title: Vaccination Serology Status and Cardiovascular Mortality: Insight from NHANES III and Continuous NHANES.
abstract: OBJECTIVE
  Prior studies have described a negative relationship between influenza vaccination and recurrence of cardiovascular (CV) events. However, due to lack of any prior studies, we evaluated and attempted to define the relationship between non-influenza vaccines and CV mortality.
  
  
  METHODS
  We used the National Health and Nutrition Examination Survey III (NHANES III-1988-1994, n = 19,215) and Continuous NHANES (1999-2004, n > 17,000), which includes oral surveys and general examination. It was designed to assess the demographic, socioeconomic, dietary, and overall health status of a nationally representative sample in non-institutionalized patients from all 50 states in the USA. Cox proportional hazard regression modeling was used to calculate the hazard ratio of CV mortality, and multivariate models were built for the individual seropositive vaccination titers as well as after creating a combined vaccination variable.
  
  
  RESULTS
  A total of >35,000 subjects (>18 years old) have been identified for analysis. Multivariate analysis from NHANES III and continuous NHANES did not show any influence of individual seroprotective titers of routine vaccinations on CV mortality. The combined effect of vaccination in NHANES III data did not show any protective effect of three or more positive vaccination titers (odds ratio = 0.94, p = 0.6) or all four positive vaccination titers (odds ratio = 0.93, p = 0.6) with two or less positive vaccination titers as the referent group.
  
  
  CONCLUSIONS
  Effect on non-influenza vaccinations in preventing CV mortality seems to be unclear.
authors.affiliation: MedStar Washington Hospital Center , Washington, DC , USA.
authors.forename: Ankit
authors.initials: A
authors.lastname: Chothani
authors.forename: Neeraj
authors.initials: N
authors.lastname: Shah
authors.forename: Nileshkumar J
authors.initials: NJ
authors.lastname: Patel
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshmukh
authors.forename: Vikas
authors.initials: V
authors.lastname: Singh
authors.forename: Nilay
authors.initials: N
authors.lastname: Patel
authors.forename: Sidakpal S
authors.initials: SS
authors.lastname: Panaich
authors.forename: Shilpkumar
authors.initials: S
authors.lastname: Arora
authors.forename: Achint
authors.initials: A
authors.lastname: Patel
authors.forename: Chirag
authors.initials: C
authors.lastname: Savani
authors.forename: Badal
authors.initials: B
authors.lastname: Thakkar
authors.forename: Parth
authors.initials: P
authors.lastname: Bhatt
authors.forename: Mauricio G
authors.initials: MG
authors.lastname: Cohen
authors.forename: Cindy
authors.initials: C
authors.lastname: Grines
authors.forename: John K
authors.initials: JK
authors.lastname: Forrest
authors.forename: Apurva O
authors.initials: AO
authors.lastname: Badheka
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D005260:Female; D006090:Gram-Negative Bacteria / Q000276:immunology*; D006094:Gram-Positive Bacteria / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D012328:RNA Viruses / Q000276:immunology*; D012189:Retrospective Studies; D014481:United States; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral
keywords: Cardiovascular mortality; hospitalization; mortality; vaccination