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.
Muszkat
Mordechai
M
Department of Medicine, Unit of Geriatrics, Hadassah University Hospital, PO Box 12000, 91120, Jerusalem, Israel.
Friedman
Gideon
G
Dannenberg
Haim D
HD
Greenbaum
Eugenia
E
Lipo
Mordechai
M
Heymann
Ya'acov
Y
Zakay-Rones
Zichria
Z
Ben-Yehuda
Arie
A
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