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Article: Prevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: A prospective cohort study

TitlePrevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: A prospective cohort study
Authors
Issue Date2010
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2010, v. 51 n. 9, p. 1007-1016 How to Cite?
AbstractBackground. Despite World Health Organization recommendations, the rate of 23-valent pneumococcal (PPV) and influenza (TIV) vaccination among elderly persons in Hong Kong, China, is exceptionally low because of doubts about effectiveness of vaccination. The efficacy of dual vaccination remains unknown. Methods. From 3 December 2007 to 30 June 2008, we conducted a prospective cohort study by recruiting outpatients aged ≥65 years with chronic illness to participate in a PPV and TIV vaccination program. All were observed until 31 March 2009. The outcome of subjects, including the rates of death, hospitalization, pneumonia, ischemic stroke, acute myocardial infarction, and coronary and intensive care admissions, were determined. Results. Of the 36,636 subjects recruited, 7292 received both PPV and TIV, 2076 received TIV vaccine alone, 1875 received PPV alone, and 25,393 were unvaccinated, with a duration of follow-up of 45,834 person-years. Baseline characteristics were well matched between the groups, except that there were fewer male patients in the PPV and TIV group and fewer cases of comorbid chronic obstructive pulmonary disease among unvaccinated persons. At week 64 from commencement of the study, dual-vaccinees experienced fewer deaths (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.55-0.77]; P < .001) and fewer cases of pneumonia (HR, 0.57; 95% CI, 0.51-0.64; P < .001), ischemic stroke (HR, 0.67; 95% CI, 0.54-0.83; P < .001), and acute myocardial infarction (HR, 0.52; 95% CI, 0.38-0.71; P < .001), compared with unvaccinated subjects. Dual vaccination resulted in fewer coronary (HR, 0.59; 95% CI, 0.44-0.79; P < .001) and intensive care admissions (HR, 0.45; 95% CI, 0.22-0.94; P = .03), compared with among unvaccinated subjects. Conclusions. Dual vaccination with PPV and TIV is effective in protecting elderly persons with chronic illness from developing complications from respiratory, cardiovascular, and cerebrovascular diseases, thereby reducing hospitalization, coronary or intensive care admissions, and death. © 2010 by the Infectious Diseases Society of America. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/133636
ISSN
2015 Impact Factor: 8.736
2015 SCImago Journal Rankings: 4.742
ISI Accession Number ID
Funding AgencyGrant Number
Li Ka Shing Foundation
Food and Health Bureau of the HKSAR
Hospital Authority
University of Hong Kong
Funding Information:

The Li Ka Shing Foundation, Research Fund for the Control of Infectious Diseases of the Food and Health Bureau of the HKSAR, the Hospital Authority, and the University of Hong Kong.

References

 

DC FieldValueLanguage
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorLeung, AYMen_HK
dc.contributor.authorChu, DWSen_HK
dc.contributor.authorLeung, Den_HK
dc.contributor.authorCheung, Ten_HK
dc.contributor.authorChan, CKen_HK
dc.contributor.authorLam, CLKen_HK
dc.contributor.authorLiu, SHen_HK
dc.contributor.authorChu, NMen_HK
dc.contributor.authorHo, PLen_HK
dc.contributor.authorChan, Sen_HK
dc.contributor.authorLam, THen_HK
dc.contributor.authorLiang, Ren_HK
dc.contributor.authorYuen, KYen_HK
dc.date.accessioned2011-05-24T02:12:44Z-
dc.date.available2011-05-24T02:12:44Z-
dc.date.issued2010en_HK
dc.identifier.citationClinical Infectious Diseases, 2010, v. 51 n. 9, p. 1007-1016en_HK
dc.identifier.issn1058-4838en_HK
dc.identifier.urihttp://hdl.handle.net/10722/133636-
dc.description.abstractBackground. Despite World Health Organization recommendations, the rate of 23-valent pneumococcal (PPV) and influenza (TIV) vaccination among elderly persons in Hong Kong, China, is exceptionally low because of doubts about effectiveness of vaccination. The efficacy of dual vaccination remains unknown. Methods. From 3 December 2007 to 30 June 2008, we conducted a prospective cohort study by recruiting outpatients aged ≥65 years with chronic illness to participate in a PPV and TIV vaccination program. All were observed until 31 March 2009. The outcome of subjects, including the rates of death, hospitalization, pneumonia, ischemic stroke, acute myocardial infarction, and coronary and intensive care admissions, were determined. Results. Of the 36,636 subjects recruited, 7292 received both PPV and TIV, 2076 received TIV vaccine alone, 1875 received PPV alone, and 25,393 were unvaccinated, with a duration of follow-up of 45,834 person-years. Baseline characteristics were well matched between the groups, except that there were fewer male patients in the PPV and TIV group and fewer cases of comorbid chronic obstructive pulmonary disease among unvaccinated persons. At week 64 from commencement of the study, dual-vaccinees experienced fewer deaths (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.55-0.77]; P < .001) and fewer cases of pneumonia (HR, 0.57; 95% CI, 0.51-0.64; P < .001), ischemic stroke (HR, 0.67; 95% CI, 0.54-0.83; P < .001), and acute myocardial infarction (HR, 0.52; 95% CI, 0.38-0.71; P < .001), compared with unvaccinated subjects. Dual vaccination resulted in fewer coronary (HR, 0.59; 95% CI, 0.44-0.79; P < .001) and intensive care admissions (HR, 0.45; 95% CI, 0.22-0.94; P = .03), compared with among unvaccinated subjects. Conclusions. Dual vaccination with PPV and TIV is effective in protecting elderly persons with chronic illness from developing complications from respiratory, cardiovascular, and cerebrovascular diseases, thereby reducing hospitalization, coronary or intensive care admissions, and death. © 2010 by the Infectious Diseases Society of America. All rights reserved.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/en_HK
dc.relation.ispartofClinical Infectious Diseasesen_HK
dc.subject.meshInfluenza Vaccines - administration and dosage-
dc.subject.meshMyocardial Infarction - mortality - prevention and control-
dc.subject.meshPneumococcal Vaccines - administration and dosage-
dc.subject.meshStroke - mortality - prevention and control-
dc.subject.meshVaccination - methods-
dc.titlePrevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: A prospective cohort studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1058-4838&volume=51&issue=9&spage=1007&epage=1016&date=2010&atitle=Prevention+of+acute+myocardial+infarction+and+stroke+among+elderly+persons+by+dual+pneumococcal+and+influenza+vaccination:+a+prospective+cohort+study-
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailLeung, AYM: angleung@hku.hken_HK
dc.identifier.emailLeung, D: dorisl@hkucc.hku.hken_HK
dc.identifier.emailLam, CLK: clklam@hku.hken_HK
dc.identifier.emailHo, PL: plho@hkucc.hku.hken_HK
dc.identifier.emailChan, S: scsophia@hku.hken_HK
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hken_HK
dc.identifier.emailLiang, R: rliang@hku.hken_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityLeung, AYM=rp00405en_HK
dc.identifier.authorityLeung, D=rp00465en_HK
dc.identifier.authorityLam, CLK=rp00350en_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.identifier.authorityChan, S=rp00423en_HK
dc.identifier.authorityLam, TH=rp00326en_HK
dc.identifier.authorityLiang, R=rp00345en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1086/656587en_HK
dc.identifier.pmid20887208-
dc.identifier.scopuseid_2-s2.0-77958540519en_HK
dc.identifier.hkuros185097en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77958540519&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume51en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1007en_HK
dc.identifier.epage1016en_HK
dc.identifier.eissn1537-6591-
dc.identifier.isiWOS:000283331300005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHung, IFN=7006103457en_HK
dc.identifier.scopusauthoridLeung, AYM=7403012650en_HK
dc.identifier.scopusauthoridChu, DWS=35108889000en_HK
dc.identifier.scopusauthoridLeung, D=16304486500en_HK
dc.identifier.scopusauthoridCheung, T=7103334170en_HK
dc.identifier.scopusauthoridChan, CK=7404813960en_HK
dc.identifier.scopusauthoridLam, CLK=24755913900en_HK
dc.identifier.scopusauthoridLiu, SH=37031375700en_HK
dc.identifier.scopusauthoridChu, NM=18834235000en_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK
dc.identifier.scopusauthoridChan, S=7404255378en_HK
dc.identifier.scopusauthoridLam, TH=7202522876en_HK
dc.identifier.scopusauthoridLiang, R=26643224900en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.citeulike7956637-

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