The effectiveness of influenza vaccine among elderly Chinese: A regression discontinuity design based on Yinzhou regional health information platform

Abstract

In China, a free influenza vaccination policy is being implemented among individuals aged 70 years and over in Zhejiang province during the COVID-19 pandemic. The objective was to assess the effectiveness of influenza vaccine in reducing hospitalization and mortality in the elderly. We used data from the Regional Health Information Platform in Yinzhou located in Zhejiang province and applied a regression discontinuity design to estimate the intention-to-treat effect on admission and mortality rates by month of age in the population who was near the age of 70 years threshold. At age 70 years, the influenza vaccination rate increased by 29.1% (95% CI, 28.2% to 29.9%) compared to those under 70 in the study population. When turning age 70 years, the potential effectiveness of receiving influenza vaccine was 8.2% (95% CI, −36.8% to 51.3%) for total hospitalization and the evaluation of vaccine effectiveness was 13.1% (95% CI, −34.2 to 61.8) for the all-cause mortality. An increase in the influenza vaccination rate was associated with a weak decline in most outcomes, but no significance was found for all outcomes. Influenza vaccination had a limited effect on hospital admission and mortality for the free influenza vaccination program that can be related to the low vaccination rate among the Chinese elderly. Supplementation strategies and future studies may be needed to expand immunization coverage and validate this finding, and further provide a reference for other cities to promote the free influenza vaccination policy in China, especially under circumstances of the COVID-19 pandemic.

A feasibility assessment of real‐world data capabilities for monitoring vaccine safety and effectiveness in China: Human papillomavirus vaccination in the Yinzhou district as a use case

“…Other large‐scale studies include a diabetes study, 48 a herpes zoster incidence study conducted to generate baseline data in view of the introduction of the zoster vaccine in China, 51 and rheumatoid arthritis epidemiology 57 . Other studies have evaluated childhood and adult vaccine administration and safety (including HPV vaccines) 45,52–56,58–60 …”

“…57 Other studies have evaluated childhood and adult vaccine administration and safety (including HPV vaccines). 45,[52][53][54][55][56][58][59][60] Findings from a 2018 survey of electronic data sources suitable for vaccine research in the Asia-Pacific region indicated that the YRHIP offers relevant vaccine-specific outcome data. 44 A presentation at the ACPE on the value of the YRHIP to generate safety outcome data for a range of recommended infant vaccines, 61 with more complete data subsequently published, further informed our feasibility assesment.…”

Investigating the causal effects of COVID-19 vaccination on the adoption of protective behaviors in Japan: Insights from a fuzzy regression discontinuity design

“…Consequently, we applied the RDD using birth month as the running variable with a cutoff of March 1957. Several studies have estimated the causal relationships between influenza, COVID-19 vaccinations, and health outcomes using RDD with age or birth timing as the running variables [ 18 – 21 ]. However, to the best of our knowledge, few studies have investigated the causal relationship between COVID-19 vaccination and protective behaviors against COVID-19.…”

An Autoregressive Integrated Moving Average Model for Predicting Varicella Outbreaks — China, 2019

“…The autoregressive integrated moving average (ARIMA) models, accommodating alterations in trends, variations in periodicity, and random disturbances within a time series, have seen extensive application in predicting infectious diseases (3)(4)(5). Our study aimed to depict the temporal patterns of varicella outbreak cases in China spanning 2005-2018, assess the practicality of employing ARIMA models to project upcoming monthly varicella outbreak cases, and contribute empirical evidence for early alarms and effective prevention measures to suppress varicella outbreaks.…”