Influenza Immunization in Adults with Diabetes Mellitus

Feery, Brian J.; Hartman, Leonard J; Hampson, Alan W.; Proietto, Joseph

doi:10.2337/diacare.6.5.475

Cited by 35 publications

(27 citation statements)

References 9 publications

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“…22 Because persons with diabetes mellitus may have an impaired antibody response to the influenza vaccine, the efficacy of the vaccine may be diminished in this group. 31,32 Nonetheless, this impaired response would not seem to be a likely basis for an increased risk of incident MI during months when influenza activity is expected to be high among diabetics who were vaccine recipients in this study and a review of the current medical literature does not provide any plausible mechanism for the association of influenza vaccination with an increased risk of MI among persons with diabetes mellitus. Residual confounding may explain these findings, as it is possible that among persons with diabetes mellitus, those at higher risk of cardiac events were more likely to have received influenza vaccine.…”

Section: Discussionmentioning

confidence: 60%

Influenza Vaccination and Risk of Incident Myocardial Infarction

Heffelfinger¹,

Heckbert²,

Psaty³

et al. 2006

Human Vaccines

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Background: Several studies suggest that influenza vaccination may be associated with a decreased risk of acute cardiovascular events. We examined the association between influenza vaccination and risk of incident myocardial infarction (MI) in persons at least 65 years of age in a population-based case-control study.Methods: Case subjects were members of Group Health Cooperative (GHC), a health maintenance organization, with incident MI during 1992-1998. Control subjects were GHC members without a history of MI who were frequency matched to case subjects by age, sex, calendar year, and presence of treated hypertension. The medical records of 750 case subjects with MI and 1735 controls were reviewed.Results: Receipt of influenza vaccine was not associated with risk of incident MI during the months of November through March (odds ratio [OR]: 0.97, 95% confidence interval [CI]: 0.75-1.27) or April through September (OR: 0.97, 95% CI 0.75-1.26).Conclusions: This study does not provide evidence supporting an association of influenza vaccination and reduction in risk of myocardial infarction.

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Section: Discussionmentioning

confidence: 60%

Influenza Vaccination and Risk of Incident Myocardial Infarction

Heffelfinger¹,

Heckbert²,

Psaty³

et al. 2006

Human Vaccines

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“…The population studied, however, was small and prevaccination titres were considerably higher in control subjects, for which no correction was made [18]. In the present study a correction was included for prevaccination titres.…”

Section: Discussionmentioning

confidence: 96%

Humoral immune response and delayed type hypersensitivity to influenza vaccine in patients with diabetes mellitus

Diepersloot

Bouter

Beyer³

et al. 1987

Diabetologia

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Summary.The antibody response and delayed type hypersensitivity reaction to commercially available trivalent influenza vaccine in 159 patients with diabetes mellitus was compared with response and reaction in 28 healthy volunteers. A correction for prevaccination titres was made. No differences were found between diabetic patients and control subjects with respect to antibody response to the three vaccine strains as measured by the difference between geometric mean titres of post-and prevaccination sera. In Type 1 (insulin-dependent) diabetic patients the incidence of non-responders to two vaccine components was significantly increased (p< 0.05). The delayed type hypersensitivity reaction to influenza antigen was significantly decreased in patients with high concentrations of glycosylated haemoglobin (p<0.01). These findings suggest a role for impaired immune response in the increased influenza morbidity and mortality in patients with diabetes mellitus. Implications for therapy and vaccination strategy are discussed.

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“…Bivariate comparisons for vaccinated and unvaccinated subjects were conducted using 2 test and Student's t test for categorical and continuous variables, respectively. In accordance with other reports (9,10,17), univariate and multivariable logistic regression models were used to obtain crude and adjusted odds ratios (ORs) (and their 95% CIs) of the association between vaccination and case status. The OR was used as an approximation of the relative risk.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effectiveness of First and Repeat Influenza Vaccination in Adult and Elderly Diabetic Patients

et al. 2006

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OBJECTIVE -Influenza vaccine uptake remains low among the high-risk group of patients with diabetes, partly because of conflicting evidence regarding its potential benefits. We assessed the clinical effectiveness of influenza vaccination in adults with diabetes and specifically examined potential modification of effect by age and prior influenza vaccine uptake.RESEARCH DESIGN AND METHODS -The study was part of the Prevention of Influenza, Surveillance and Management (PRISMA) study, a nested case-control study conducted during the 1999 -2000 influenza A epidemic, among 75,235 patients from primary care of any age recommended for vaccination. Among 9,238 adult patients with diabetes, 131 cases arose who were either hospitalized for diabetes dysregulation, acute respiratory disease, or cardiovascular disease and 61 cases who died, and we compared them with 1,561 control subjects. We evaluated the effect of (prior) influenza vaccination by means of logistic regression analysis controlling for age, sex, health insurance coverage, prior health care use, medication use, and comorbid conditions. RESULTS -Vaccination was associated with a 56% reduction in any complication (95% CI 36 -70%), a 54% reduction in hospitalizations (26 -71%), and 58% reduction in deaths (13-80%). Among study subjects aged 18 -64 years, we observed somewhat higher reductions in the occurrence of any complication than among those aged Ͼ65 years (72 vs. 39%). In first-time vaccinated subjects, the primary end point was reduced by 47% (0.2-72%), and in those who received vaccination in the year before, the reduction was 58% (4 -81%).CONCLUSIONS -Adults with type 2 diabetes, like other individuals from recognized risk groups, benefit considerably from influenza vaccination, and no difference in vaccine effectiveness was observed between first-time and repeat vaccination.

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Influenza Immunization in Adults with Diabetes Mellitus

Cited by 35 publications

References 9 publications

Influenza Vaccination and Risk of Incident Myocardial Infarction

Influenza Vaccination and Risk of Incident Myocardial Infarction

Humoral immune response and delayed type hypersensitivity to influenza vaccine in patients with diabetes mellitus

Clinical Effectiveness of First and Repeat Influenza Vaccination in Adult and Elderly Diabetic Patients

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