title: Influenza vaccination and risk of hospitalization among adults with laboratory confirmed influenza illness.
abstract: BACKGROUND
  Influenza vaccine is moderately effective for preventing influenza illness. It is not known if vaccination reduces the risk of subsequent hospital admission among patients with vaccine failure and laboratory confirmed influenza illness.
  
  
  METHODS
  Patients in a community cohort presenting with acute respiratory illness were prospectively enrolled and tested for influenza during 8 seasons to estimate seasonal vaccine effectiveness. Hospital admissions within 14 days after illness onset were identified for all participants aged ≥20 years with laboratory confirmed influenza. The association between vaccination and hospital admission was examined in a propensity score adjusted logistic regression model. The model was validated by examining the association between vaccination and hospital admission in participants without influenza.
  
  
  RESULTS
  Influenza was identified in 1393 (28%) of 4996 participants. Sixty-two (6%) of 1020 with influenza A and 17 (5%) of 369 with influenza B were hospitalized. Vaccination was not associated with a reduced risk of hospital admission among all participants with influenza [adjusted odds ratio (aOR)=1.08; 95% CI: 0.62, 1.88]; or among those with influenza A (aOR=1.35; 95% CI: 0.71, 2.57) or influenza B (aOR=0.67; 95% CI: 0.21, 2.15). Influenza vaccination was not associated with hospitalization after non-influenza respiratory illness (aOR=1.14; 95% CI: 0.84, 1.54).
  
  
  CONCLUSIONS
  Influenza vaccination did not reduce the risk of subsequent hospital admission among patients with vaccine failure. These findings do not support the hypothesis that vaccination mitigates influenza illness severity.
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, WI, USA. Electronic address: mclean.huong@marshfieldclinic.org.
authors.forename: Huong Q
authors.initials: HQ
authors.lastname: McLean
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, WI, USA.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Meece
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, WI, USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Belongia
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Effectiveness; Hospitalization; Influenza vaccine; Severity