Comparative effectiveness of high dose versus adjuvanted influenza vaccine: A retrospective cohort study

Robertus van Aalst*, Stefan Gravenstein, Vincent Mor, Salaheddin M Mahmud, Jan Wilschut, Maarten Postma, Ayman Chit

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
224 Downloads (Pure)

Abstract

Background: Adults 65 years and older (seniors) experience more complications following influenza infection than younger adults. We estimated the relative vaccine effectiveness (rVE) of a trivalent high dose (HD-IIV3) versus an adjuvanted trivalent influenza vaccine (aIIV3) in seniors for respiratory-related hospitalizations. Methods: We conducted a retrospective cohort study using claims data from Optum's Clinformatics® Data Mart to compare outcome rates between seniors who received HD-IIV3 versus aIIV3 during the 2016/17 and 2017/18, predominantly A/H3N2 respiratory seasons. Rates were adjusted for demographic characteristics, comorbid conditions, previous influenza vaccination, and geography. We used the previous event rate ratio (PERR) approach to address bias by time-fixed unmeasured confounders. Results: We identified 842,282 HD-IIV3 and 34,157 aIIV3 recipients for the 2016/17 season and 1,058,638 HD-IIV3 and 189,636 aIIV3 recipients for the 2017/18 season. The pooled rVE of HD-IIV3 versus aIIV3 for respiratory-related hospitalizations over both seasons was 12% (95% confidence interval: 3.3%–20%); 13% (−6.4% to 32%) for the 2016/17 season and 12% (2.1%–21%) for the 2017/18 season. Conclusions: Pooled over two predominantly A/H3N2 respiratory seasons, HD-IIV3 was associated with fewer respiratory hospital admissions than aIIV3 in senior members of large national managed health care company in the U.S.

Original languageEnglish
Pages (from-to)372-379
Number of pages8
JournalVaccine
Volume38
Issue number2
Early online date9-Oct-2019
DOIs
Publication statusPublished - 10-Jan-2020

Keywords

  • HD-IIV3
  • aIIV3
  • High-dose
  • Adjuvanted
  • Influenza vaccine
  • Comparative effectiveness
  • Relative vaccine effectiveness
  • rVE
  • Previous event rate ratio
  • PERR
  • Unmeasured confounding factors
  • Residual confounding
  • EVENT RATE RATIO
  • RESPIRATORY SYNCYTIAL VIRUS
  • OLDER-ADULTS
  • UNITED-STATES
  • ADJUSTMENT
  • HOSPITALIZATIONS
  • MORTALITY
  • EFFICACY
  • DEATHS

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