Influenza vaccination and mortality benefits:

new insights, new opportunities

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

Research output: Contribution to journalJournal articleResearchpeer-review

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.
Original languageEnglish
JournalVaccine
Volume27
Issue number45
Pages (from-to)6300-6304
ISSN0264-410X
Publication statusPublished - 2009

Keywords

  • Influenza
  • Vaccine effectiveness
  • Seniors

Cite this

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. In: Vaccine. 2009 ; Vol. 27, No. 45. pp. 6300-6304.
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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, vol. 27, no. 45, pp. 6300-6304.

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

In: Vaccine, Vol. 27, No. 45, 2009, p. 6300-6304.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Influenza vaccination and mortality benefits:

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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

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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.