High-Dose Flu Vaccine Reduces Hospitalization Risk in LTC Residents

In a presentation given at IDWeek 2016, Fluzone High-Dose vaccine reduced the risk of all-cause hospitalization as well as hospitalization for respiratory conditions among long-term care residents, compared with the standard-dose Fluzone vaccine.

Human immune defenses become weaker with age, which places older people at greater risk of severe illness from influenza. Also, ageing decreases the body’s ability to have a good immune response after getting the influenza vaccine. A higher dose of antigen in the vaccine is supposed to give older people a better immune response, and therefore, better protection against the flu. The Fluzone High-Dose vaccine was designed specifically for adults aged 65 and older.

For their study, lead author Stefan Gravenstein, MD, MPH, Warren Alpert Medical School, Brown University (Providence, RI), and colleagues sought to determine whether or not a more immunogenic vaccine would reduce hospitalizations among nursing home residents.

Using data from the Center for Medicare & Medicaid Services and from enrolled facilities, they analyzed intent-to-treat hospitalization incidence using marginal Poisson regression, accounting for clustering of residents within facilities, and adjusting for a priori facility and resident covariates. Secondary outcomes included mortality and activities of daily living.

The study randomly assigned 823 facilities in 38 states with 53,008 long-stay residents to administer either high-dose or standard-dose vaccines for the 2013–2014 season. Analyses included residents age 65 years or older who had lived in the facilities for more than 90 days. During the study period, flu A/H1N1 was the dominant strain.

The research team found fewer all-cause hospitalizations in high-dose group patients compared with standard-dose facilities for all-causes. And all-cause mortality was similar between the two groups. —Amanda Del Signore