Influenza vaccination and mortality benefits: new insights, new opportunities

Lone Simonsen, Cecile Viboud, Robert J Taylor, Mark Miller, Lisa Jackson

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Influenza vaccination control strategies in most countries rely on vaccination of seniors and other high risk groups. Although placebo-controlled randomized trials show influenza vaccine is effective in younger age groups, few seniors >70 years were studied even though they suffer >90% of influenza-related deaths. Excess mortality studies could not confirm a national decline in influenza-related mortality while vaccine coverage quadrupled. Cohort studies have consistently reported that vaccination reduces all-cause winter mortality by approximately 50%, an astonishing claim given only approximately 5% of all winter deaths are attributable to influenza. This VE overestimation has now been attributed to profound confounding frailty selection bias. A way forward includes a new generation of unbiased studies with laboratory endpoints, and requires an agreement that the evidence base was flawed. The latter may clear the way for more immunogenic vaccines for seniors and exploration of other influenza control strategies.
OriginalsprogEngelsk
TidsskriftVaccine
Vol/bind27
Udgave nummer45
Sider (fra-til)6300-6304
ISSN0264-410X
StatusUdgivet - 2009

Emneord

    Citer dette

    Simonsen, L., Viboud, C., Taylor, R. J., Miller, M., & Jackson, L. (2009). Influenza vaccination and mortality benefits: new insights, new opportunities. Vaccine, 27(45), 6300-6304.
    Simonsen, Lone ; Viboud, Cecile ; Taylor, Robert J ; Miller, Mark ; Jackson, Lisa. / Influenza vaccination and mortality benefits: new insights, new opportunities. I: Vaccine. 2009 ; Bind 27, Nr. 45. s. 6300-6304.
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    abstract = "Influenza vaccination control strategies in most countries rely on vaccination of seniors and other high risk groups. Although placebo-controlled randomized trials show influenza vaccine is effective in younger age groups, few seniors >70 years were studied even though they suffer >90{\%} of influenza-related deaths. Excess mortality studies could not confirm a national decline in influenza-related mortality while vaccine coverage quadrupled. Cohort studies have consistently reported that vaccination reduces all-cause winter mortality by approximately 50{\%}, an astonishing claim given only approximately 5{\%} of all winter deaths are attributable to influenza. This VE overestimation has now been attributed to profound confounding frailty selection bias. A way forward includes a new generation of unbiased studies with laboratory endpoints, and requires an agreement that the evidence base was flawed. The latter may clear the way for more immunogenic vaccines for seniors and exploration of other influenza control strategies.",
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    Simonsen, L, Viboud, C, Taylor, RJ, Miller, M & Jackson, L 2009, 'Influenza vaccination and mortality benefits: new insights, new opportunities' Vaccine, bind 27, nr. 45, s. 6300-6304.

    Influenza vaccination and mortality benefits: new insights, new opportunities. / Simonsen, Lone; Viboud, Cecile; Taylor, Robert J; Miller, Mark; Jackson, Lisa.

    I: Vaccine, Bind 27, Nr. 45, 2009, s. 6300-6304.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Influenza vaccination and mortality benefits:

    T2 - new insights, new opportunities

    AU - Simonsen, Lone

    AU - Viboud, Cecile

    AU - Taylor, Robert J

    AU - Miller, Mark

    AU - Jackson, Lisa

    PY - 2009

    Y1 - 2009

    N2 - Influenza vaccination control strategies in most countries rely on vaccination of seniors and other high risk groups. Although placebo-controlled randomized trials show influenza vaccine is effective in younger age groups, few seniors >70 years were studied even though they suffer >90% of influenza-related deaths. Excess mortality studies could not confirm a national decline in influenza-related mortality while vaccine coverage quadrupled. Cohort studies have consistently reported that vaccination reduces all-cause winter mortality by approximately 50%, an astonishing claim given only approximately 5% of all winter deaths are attributable to influenza. This VE overestimation has now been attributed to profound confounding frailty selection bias. A way forward includes a new generation of unbiased studies with laboratory endpoints, and requires an agreement that the evidence base was flawed. The latter may clear the way for more immunogenic vaccines for seniors and exploration of other influenza control strategies.

    AB - Influenza vaccination control strategies in most countries rely on vaccination of seniors and other high risk groups. Although placebo-controlled randomized trials show influenza vaccine is effective in younger age groups, few seniors >70 years were studied even though they suffer >90% of influenza-related deaths. Excess mortality studies could not confirm a national decline in influenza-related mortality while vaccine coverage quadrupled. Cohort studies have consistently reported that vaccination reduces all-cause winter mortality by approximately 50%, an astonishing claim given only approximately 5% of all winter deaths are attributable to influenza. This VE overestimation has now been attributed to profound confounding frailty selection bias. A way forward includes a new generation of unbiased studies with laboratory endpoints, and requires an agreement that the evidence base was flawed. The latter may clear the way for more immunogenic vaccines for seniors and exploration of other influenza control strategies.

    KW - Influenza

    KW - Vaccine effectiveness

    KW - Seniors

    M3 - Journal article

    VL - 27

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    JO - Vaccine

    JF - Vaccine

    SN - 0264-410X

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    Simonsen L, Viboud C, Taylor RJ, Miller M, Jackson L. Influenza vaccination and mortality benefits: new insights, new opportunities. Vaccine. 2009;27(45):6300-6304.