Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 Epidemic
<b>Background:</b> In Australia, 2017 was a severe A/H3N2 season and, therefore, we estimated the effectiveness of standard-dose quadrivalent influenza vaccine in preventing hospitalization for cardiovascular disease (CVD) among New South Wales (NSW) residents aged ≥50 years. <b>Me...
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MDPI AG
2025-04-01
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| author | Zubair Akhtar Aye M. Moa Timothy C. Tan Ole Fröbert Robert Menzies C. Raina MacIntyre |
| author_facet | Zubair Akhtar Aye M. Moa Timothy C. Tan Ole Fröbert Robert Menzies C. Raina MacIntyre |
| author_sort | Zubair Akhtar |
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| description | <b>Background:</b> In Australia, 2017 was a severe A/H3N2 season and, therefore, we estimated the effectiveness of standard-dose quadrivalent influenza vaccine in preventing hospitalization for cardiovascular disease (CVD) among New South Wales (NSW) residents aged ≥50 years. <b>Methods:</b> We conducted a nested, matched case–control study within the 45 and Up study, linking data from the Australian Immunization Register, NSW Admitted Patient Data Collection and Pharmaceutical Benefits Schedule. Cases were individuals hospitalized for CVD and controls were those who were hospitalized for gastrointestinal diseases. The two groups were balanced using 1:1 propensity score matching based on age group (50–64, 65–74, 75–84, and ≥85 years) and sex. After adjusting for confounders (smoking, body mass index and income), we calculated the adjusted odds ratio (aOR) for vaccination during the season using multivariable logistic regression. E-values were estimated to assess residual confounding. Vaccine effectiveness (VE) was calculated as (1 − aOR) × 100. <b>Results:</b> There were 10,445 (4452 cases and 5993 controls) study participants. After matching, 8904 (85.2%) were retained with a mean age of 76.4 ± 10.4 years and 58.3% men. Following adjustment for confounders, the aOR of averting a CVD hospitalization was 0.15 (95% CI: 0.13 to 0.17; <i>p</i> < 0.001). The estimated VE against CVD hospitalization was 85% (95% CI: 83 to 87). We found an E-value of 12.82, indicating strong evidence of minimal residual confounding. <b>Conclusions:</b> In the severe 2017 influenza A/H3N2 season in Australia, we observed a high VE in preventing cardiovascular hospitalization despite a low VE against influenza infection prevention. Improving vaccine uptake may reduce cardiovascular burden. |
| format | Article |
| id | doaj-art-4740820835f5417da28d11944d0dfd5b |
| institution | OA Journals |
| issn | 2076-393X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj-art-4740820835f5417da28d11944d0dfd5b2025-08-20T02:18:10ZengMDPI AGVaccines2076-393X2025-04-0113440710.3390/vaccines13040407Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 EpidemicZubair Akhtar0Aye M. Moa1Timothy C. Tan2Ole Fröbert3Robert Menzies4C. Raina MacIntyre5Biosecurity Program, The Kirby Institute, Faculty of Medicine and Health, UNSW, Sydney, NSW 2033, AustraliaBiosecurity Program, The Kirby Institute, Faculty of Medicine and Health, UNSW, Sydney, NSW 2033, AustraliaDepartment of Cardiology, Blacktown Hospital, University of Western Sydney, Blacktown, NSW 2148, AustraliaDepartment of Cardiology, Faculty of Health, Örebro University, 701 82 Örebro, SwedenSanofi, ANZ, Sydney, NSW 2133, AustraliaBiosecurity Program, The Kirby Institute, Faculty of Medicine and Health, UNSW, Sydney, NSW 2033, Australia<b>Background:</b> In Australia, 2017 was a severe A/H3N2 season and, therefore, we estimated the effectiveness of standard-dose quadrivalent influenza vaccine in preventing hospitalization for cardiovascular disease (CVD) among New South Wales (NSW) residents aged ≥50 years. <b>Methods:</b> We conducted a nested, matched case–control study within the 45 and Up study, linking data from the Australian Immunization Register, NSW Admitted Patient Data Collection and Pharmaceutical Benefits Schedule. Cases were individuals hospitalized for CVD and controls were those who were hospitalized for gastrointestinal diseases. The two groups were balanced using 1:1 propensity score matching based on age group (50–64, 65–74, 75–84, and ≥85 years) and sex. After adjusting for confounders (smoking, body mass index and income), we calculated the adjusted odds ratio (aOR) for vaccination during the season using multivariable logistic regression. E-values were estimated to assess residual confounding. Vaccine effectiveness (VE) was calculated as (1 − aOR) × 100. <b>Results:</b> There were 10,445 (4452 cases and 5993 controls) study participants. After matching, 8904 (85.2%) were retained with a mean age of 76.4 ± 10.4 years and 58.3% men. Following adjustment for confounders, the aOR of averting a CVD hospitalization was 0.15 (95% CI: 0.13 to 0.17; <i>p</i> < 0.001). The estimated VE against CVD hospitalization was 85% (95% CI: 83 to 87). We found an E-value of 12.82, indicating strong evidence of minimal residual confounding. <b>Conclusions:</b> In the severe 2017 influenza A/H3N2 season in Australia, we observed a high VE in preventing cardiovascular hospitalization despite a low VE against influenza infection prevention. Improving vaccine uptake may reduce cardiovascular burden.https://www.mdpi.com/2076-393X/13/4/407influenza vaccinationcardiovascular disease (CVD)hospitalizationvaccine effectivenesspropensity score matching |
| spellingShingle | Zubair Akhtar Aye M. Moa Timothy C. Tan Ole Fröbert Robert Menzies C. Raina MacIntyre Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 Epidemic Vaccines influenza vaccination cardiovascular disease (CVD) hospitalization vaccine effectiveness propensity score matching |
| title | Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 Epidemic |
| title_full | Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 Epidemic |
| title_fullStr | Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 Epidemic |
| title_full_unstemmed | Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 Epidemic |
| title_short | Prevention of Cardiovascular Diseases with Standard-Dose Quadrivalent Influenza Vaccine in People Aged ≥50 Years in Australia During the 2017 A/H3N2 Epidemic |
| title_sort | prevention of cardiovascular diseases with standard dose quadrivalent influenza vaccine in people aged ≥50 years in australia during the 2017 a h3n2 epidemic |
| topic | influenza vaccination cardiovascular disease (CVD) hospitalization vaccine effectiveness propensity score matching |
| url | https://www.mdpi.com/2076-393X/13/4/407 |
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