High-dose influenza vaccines for the prevention of hospitalization due to cardiovascular events in older adults in the nursing home: Post-hoc analysis of a cluster-randomized trial

• Published in: Vaccine Vol. 40; no. 47; pp. 6700 - 6705
• Main Authors: Saade, Elie A., Abul, Yasin, McConeghy, Kevin, Edward Davidson, H, Han, Lisa, Joyce, Nina, Canaday, David H., Hsueh, Leon, Bosco, Elliott, Gravenstein, Stefan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 08-11-2022; Elsevier Limited
• Subjects: Activities of daily living; Adults; Age; Aged; Antigens; Cardiovascular disease; Cardiovascular Diseases; Clusters; Cognitive ability; Congestive heart failure; Data collection; Disease prevention; Heart failure; High-dose influenza vaccine; Hospitalization; Humans; Influenza; Influenza Vaccines; Influenza vaccines/administration & dosage; Influenza, Human; Medicaid; Medicare; Morbidity; Mortality; Nurses; Nursing Homes; Observational studies; Older people; Outbreaks; Patient admissions; Pneumonia; Population; Respiratory function; Risk; Statistical analysis; United States; Vaccines; United States; United States > US; Nursing homes; CDC; CMS; High-dose influenza vaccine; Outbreaks; ADL; Influenza vaccines/administration & dosage; SD; FFS; ICD-9; MA; MACE; Influenza; IIV; NH; HD; MDS
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2022.09.085

Older adults are at high risk of major acute cardiovascular events (MACE) linked to influenza illness andpreventable by influenza vaccination. It is unknown whether high-dose vaccine might incrementally reduce the risk of MACE.We conducted a post-hoc analysis of data collected from a pragmatic cluster randomized study of 823 nursing homes (NH) randomized to standard-dose (SD) or high-dose (HD) influenza vaccine in the 2013–14 season. Adults age 65 year or older who are Medicare-enrolled long-stay residents were included in the analysis.There were no statistically significant differences in hospitalization for MACE, acute coronary syndromes (ACS), stroke or heart failure between the HD and SD arms. However, in the fee-for-service group, participants in the HD arm had significantly decreased risk of hospitalization for respiratory problems, which was not observed in the Medicare Advantage group.High-dose influenza vaccine was not shown to be incrementally protective against MACE relative to standard-dose vaccine.