Influenza vaccination for older adults

Figures & data

Figure 1. Comparison of the test characteristics of each diagnostic method used for older adult patients hospitalized with symptoms of respiratory illness or nonlocalizing fever during the 2006–2007 and 2007–2008 influenza seasons. Error bars represent confidence intervals. Hospital rapid, hospital rapid antigen test; ILI, diagnostic use of the clinical definition of influenza-like illness; Research rapid, research rapid antigen test. Copyright © (2010) by The Society for Healthcare Epidemiology of America. Reprinted with permission; Talbot et al.²³

Figure 2. Propensity score–adjusted vaccine effectiveness [(1 – Odds Ratio)*100%] overall and stratified by year for hospitalization, age, sex, race, and smoking status in adults aged >50 y, Davidson County, Tennessee Overall VE is adjusted for age in years, sex, race, smoking status, home oxygen use, underlying medical conditions, immunosuppression, timing of admission relative to onset of influenza season, and specific influenza season (2006–2007, 2007–2008, or 2008–2009). Copyright © (2011). Published by Oxford University Press on behalf of the Infectious Diseases Society of America. Reprinted with permission; Talbot et al.²³

Figure 3. GMT ratios to H1N1, H3N2, and B strains in all study participants “All (n = 71),” nonfrail (n = 22), prefrail (n = 32), and frail (n = 17) groups. p Values were derived from linear regression analysis for stepwise trend of decrease in nonfrail, prefrail, to frail study groups, adjusted for age. Copyright © (2011) Elsevier Ltd. Reprinted with permission; Yao et al.²⁷

Table 1. Vaccination groups are as follows: 1 x H5N1-AS, single dose of the AS03A-adjuvanted vaccine; 1 x H5N1, single dose of the nonadjuvanted vaccine; 2 x H5N1-AS, double dose of the AS03A-adjuvanted vaccine; 2 x H5N1, double dose of the nonadjuvanted vaccine. ATP, according to protocol

		ATP cohort (total)				ATP cohort (seronegative at baseline)
	Time	1xH5N1-AS	1xH5N1	2xH5N1-AS	2xH5N1	1xH5N1-AS	1xH5N1	2xH5N1-AS	2xH5N1
No. of subjects		152	54	145	44	90	33	93	28
GMT (95% CI)	Day 0	11.3 (9.2–13.9)	9.7 (7.3–13.0)	10.2 (8.4–12.5)	8.8 (6.6–11.8)	5.0 (5.0–5.0)	5.0 (5.0–5.0)	5.0 (5.0–5.0)	5.0 (5.0–5.0)
	Day 21	50.0 (38.1–65.6)	16.8 (11.7–24.0)	69.4 (52.1–92.3)	20.8 (13.0–33.3)	25.3 (18.5–34.6)	9.7 (6.4–14.7)	40.2 (29.5–54.8)	10.5 (6.5–16.9)
	Day 42	126.8 (99.4–161.7)	22.7 (15.1–34.1)	237.3 (191.9–293.6)	25.3 (16.0–40.1)	80.0 (58.3–109.8)	13.4 (8.0–22.5)	198.5 (157.5–250.2)	13.1 (8.1–21.3)

Copyright © (2011). Published by Oxford University Press on behalf of the Infectious Diseases Society of America, reprinted with permission. Modified from Heijmans et al.⁴⁵

Talbot HK, Williams JV, Zhu Y, Poehling KA, Griffin MR, Edwards KM. Failure of routine diagnostic methods to detect influenza in hospitalized older adults. Infect Control Hosp Epidemiol 2010; 31:683 - 8; http://dx.doi.org/10.1086/653202; PMID: 20470035

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Yao X, Hamilton RG, Weng NP, Xue QL, Bream JH, Li H, et al. Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults. Vaccine 2011; 29:5015 - 21; http://dx.doi.org/10.1016/j.vaccine.2011.04.077; PMID: 21565245

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Heijmans S, De Meulemeester M, Reynders P, Giet D, Demanet E, Devresse PY, et al. Immunogenicity profile of a 3.75-mug hemagglutinin pandemic rH5N1 split virion AS03A-adjuvanted vaccine in elderly persons: a randomized trial. J Infect Dis 2011; 203:1054 - 62; http://dx.doi.org/10.1093/infdis/jiq174; PMID: 21450995

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