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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1997 Oct;51(5):526–530. doi: 10.1136/jech.51.5.526

Reduction in hospital admissions for pneumonia in non-institutionalised elderly people as a result of influenza vaccination: a case-control study in Spain.

J Puig-Barberà 1, S Márquez-Calderón 1, A Masoliver-Fores 1, F Lloria-Paes 1, A Ortega-Dicha 1, M Gil-Martín 1, M J Calero-Martínez 1
PMCID: PMC1060539  PMID: 9425463

Abstract

OBJECTIVE: To estimate the effectiveness of influenza vaccine in preventing hospital admission for pneumonia in non-institutionalised elderly people. DESIGN: This was a case-control study. SETTING: All three public hospitals in the Castellón area of Spain. PARTICIPANTS: Cases were people aged 65 or more not living in an institution who were admitted to hospital for pneumonia between November 15, 1994 and March 31, 1995. Each case was matched with two sex matched control subjects aged 65 years or older admitted to hospital in the same week for acute abdominal surgical conditions or trauma. The sampling of incident cases was consecutive. Eighty three cases and 166 controls were identified and included in the study. MEASUREMENTS: Trained interviewers completed a questionnaire for each subject on the vaccination status, smoking habits, previous diseases, health care use, social contacts, family background, the vaccination status of the family carer, home characteristics, and socioeconomic status. RESULTS: The adjusted odds ratio of the influenza vaccination preventing admission to hospital for pneumonia was 0.21 (95% confidence interval 0.09, 0.55). The variables which best explained the risk of being a case were age, intensity of social contacts, health care use, previous diseases, and the existence of a vaccinated family carer. CONCLUSIONS: Influenza vaccination reduced significantly hospital admissions for pneumonia in non-institutionalised elderly people.

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Selected References

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  1. Barker W. H. Excess pneumonia and influenza associated hospitalization during influenza epidemics in the United States, 1970-78. Am J Public Health. 1986 Jul;76(7):761–765. doi: 10.2105/ajph.76.7.761. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Benavides F. G., Bolumar F., Gómez M. L., Cortes M., Nájera E. Estudio epidemiológico descriptivo de la mortalidad por enfermedades del aparato respiratorio. España 1900-1978. II. Enfermedades respiratorias transmisibles. Rev Sanid Hig Publica (Madr) 1984 May-Jun;58(5-6):437–462. [PubMed] [Google Scholar]
  3. Black R. A., Rota P. A., Gorodkova N., Klenk H. D., Kendal A. P. Antibody response to the M2 protein of influenza A virus expressed in insect cells. J Gen Virol. 1993 Jan;74(Pt 1):143–146. doi: 10.1099/0022-1317-74-1-143. [DOI] [PubMed] [Google Scholar]
  4. Connolly A. M., Salmon R. L., Lervy B., Williams D. H. What are the complications of influenza and can they be prevented? Experience from the 1989 epidemic of H3N2 influenza A in general practice. BMJ. 1993 May 29;306(6890):1452–1454. doi: 10.1136/bmj.306.6890.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fedson D. S. Influenza and pneumococcal vaccination of the elderly: newer vaccines and prospects for clinical benefits at the margin. Prev Med. 1994 Sep;23(5):751–755. doi: 10.1006/pmed.1994.1129. [DOI] [PubMed] [Google Scholar]
  6. Fedson D. S., Wajda A., Nicol J. P., Hammond G. W., Kaiser D. L., Roos L. L. Clinical effectiveness of influenza vaccination in Manitoba. JAMA. 1993 Oct 27;270(16):1956–1961. [PubMed] [Google Scholar]
  7. Fiebach N., Beckett W. Prevention of respiratory infections in adults. Influenza and pneumococcal vaccines. Arch Intern Med. 1994 Nov 28;154(22):2545–2557. [PubMed] [Google Scholar]
  8. Foster D. A., Talsma A., Furumoto-Dawson A., Ohmit S. E., Margulies J. R., Arden N. H., Monto A. S. Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. Am J Epidemiol. 1992 Aug 1;136(3):296–307. doi: 10.1093/oxfordjournals.aje.a116495. [DOI] [PubMed] [Google Scholar]
  9. Frame P. S. Is routine influenza immunization indicated for people over 65 years of age? An opposing view. J Fam Pract. 1988 Feb;26(2):215–217. [PubMed] [Google Scholar]
  10. Ghendon Y. Influenza--its impact and control. World Health Stat Q. 1992;45(2-3):306–311. [PubMed] [Google Scholar]
  11. Govaert T. M., Thijs C. T., Masurel N., Sprenger M. J., Dinant G. J., Knottnerus J. A. The efficacy of influenza vaccination in elderly individuals. A randomized double-blind placebo-controlled trial. JAMA. 1994 Dec 7;272(21):1661–1665. [PubMed] [Google Scholar]
  12. Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989 Mar;79(3):340–349. doi: 10.2105/ajph.79.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Gross P. A., Hermogenes A. W., Sacks H. S., Lau J., Levandowski R. A. The efficacy of influenza vaccine in elderly persons. A meta-analysis and review of the literature. Ann Intern Med. 1995 Oct 1;123(7):518–527. doi: 10.7326/0003-4819-123-7-199510010-00008. [DOI] [PubMed] [Google Scholar]
  14. Lui K. J., Kendal A. P. Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985. Am J Public Health. 1987 Jun;77(6):712–716. doi: 10.2105/ajph.77.6.712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McBean A. M., Babish J. D., Warren J. L. The impact and cost of influenza in the elderly. Arch Intern Med. 1993 Sep 27;153(18):2105–2111. [PubMed] [Google Scholar]
  16. Miettinen O. S. Proportion of disease caused or prevented by a given exposure, trait or intervention. Am J Epidemiol. 1974 May;99(5):325–332. doi: 10.1093/oxfordjournals.aje.a121617. [DOI] [PubMed] [Google Scholar]
  17. Miettinen O. S. The "case-control" study: valid selection of subjects. J Chronic Dis. 1985;38(7):543–548. doi: 10.1016/0021-9681(85)90039-6. [DOI] [PubMed] [Google Scholar]
  18. Nichol K. L., Margolis K. L., Wuorenma J., Von Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med. 1994 Sep 22;331(12):778–784. doi: 10.1056/NEJM199409223311206. [DOI] [PubMed] [Google Scholar]
  19. Orenstein W. A., Bernier R. H., Hinman A. R. Assessing vaccine efficacy in the field. Further observations. Epidemiol Rev. 1988;10:212–241. doi: 10.1093/oxfordjournals.epirev.a036023. [DOI] [PubMed] [Google Scholar]
  20. Patriarca P. A. A randomized controlled trial of influenza vaccine in the elderly. Scientific scrutiny and ethical responsibility. JAMA. 1994 Dec 7;272(21):1700–1701. [PubMed] [Google Scholar]
  21. Pearce N. What does the odds ratio estimate in a case-control study? Int J Epidemiol. 1993 Dec;22(6):1189–1192. doi: 10.1093/ije/22.6.1189. [DOI] [PubMed] [Google Scholar]
  22. Puig Barberà J., Márquez Calderón S. Efectividad de la vacunación antigripal en los ancianos. Una revisión crítica de la bibliografía. Med Clin (Barc) 1995 Nov 18;105(17):645–648. [PubMed] [Google Scholar]
  23. Rodrigues L., Kirkwood B. R. Case-control designs in the study of common diseases: updates on the demise of the rare disease assumption and the choice of sampling scheme for controls. Int J Epidemiol. 1990 Mar;19(1):205–213. doi: 10.1093/ije/19.1.205. [DOI] [PubMed] [Google Scholar]
  24. Salleras L., Vidal J., Bruguera M., Gené J., Navas E., Batalla J., Bayas J. M., Esteban R. Vacunaciones del adulto. Med Clin (Barc) 1994;102 (Suppl 1):42–55. [PubMed] [Google Scholar]
  25. Thompson M. P. Is routine influenza immunization indicated for people over 65 years of age? An affirmative view. J Fam Pract. 1988 Feb;26(2):211–214. [PubMed] [Google Scholar]
  26. Wacholder S., McLaughlin J. K., Silverman D. T., Mandel J. S. Selection of controls in case-control studies. I. Principles. Am J Epidemiol. 1992 May 1;135(9):1019–1028. doi: 10.1093/oxfordjournals.aje.a116396. [DOI] [PubMed] [Google Scholar]
  27. Wacholder S., Silverman D. T., McLaughlin J. K., Mandel J. S. Selection of controls in case-control studies. II. Types of controls. Am J Epidemiol. 1992 May 1;135(9):1029–1041. doi: 10.1093/oxfordjournals.aje.a116397. [DOI] [PubMed] [Google Scholar]
  28. Williams W. W., Hickson M. A., Kane M. A., Kendal A. P., Spika J. S., Hinman A. R. Immunization policies and vaccine coverage among adults. The risk for missed opportunities. Ann Intern Med. 1988 Apr;108(4):616–625. doi: 10.7326/0003-4819-108-4-616. [DOI] [PubMed] [Google Scholar]

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