Decline in influenza-associated mortality among Dutch elderly following the introduction of a nationwide vaccination program

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
Vaccine (Impact Factor: 3.62). 09/2008; 26(44):5567-74. DOI: 10.1016/j.vaccine.2008.08.003
Source: PubMed


With a retrospective nationwide cohort study in the Netherlands over 1992-2003, using mortality and viral surveillance data, the aim was to assess by means of rate difference methods the influenza-associated mortality in the elderly before and after the introduction of a nationwide influenza vaccination program in 1996 (vaccination coverage raised from below 50 to 80%). The average annual influenza-associated mortality declined in the years before and after the introduction from 131 to 105 per 100,000 persons (relative risk 0.80). The decline was largest in the age group 65-69 years (relative risk 0.54) and less in those aged 75 years and older. Validation by Serfling-type regression analysis revealed similar results. In conclusion, routine influenza vaccination among Dutch elderly was associated with a significant decrease in influenza-associated mortality, notably in those aged 65-69 years.

Download full-text


Available from: Eelko Hak, Oct 06, 2015
24 Reads
  • Source
    • "In some regions, the lack of harmonization of vaccination strategies and of selection of high-risk populations has contributed to insufficient vaccination coverage of some target groups [9,42]. Some studies have shown that nationwide vaccination programs maybe a better strategy to decrease influenza-associated mortality in the elderly [45,46]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Vaccination against influenza is considered the most important public health intervention to prevent unnecessary hospitalizations and premature deaths related to influenza in the elderly, though there are significant inequities among global influenza vaccine resources, capacities, and policies. The objective of this study was to assess the social determinants of health preventing adults ≥65 years old from accessing and accepting seasonal influenza vaccination. Methods A systematic search was performed in January 2011 using MEDLINE, ISI – Web of Science, PsycINFO, and CINAHL (1980–2011). Reference lists of articles were also examined. Selection criteria included qualitative and quantitative studies written in English that examined social determinants of and barriers against seasonal influenza vaccination among adults≥65 years. Two authors performed the quality assessment and data extraction. Thematic analysis was the main approach for joint synthesis, using identification and juxtaposition of themes associated with vaccination. Results Overall, 58 studies were analyzed. Structural social determinants such as age, gender, marital status, education, ethnicity, socio-economic status, social and cultural values, as well as intermediary determinants including housing-place of residence, behavioral beliefs, social influences, previous vaccine experiences, perceived susceptibility, sources of information, and perceived health status influenced seasonal influenza vaccination. Healthcare system related factors including accessibility, affordability, knowledge and attitudes about vaccination, and physicians’ advice were also important determinants of vaccination. Conclusions Our results demonstrate that the ability of adults ≥65 years to receive seasonal influenza vaccine is influenced by structural, intermediate, and healthcare-related social determinants which have an impact at the health system, provider, and individual levels.
    BMC Public Health 04/2013; 13(1):388. DOI:10.1186/1471-2458-13-388 · 2.26 Impact Factor
  • Source
    • "Differences in the analysis methodology, a limited number of subjects, and variability in influenza attack rates from season to season have resulted in variable and often conflicting conclusions [10] [11] [12]. While some studies claim a definite benefit from influenza vaccination of older adults, others question the benefit of vaccination, and point to a 'healthy vaccine bias' that may confound the results of many large analyses [13] [14] [15]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Influenza is an important contributor to morbidity and mortality worldwide. Accumulation of genetic mutations termed antigenic drift, allows influenza viruses to inflict yearly epidemics that may result in 250,000 to 500,000 deaths annually. Over 90% of influenza-related deaths occur in the older adult population. This is at least in part a result of increasing dysregulation of the immune system with age, termed immunosenescence. This dysregulation results in reduced capacity to cope with infections and decreased responsiveness to vaccination. The older adult population is in dire need of improved vaccines capable of eliciting protective responses in the face of a waning immune system. This review focuses on the status of immunity, responses to influenza vaccination, and strategies that are currently being explored to elicit enhanced immune responses in this high risk population.
    Aging and Disease 02/2012; 3(1):68-90. · 3.07 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A CMOS voltage-to-current converter with exponential characteristic is presented in this paper. The concept of Taylor series expansion is used for realizing the exponential characteristic. The proposed exponential V-I converter is composed of a current-to-current squarer and a linear V-I converter with the use of linearization technique. Based on a 0.25 μm CMOS process, simulations show a 23 dB of linear-output current range and the linearity within 20 dB with error less than ±0.5dB is achieved. The total power consumption is below 0.2 mW with 1.25 V supply voltage. The proposed circuit can be used for the design of an extremely low-voltage low-power variable gain amplifier (VGA).
    Low Power Electronics and Design, 2003. ISLPED '03. Proceedings of the 2003 International Symposium on; 09/2003
Show more