Response to influenza vaccination in community and in nursing home residing elderly: relation to clinical factors.
Intramuscular (IM) influenza vaccines are about 50% effective in preventing respiratory illness among the elderly. The aim of this study was to identify factors associated with immune response to influenza vaccination among nursing home and community-residing elderly. 114 nursing home (NHE) and 62 community residing elderly (CE) were vaccinated with a commercial IM vaccine. Serum antibodies were evaluated by HIA, and the impact of subjects' clinical characteristics on seroconversion was determined. Factors that were associated with low seroconversion among NHE, included: type II diabetes [for B/Harbin: p=0.044, OR 0.12, (CI: 0.015-0.94)], and antibody titer prior to vaccination A/(H1N1): p=0.03, OR 2.38, (CI: 1.09-5.22); A/(H3N2): p=0.015, OR 2.68 (CI: 1.22-5.92), B/Harbin: p=0.057, OR 4.46 (CI: 0.96-20.85)]. Factors that were associated with lower seroconversion CE elderly, included older age [A/(H1N1): p=0.008, OR 0.846, (CI 0.75-0.96), B/Harbin: p=0.016, OR 0.812, (CI:0.69-0.96)], and antibody titer prior to vaccination A/(H1N1): p=0.029, OR 4.08, (CI: 1.16-14.37); A/(H3N2): p<0.0001, OR 11.495 (CI: 3.18-41.55)]. There was no significant difference in seroconversion between nursing home residing elderly and community elderly. We conclude that Type-II diabetes and antibody titer>1:40 prior to vaccination are associated with reduced response to the influenza vaccination in nursing home elderly.
Department of Medicine, Unit of Geriatrics, Hadassah University Hospital, PO Box 12000, 91120, Jerusalem, Israel.
Mordechai
M
Muszkat
Gideon
G
Friedman
Haim D
HD
Dannenberg
Eugenia
E
Greenbaum
Mordechai
M
Lipo
Ya'acov
Y
Heymann
Zichria
Z
Zakay-Rones
Arie
A
Ben-Yehuda
D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000096:biosynthesis*; D003153:Community Health Services; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology; D005260:Female; D015577:Geriatric Assessment; D006385:Hemagglutination Inhibition Tests; D006707:Homes for the Aged; D006801:Humans; D009980:Influenza A virus / Q000276:immunology*; D009981:Influenza B virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D012111:Residence Characteristics; D012307:Risk Factors
D000914:Antibodies, Viral; D007252:Influenza Vaccines