Additive preventive effect of influenza and pneumococcal vaccines in the elderly

Figures & data

Table 1. Baseline characteristics of the cohort during the vaccination campaign, from 04-10-01 to 2004-12-31 (n = 68,897).

(%)	ALL	BOTH	IV	PV	NONE	p-value
Total	100.0	30.9	27.1	5.5	36.5	< 0.0001
Gender						< 0.0001
Men	39.8	33.6	25.9	5.8	34.7
Women	60.2	29.1	27.8	5.3	37.8
Presence at least one ALD30						< 0.0001
Yes	43.7	36.8	27.4	6.3	29.5
No	56.3	26.4	26.8	4.8	42.0
Age-group (years)						< 0.0001
65–69	25.1	26.3	23.6	5.2	44.9
70–74	26.6	30.7	26.2	5.2	37.9
75–80	25.3	33.6	28.2	5.6	32.6
> 80	23.0	33.2	30.6	5.9	30.3

ALD30, 30 long-lasting affections (e.g., chronic organ failure, diabetes, immunodepression); ALL, all groups together; BOTH, Influenza and Pneumococcal vaccine; IV, influenza vaccine alone; NONE, unvaccinated; PV, pneumococcal vaccine alone.

Table 2. All cause-mortality rate per 1,000 PY [95% CI] according to vaccine groups between 2005-01-01 and 2005-12-31 (n = 68,897).

	BOTH	IV	PV	NONE
Deaths	702	638	150	771
Mortality Rate (a)	17.9 [16.3–19.6] (b)	20.8 [19.0–22.8] (b)	22.5 [19.0–26.6] (c)	24.7 [22.7–26.8]
Gender
Women	346	358	84	426
	14.4 [13.0–15.9]	16.7 [15.1–18.5]	18.1 [15.2–21.5]	19.8 [18.1–21.7]
Men	356	280	66	345
	22.3 [20.2–24.6]	26.0 [23.4–28.4]	28.1 [23.6–33.4]	30.8 [28.0–33.8]
ALD30
Yes	632	544	131	633
	42.1 [38.8–45.8]	49.0 [45.0–53.5]	53.0 [45.0–62.4]	58.1 [53.7–62.9]
No	70	94	19	138
	7.6 [6.7–8.7]	8.8 [7.8–10.1]	9.6 [7.9–11.6]	10.5 [9.3–11.8]
Age-group
65–70 y	61	42	16	93
	9.3 [7.9–10.8]	10.8 [9.2–12.6]	11.7 [9.5–14.4]	12.8 [11.1–14.8]
70–74 y	107	78	16	123
	12.4 [10.9–14.2]	14.4 [12.6–16.5]	15.6 [12.8–18.9]	17.1 [15.1–19.4]
75–80 y	147	137	34	171
	18.4 [16.3–20.6]	21.4 [19.0–24.0]	23.1 [19.2–27.7]	25.3 [22.6–28.3]
> 80 y	387	381	84	384
	48.6 [44.1–53.6]	56.4 [51.2–62.4]	61.1 [51.4–72.6]	67.0 [61.0–73.6]

ALD30, 30 long-lasting affections (e.g., chronic organ failure, diabetes, immunodepression); BOTH, Influenza and Pneumococcal vaccines group; IV, influenza vaccine alone; NONE, unvaccinated; PV, pneumococcal vaccine alone; PY, (inhabitants) per year; (a) mortality rate per 1,000 PY, adjusted on gender, existing of ALD30 and age [95% CI]; (b) p < 0.05, compared with the group of unvaccinated subjects; (c) p > 0.05, compared with the group of unvaccinated subjects; n, number of deaths; CI, 95% confidence interval

Table 3. Risk* of all-cause mortality according to vaccine groups between 2005-01-01 and 2005-12-31.

Risk	Hazard Ratio	p-value	Mortality decrease
	[95% CI]		[95% CI]
Vaccination
No vaccination	1
Pneumococcal vaccination	0.91 [0.77–1.08]	0.30	9.0 [-8.0–23.0]
Influenza vaccination	0.84 [0.76–0.94]	0.001	16.0 [6.0–24.0]
Influenza + Pneumococcal vaccination	0.73 [0.66–0.80]	< 0.001	27.0 [20.0–34.0]
Existing of chronic diseases
Healthy elderly persons	1
Chronic disease (ALD 30)	5.52 [4.90–6.23]	< 0.001
Gender
Female	1
Male vs. female	1.55 [1.43–1.69]	< 0.001
Age (in years)
70–74	1.34 [1.12–1.59]	< 0.001
75–79	1.98 [1.68–2.32]	< 0.001
≥ 80	5.20 [4.49–6.04]	< 0.001

Note: Multivariate Cox regression analysis in all patients adjusted for all variables listed in the table. ALD30, 30 long-lasting affections; CI, confidence interval. *Adjusted on gender, existing of chronic diseases and age.

Figure 1. Antibiotic use one year before and one after vaccination campaign per vaccine groups (from 2003-10-01 to 2005-12-31).