title: Effect of Statin Use on Influenza Vaccine Effectiveness.
abstract: Recent studies suggest that statin use may reduce influenza vaccine effectiveness (VE), but laboratory-confirmed influenza was not assessed.
  
  
  
  Patients ≥45 years old presenting with acute respiratory illness were prospectively enrolled during the 2004-2005 through 2014-2015 influenza seasons. Vaccination and statin use were extracted from electronic records. Respiratory samples were tested for influenza virus.
  
  
  
  The analysis included 3285 adults: 1217 statin nonusers (37%), 903 unvaccinated statin nonusers (27%), 847 vaccinated statin users (26%), and 318 unvaccinated statin users (10%). Statin use modified VE and the risk of influenza A(H3N2) virus infection (P = .002) but not 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) or influenza B virus infection (P = .2 and .4, respectively). VE against influenza A(H3N2) was 45% (95% confidence interval [CI], 27%-59%) among statin nonusers and -21% (95% CI, -84% to 20%) among statin users. Vaccinated statin users had significant protection against influenza A(H1N1)pdm09 (VE, 68%; 95% CI, 19%-87%) and influenza B (VE, 48%; 95% CI, 1%-73%). Statin use did not significantly modify VE when stratified by prior season vaccination. In validation analyses, the use of other cardiovascular medications did not modify influenza VE.
  
  
  
  Statin use was associated with reduced VE against influenza A(H3N2) but not influenza A(H1N1)pdm09 or influenza B. Further research is needed to assess biologic plausibility and confirm these results.
authors.affiliation: Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Huong Q
authors.initials: HQ
authors.lastname: McLean
authors.affiliation: Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Brian D W
authors.initials: BD
authors.lastname: Chow
authors.affiliation: Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: VanWormer
authors.affiliation: Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: King
authors.affiliation: Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Wisconsin.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Belongia
mesh_terms: D000368:Aged; D004347:Drug Interactions / Q000276:immunology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012621:Seasons; D014611:Vaccination / Q000379:methods
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007252:Influenza Vaccines
keywords: influenza; influenza vaccine; statin; vaccine effectiveness