
Laurie M. Billing, MPH
Epidemiologist
Ohio Department of Health
Columbus, Ohio
Disclosure: Nothing to disclose
Ann Thomas, MD, MPH
Public Health Physician
Oregon Public Health Division
Portland, Oregon
Disclosure: Nothing to disclose
Keipp Talbot, MD, MPH
Infectious Diseases Physician
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Sanofi Pasteur: Grant/Research Support
Sequirus: Advisor or Review Panel member
Keegan McCaffrey, BA
Epidemiologist
Utah Department of Health
Salt Lake City, UT
Disclosure: Nothing to disclose
Alicia M. Fry, MD, MPH
Medical Epidemiologist
Centers for Disease Control and Prevention
Atlanta, Georgia
Disclosure: Nothing to disclose
Background :
Influenza vaccination may reduce illness severity among those with influenza; however, data are limited. We determined whether outcomes were less severe among vaccinated compared to unvaccinated adults hospitalized with influenza over 5 seasons.
Methods : We included adults (≥18 years) hospitalized with laboratory-confirmed influenza during seasons 2013-14 through 2017-18 and identified through the U.S. Influenza Hospitalization Surveillance Network (FluSurv-NET). Vaccination status was obtained through medical records, vaccine registries and interviews. We excluded patients who were institutionalized, did not receive antivirals, or had unknown vaccine status or vaccine receipt <14 days before positive influenza test. We used inverse propensity score weighting to balance differences between vaccinated and unvaccinated groups and multivariable logistic and competing risk regression to evaluate the association between vaccination and outcomes including pneumonia, intensive care unit (ICU) admission, mechanical ventilation (MV), death, and ICU and hospital length of stay (LOS) in days. Models were adjusted for season and admission timing in relation to timing of antiviral treatment, symptom onset and season peak.
Results : Among 67,452 adults hospitalized with influenza, 43,608 were included; 47% were 18-64 years (38% vaccinated) and 53% were ≥65 years (65% vaccinated). Among patients with influenza A(H1N1)pdm09, vaccination was associated with decreased odds of ICU admission (odds ratio (OR) 0.81; OR 0.72) and MV (OR 0.66; OR 0.54) in adults 18-64 and ≥65 years, respectively; decreased odds of pneumonia (OR 0.83), death (OR 0.64) and shortened ICU LOS (relative hazard (RH) 0.82) in adults 18-64 years; and shortened hospital LOS (RH 0.91) in adults ≥65 years (Figure). Vaccination was not associated with attenuation of severe outcomes in patients with influenza A(H3N2) and B.
Conclusion : Vaccination was associated with reduced odds of severe outcomes, including death, by up to 36% in adults hospitalized with influenza A(H1N1)pdm09. All adults without contraindications should receive annual influenza vaccination as there is evidence that it can improve outcomes among those who develop influenza despite vaccination.
