Effect of influenza vaccination on excess deaths occurring during periods of high circulation of influenza: cohort study in elderly people.
OBJECTIVE
To estimate the protection against death provided by vaccination against influenza.


METHODS
Prospective cohort follow up supplemented by weekly national counts of influenza confirmed in the community.


METHODS
Primary care.


METHODS
24,535 patients aged over 75 years from 73 general practices in Great Britain.


METHODS
Death.


RESULTS
In unvaccinated members of the cohort daily all cause mortality was strongly associated with an index of influenza circulating in the population (mortality ratio 1.16, 95% confidence interval 1.04 to 1.29 at 90th centile of circulating influenza). The association was strongest for respiratory deaths but was also present for cardiovascular deaths. In contrast, in vaccinated people mortality from any cause was not associated with circulating influenza. The difference in patterns between vaccinated and unvaccinated people could not easily be due to chance (P = 0.02, all causes).


CONCLUSIONS
This study, using a novel and robust approach to control for confounding, provides robust evidence of a protective effect on mortality of vaccination against influenza.
London School of Hygiene and Tropical Medicine, London WC1E 7HT. ben.armstrong@lshtm.ac.uk
Ben G
BG
Armstrong
Punam
P
Mangtani
Astrid
A
Fletcher
Sari
S
Kovats
Anthony
A
McMichael
Sam
S
Pattenden
Paul
P
Wilkinson
D000368:Aged; D015331:Cohort Studies; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000401:mortality / Q000517:prevention & control*; D011446:Prospective Studies; D012044:Regression Analysis; D006113:United Kingdom / Q000453:epidemiology; D014611:Vaccination / Q000401:mortality
D007252:Influenza Vaccines