≥70岁老年人接种流感疫苗的保护效果真实世界回顾性队列研究

Influenza vaccine effectiveness in elderly people≥70 years of age in Yinzhou district of Ningbo city:a real-world retrospective cohort study

目的评价宁波市鄞州区老年人免费接种流感疫苗(Influenza vaccine,InfV)的保护效果(Vaccine effectiveness,VE)。方法利用鄞州区健康大数据平台构建≥70岁老年人回顾性队列,收集2020/2021年流感季InfV接种和流感样疾病(Influenza-like illness,ILI)发病信息,采用Logistic回归模型评估InfV预防ILI的调整后VE。结果InfV接种组和未接种组研究对象的ILI发病率分别为0.32%(94/29754)、0.54%(240/44818),InfV预防老年人ILI的调整后总VE(95%CI)为32.37%(19.24%-43.37%);70-74岁、75-79岁、80-84岁、≥85岁年龄组的VE(95%CI)分别为43.94%(22.59%-59.39%)、62.91%(45.12%-74.94%)、14.21%(-20.51%-38.93%)、-25.22%(-81.12%-13.43%);患有心血管疾病(单纯高血压除外)、慢性呼吸系统疾病、神经系统疾病、糖尿病/肾脏疾病、内分泌/代谢/血液/免疫系统疾病人群的VE(95%CI)分别为27.33%(12.04%-39.96%)、42.92%(27.81%-54.87%)、48.75%(9.64%-70.93%)、33.91%(12.64%-50.00%)、24.27%(7.31%-38.13%)。结论研究地区2020-2021年流感季≥70岁老年人免费接种InfV对预防ILI发病具有保护效果,且在不同年龄和慢性病状态人群中存在差异。

Objective To evaluate the effectiveness of influenza vaccine(Inf V)in elderly people≥70 years of age given as a free vaccine in Yinzhou district,Ningbo city.MethodsWe assembled a retrospective cohort of≥70-year-olds from the Yinzhou Health Information System(YHIS)and obtained InfV vaccination histories and influenza-like illness(ILI)incidence data during the 2020-2021 influenza season.We estimated vaccine effectiveness(VE)against ILI using a logistic regression model.ResultsIncidences of ILI for Inf V-vaccinated and unvaccinated subjects were 0.32%(94/29754)and 0.54%(240/44818),respectively.The adjusted overall Inf V VE against ILI was 32.37%(95%CI:19.24%to 43.37%).VEs(95%CI)for 70-74-,75-79-,80-84-,and≥85-year-olds were 43.94%(22.59%-59.39%),62.91%(45.12%-74.94%),14.21%(-20.51%-38.93%),and-25.22%(-81.12%-13.43%).VEs(95%CI)for subjects with cardiovascular disease(excluding simple hypertension),chronic respiratory disease,neurological disease,diabetes or kidney disease,and endocrine/metabolic/hematological/immune system diseases were 27.33%(12.04%-39.96%),42.92%(27.81%-54.87%),48.75%(9.64%-70.93%),33.91%(12.64%-50.00%),and 24.27%(7.31%-38.13%).ConclusionsInfluenza vaccination was offered as a free service to elderly people≥70 years of age during the 2020-2021 influenza season.Influenza vaccine provided protection against influenza-like illness,with effectiveness varying by age and type of chronic medical condition.