Benefits of influenza vaccination on influenza-related mortality among elderly in the US

An unexpected finding

Lone Simonsen, Thomas A. Reichert, William C. Blackwelder, Mark Miller

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Although elderly influenza vaccination coverage increased from ∼15% to ∼65% during 1980–1999 in the US, estimates of influenza-related mortality also increased during this period. We examined these apparently conflicting findings by adjusting mortality estimates for aging within the elderly and the incidence of influenza A (H3N2) virus circulation. Using national mortality statistics for 1968 through 1999, we generated age-specific monthly rates for pneumonia and influenza (P&I) and all-cause mortality for persons ≥65 years of age. We estimated influenza-related mortality as the winter excess in mortality over a Serfling model baseline. After adjusting for age and considering only A (H3N2)-dominated seasons, we found that excess mortality declined sharply among younger elderly (65–74 years) during 1968–1980, but remained level after 1980. Among the most elderly (85+ years), excess mortality rates were essentially unchanged over the entire study period. In conclusion, the increase in elderly influenza vaccination coverage in the US after 1980 was not accompanied by a decline in influenza-related mortality. We hypothesize that disparity in vaccination rates among frail elderly, combined with reduced responsiveness to vaccination with age, may account for these findings.
OriginalsprogEngelsk
TidsskriftInternational Congress Series
Vol/bind1263
Antal sider5
ISSN0531-5131
DOI
StatusUdgivet - 2018
Udgivet eksterntJa

Citer dette

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title = "Benefits of influenza vaccination on influenza-related mortality among elderly in the US: An unexpected finding",
abstract = "Although elderly influenza vaccination coverage increased from ∼15{\%} to ∼65{\%} during 1980–1999 in the US, estimates of influenza-related mortality also increased during this period. We examined these apparently conflicting findings by adjusting mortality estimates for aging within the elderly and the incidence of influenza A (H3N2) virus circulation. Using national mortality statistics for 1968 through 1999, we generated age-specific monthly rates for pneumonia and influenza (P&I) and all-cause mortality for persons ≥65 years of age. We estimated influenza-related mortality as the winter excess in mortality over a Serfling model baseline. After adjusting for age and considering only A (H3N2)-dominated seasons, we found that excess mortality declined sharply among younger elderly (65–74 years) during 1968–1980, but remained level after 1980. Among the most elderly (85+ years), excess mortality rates were essentially unchanged over the entire study period. In conclusion, the increase in elderly influenza vaccination coverage in the US after 1980 was not accompanied by a decline in influenza-related mortality. We hypothesize that disparity in vaccination rates among frail elderly, combined with reduced responsiveness to vaccination with age, may account for these findings.",
author = "Lone Simonsen and Reichert, {Thomas A.} and Blackwelder, {William C.} and Mark Miller",
year = "2018",
doi = "10.1016/j.ics.2004.02.038",
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journal = "International Congress Series",
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Benefits of influenza vaccination on influenza-related mortality among elderly in the US : An unexpected finding. / Simonsen, Lone; Reichert, Thomas A.; Blackwelder, William C.; Miller, Mark.

I: International Congress Series, Bind 1263, 2018.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Benefits of influenza vaccination on influenza-related mortality among elderly in the US

T2 - An unexpected finding

AU - Simonsen, Lone

AU - Reichert, Thomas A.

AU - Blackwelder, William C.

AU - Miller, Mark

PY - 2018

Y1 - 2018

N2 - Although elderly influenza vaccination coverage increased from ∼15% to ∼65% during 1980–1999 in the US, estimates of influenza-related mortality also increased during this period. We examined these apparently conflicting findings by adjusting mortality estimates for aging within the elderly and the incidence of influenza A (H3N2) virus circulation. Using national mortality statistics for 1968 through 1999, we generated age-specific monthly rates for pneumonia and influenza (P&I) and all-cause mortality for persons ≥65 years of age. We estimated influenza-related mortality as the winter excess in mortality over a Serfling model baseline. After adjusting for age and considering only A (H3N2)-dominated seasons, we found that excess mortality declined sharply among younger elderly (65–74 years) during 1968–1980, but remained level after 1980. Among the most elderly (85+ years), excess mortality rates were essentially unchanged over the entire study period. In conclusion, the increase in elderly influenza vaccination coverage in the US after 1980 was not accompanied by a decline in influenza-related mortality. We hypothesize that disparity in vaccination rates among frail elderly, combined with reduced responsiveness to vaccination with age, may account for these findings.

AB - Although elderly influenza vaccination coverage increased from ∼15% to ∼65% during 1980–1999 in the US, estimates of influenza-related mortality also increased during this period. We examined these apparently conflicting findings by adjusting mortality estimates for aging within the elderly and the incidence of influenza A (H3N2) virus circulation. Using national mortality statistics for 1968 through 1999, we generated age-specific monthly rates for pneumonia and influenza (P&I) and all-cause mortality for persons ≥65 years of age. We estimated influenza-related mortality as the winter excess in mortality over a Serfling model baseline. After adjusting for age and considering only A (H3N2)-dominated seasons, we found that excess mortality declined sharply among younger elderly (65–74 years) during 1968–1980, but remained level after 1980. Among the most elderly (85+ years), excess mortality rates were essentially unchanged over the entire study period. In conclusion, the increase in elderly influenza vaccination coverage in the US after 1980 was not accompanied by a decline in influenza-related mortality. We hypothesize that disparity in vaccination rates among frail elderly, combined with reduced responsiveness to vaccination with age, may account for these findings.

U2 - 10.1016/j.ics.2004.02.038

DO - 10.1016/j.ics.2004.02.038

M3 - Journal article

VL - 1263

JO - International Congress Series

JF - International Congress Series

SN - 0531-5131

ER -