在免疫能力较强的老年人中,流感疫苗接种和社区获得性肺炎的风险:基于人口的嵌套病例控制研究
Michael L Jackson1, Jennifer C Nelson, Noel S Weiss
1Group Health Center for Health Studies, Seattle, WA 98101-1448, USA. mlj3@cornell.edu
Lancet (London, England)
|August 5, 2008
概括
在免疫能力较强的老年人中,接种流感疫苗并没有降低社区获得性肺炎的风险. 这项研究表明,流感疫苗对肺炎的保护作用可能低于此前所认为的.
科学领域:
- 老年学是一门学科.
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 肺炎是老年人流感的常见并发症.
- 接种流感疫苗可以预防肺炎,但之前的研究存在局限性.
- 以前的研究往往忽视了门诊肺炎病例和潜在偏见.
研究的目的:
- 评估在免疫能力较强的老年人中,流感疫苗接种与社区获得的肺炎风险之间的关联.
- 解决先前研究的局限性,包括住院和门诊肺炎病例.
- 为了控制健康状况指标和潜在的混因素.
主要方法:
- 在65-94岁的成年人中进行了基于人口的,嵌套的病例控制研究.
- 病例是社区获得的肺炎 (门诊或住院) 患者.
- 选择了年龄和性别匹配的对照组;审查了医疗记录以寻找混因素.
主要成果:
- 分析了1173个病例和2346个对照.
- 流感疫苗接种与社区获得的肺炎风险降低无关.
- 肺炎的调整后几率比为0.92 (95% CI 0.77-1.10).
结论:
- 在流感季节,老年人接种流感疫苗预防肺炎的保护作用可能被高估了.
- 需要进一步的研究来澄清疫苗接种对肺炎预防的确切影响.
- 这些发现强调了在评估疫苗疗效时,强大的研究设计的重要性.
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