The association of previous influenza vaccination and coronavirus disease-2019

Figures & data

Figure 1. Study flow chart. A) by results of SARS-CoV-2 testing, B) population-based

Table 1. Demographic variables and their association with SARS-CoV-2 results

Demographic variable	Total tested	SARS-CoV-2 positive	SARS-CoV-2 negative	p-valuea
All cohort tested, number (%)	22,563 (100%)	1,824 (8.08%)	20,739 (91.92%)	-
Age, years (mean±SD0	39.2 ± 22.5	33.4 ± 20.4	39.8 ± 22.6	<0.001
Age category N (%)
0–5 years	995 (4.41%)	71 (7.14%)	924 (92.86%)	<0.001
>5–20 years	3,178 (14.08%)	481 (15.14%)	2,697 (84.86%)
>20–40 years	8,501 (37.67%)	620 (7.30%)	7,881 (92.70%)
>40–60 years	5,401 (23.93%)	416 (7.70%)	4,985 (92.30%)
>60–80 years	2,994 (13.26%)	202 (6.74%)	2,792 (93.26%)
80+ years	1,494 (6.62%)	34 (2.27%)	1,460 (97.73%)
≥65 years	3,347 (14.83%)	151 (4.51%)	3,196 (95.49%)	<0.001
Residential socioeconomic status
Low	12,235 (54.23%)	1,341(73.52%)	10,894(52.53%)	<0.001
Middle	7,308 (32.39%)	296(16.23%)	7,012(33.81%)
High	1,308 (5.80%)	68(3.73%)	1,240 (5.98%)
Missing data	1,712 (7.59%)	119 (6.52%)	1,593 (7.68%)
Gender, N (%)
Male	11,635 (51.57%)	975 (8.37%)	10,660 (91.62%)	0.093
Ethnic group
Secular Jews	7,725 (34.24%)	329 (4.26%)	7,396 (95.74%)	<0.001
Orthodox Jews	5,530 (24.51%)	1,136 (20.54%)	4,394 (79.46%)
Arabs	4,997 (22.15%	116 (2.32%)	4,881 (97.68%)
Missing data	4,311 (19.10%)	243 (5.63%)	4,068 (94.36%)

^aThe p-values relate to the various strata of each category (age, SES, gender, etc).

Table 2. Underlying medical conditions and their association with SARS-CoV-2 results

Variable N (%)	Total tested	SARS-CoV-2 positive	SARS-CoV-2 negative	P-value
Smoking	3,359 (14.88%)	90 (2.67%)	3,269 (97.33%)	<0.001
Depression/anxiety	1,917 (8.5%)	114 (5.94%)	1,803 (94.05%)	<0.001
Schizophrenia	505 (2.24%)	30 (5.94%)	475 (94.06%)	0.074
Dementia	1,066 (4.72%)	35 (3.28%)	1,031 (96.72%)	<0.001
Chronic lung disease	2,298 (10.18%)	131 (5.70%)	2,167 (94.3%)	0.005
Diabetes mellitus	3,389 (15.02%)	207 (6.1%)	3,182 (93.9%)	0.023
Hypertension	4,363 (19.33%)	230 (5.27%)	4,133 (94.73%)	<0.001
Ischemic heart disease	2,139 (94.80%)	84 (3.93%)	2,055 (96.07%)	<0.001
Cerebrovascular disease	550 (2.43%)	18 (3.27%)	532 (96.73%)	<0.001
Chronic heart failure	593 (2.62%)	20 (3.37%)	573 (96.63%)	<0.001
Obesity	4,708 (20.86%)	366 (7.77%)	4,342 (92.22%)	0.667

Table 3. Crude odds ratio of previous influenza vaccination status and SARS-CoV-2 results (sensitivity analysis)

Previous vaccination status	Total tested	SARS-CoV-2 positive	SARS-CoV-2 negative	Crude OR (95% CI) for positivity	P-value
All cohort	22,563 (100%)	1,824 (8.08%)	20,739 (91.92%)	-	-
Not vaccinated	16,779 (74.36%)	1,511 (9.00%)	15,268 (91.00%)	1 (reference)	-
Vaccinated only in 2018–19	1,073(4.75%)	69(6.43%)	1,004 (93.57%)	0.69(0.54–0.89)	0.004
Vaccinated only in 2019–20	2,310 (10.23%)	139(6.01%)	2,171(93.99%)	0.65 (0.54–0.77)	<0.001
Vaccinated in 2019–20 and 2018–19	2,401 (10.64%)	105(4.37%)	2,296(95.63%)	0.47 (0.38–0.57)	<0.001

Table 4. Multivariate analysis of the variables associated with SARS-CoV-2 positivity

Variable	Crude OR (95% CI)	P value	Multivariate analysis OR (95% CI)	P value	VIF*
Vaccinated in 2019–20 and 2018–19	0.47 (0.38–0.57)	0.001	0.76 (0.61–0.97)	0.004
Vaccinated in 2019–20	0.65 (0.54–0.77)	0.001	0.79 (0.67–0.98)	0.005	1.01
Vaccinated in 2018–19	0.69 (0.54–0.89)	0.004	0.82 (0.68–0.99)	0.048	1.03
Age	0.97 (0.96–0.98)	0.001	0.99 (0.99–0.99)	0.007	1.08
Orthodox Jews	2.63 (2.32–2.94)	0.001	1.52 (1.29–1.79)	<0.001	1.03
Low socioeconomic status	2.79 (2.48–3.14)	0.001	2.57(2.26–2.89)	<0.001	1.73
Smoking	1.16 (1.11–1.23)	0.001	1.09 (1.02–1.17)	0.012	1.56
Depression/anxiety	0.70 (0.58–0.85)	0.001	0.90 (0.72–1.13)	0.381	1.91
Dementia	0.37 (0.27–0.53)	0.001	0.81 (0.54–1.22)	0.332	1.73
Hypertension	0.58 (0.50–0.67)	0.001	0.85 (0.69–1.04)	0.119	1.69
Ischemic heart disease	0.44 (0.35–0.55)	0.001	0.63 (0.48–0.82)	<0.001	1.85
Cerebrovascular disease	0.38 (0.24–0.61)	0.001	0.75 (0.45–1.25)	0.280	1.07
Chronic heart failure	0.39 (0.25–0.61)	0.001	0.72 (0.43–1.22)	0.231	2.47
Diabetes mellitus	0.71 (0.61–0.82)	0.023	1.21 (0.99–1.48)	0.485	2.67
Chronic lung disease	0.66 (0.55–0.79)	0.005	0.78 (0.62–0.95)	0.024	2.21

*VIF when all covariates are in the model

Table 5. Prevalence of population-based SARS-CoV-2 positivity by previous influenza vaccination status

Previous influenza vaccination status	Total	SARS-CoV-2 positive	Risk ratio (95%CI)	P value
Total insured population	715,164	1,824 (0.26%)	-	-
Not vaccinated	571,836 (79.96%)	1,511 (0.26%)	1 (reference)	-
Vaccinated only in 2018–19	26,130 (3.65%)	69 (0.26%)	1.002 (0.99–1.00)	0.062
Vaccinated only in 2019–20	57,716 (8.07%)	139 (0.24%)	0.91 (0.85–0.98)	0.023
Vaccinated in 2019–20 and 2018–19	59,482 (8.32%)	105 (0.18%)	0.67 (0.56–0.79)	<0.001