title: Additive preventive effect of influenza and pneumococcal vaccines in the elderly: results of a large cohort study.
abstract: Elderly people are at increased risk of influenza and pneumococcal diseases. Influenza increases clinical pneumococcal disease incidence. Pneumococcal vaccination could therefore be a supplement to influenza vaccination. This study evaluated all-cause mortality and antibiotic consumption according to elderly people's influenza and pneumococcal vaccination status. Its goal was to demonstrate that vaccination with both Influenza and pneumococcal vaccines decrease all-cause mortality and antibiotic consumption. From 2004-10-01 to 2004-12-31 (3 mo), elderly people (≥ 65 y) who lived in the Gard department (South of France) were offered both vaccinations. Among the 68,897 subjects followed-up one year after this vaccination campaign, 21,303 (30.9%) were vaccinated with both vaccines, 18,651 (27.1%) with influenza vaccine alone, 3,769 (5.5%) with pneumococcal vaccine alone; 25,174 (36.5%) subjects were unvaccinated. Mortality rate (per 1,000 inhabitants-year) adjusted on gender, age and prior underlying chronic disease was 17.9 (95% CI: 16.3-19.6), 20.8 (19.0-22.8), 22.5 (19.0-26.6) and 24.7 (22.7-26.8), respectively. It was 42.1 (38.8-45.8) in elderly people with underlying chronic disease who received both vaccines vs. 58.1 (53.7-62.9) in unvaccinated elderly people. The decrease in mortality rate was 27.0% (20.0-34.0) in subjects who received both vaccines and 16.0% (6.0-24.0) in those who received influenza vaccine. No significant reduction in mortality rate was seen with the pneumococcal vaccine alone. Influenza and/or pneumococcal vaccinations did not decrease antibiotic consumption that drastically increases during the winter period. An additive effect was observed in the prevention of all-cause mortality with influenza and pneumococcal vaccines given together in elderly people, including in those with underlying chronic disease.
authors: Infectious Diseases and Tropical Medicine Department, Cayenne General Hospital, Cayenne, French Guiana. mahamataba@gmail.com
authors: Aba
authors: A
authors: Mahamat
authors: Jean-Pierre
authors: JP
authors: Daurès
authors: Benoît
authors: B
authors: de Wzieres
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D016019:Survival Analysis
chemical_list: D000900:Anti-Bacterial Agents; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines
keywords: 23-valent pneumococcal capsular polysaccharide vaccine; additive effect; cohort study; elderly; influenza vaccine; treatment outcome