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首页> 外文期刊>Diabetes care >Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients.
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Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients.

机译：成人和老年糖尿病患者首次和重复流感疫苗接种的临床效果。

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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 >65 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.
机译：目的：在高危糖尿病患者中，流感疫苗的摄取率仍然较低，部分原因是有关其潜在益处的证据相互矛盾。我们评估了在成人糖尿病患者中进行流感疫苗接种的临床效果，并特别研究了按年龄和以前接种流感疫苗的效果可能产生的影响。研究设计和方法：该研究是“流感预防，监控和管理”（PRISMA）研究的一部分，该研究是在1999-2000年甲型流感流行期间进行的嵌套病例对照研究，研究对象是75235名来自任何年龄的推荐初级保健患者。疫苗接种。在9238名成人糖尿病患者中，有131例因糖尿病失调，急性呼吸系统疾病或心血管疾病而住院，有61例死亡，我们将其与1561名对照受试者进行了比较。我们通过逻辑回归分析评估了（先前）流感疫苗接种的效果，该回归分析控制了年龄，性别，健康保险范围，以前的医疗保健使用，药物使用和合并症。结果：接种疫苗可使并发症减少56％（95％CI 36-70％），住院减少54％（26-71％）和死亡减少58％（13-80％）。在年龄在18-64岁的研究对象中，我们观察到的并发症发生率比年龄在65岁以上的患者有所降低（分别为72％和39％）。在初次接种疫苗的受试者中，主要终点指标降低了47％（0.2-72％），而在前一年接受过疫苗接种的受试者中，主要终点指标降低了58％（4-81％）。结论：2型糖尿病的成年人，与其他公认的危险人群一样，都从流感疫苗中受益匪浅，并且首次和重复接种之间没有发现疫苗效力的差异。

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