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Unvaccinated patients hit hardest by severe influenza this season
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During this year’s influenza season, patients with the most severe infections and those who required admission to the ICU for influenza were not vaccinated with influenza vaccine, according to recent study findings published in the American Journal Respiratory and Critical Care Medicine.
“Our observations are important because they reinforce a growing body of evidence that the influenza vaccine provides protection from severe illness requiring hospitalizations,” Cameron Wolfe, MD, an assistant professor of medicine at Duke University Medical Center, said in a press release. “The public health implications are important because not only could a potentially deadly infection be avoided with a $30 shot, but costly hospitalizations could also be reduced.”
Wolfe and colleagues evaluated the first 55 patients aged 2 months to 101 years (median age, 28.5 years) who were treated for influenza from Nov. 1 to Jan. 8 to determine whether patients who required ICU admission were less likely to have been vaccinated. Overall, 48 patients were infected with the 2009 H1N1 virus. Thirteen patients had been vaccinated at least 2 weeks before illness onset.
“We observed a high percentage of hospitalized patients for influenza requiring ICU level care, which appears higher than observed in our hospital during the 2009 pandemic flu season,” John W. Hollingsworth, MD, associate professor of medicine at Duke University Medical Center, said in the release. “It remains unclear whether the high rate of ICU admissions represents a diagnosis bias or whether the severity of illness being caused by the current H1N1 virus is higher.”
Of 33 patients admitted to regular wards, 11 had been vaccinated compared with two patients requiring ICU admission. The two patients admitted to the ICU had comorbid conditions: one patient had chronic lymphocytic leukemia and was assigned rituximab (Rituxan, Genentech/Idec); and the other had hepatitis C with a history of ethanol abuse and was admitted to the ICU overnight for alcohol withdrawal.
“Together, our observations during this influenza season support a high prevalence of the H1N1 virus affecting young adults and requiring ICU care, high false-negative rates of rapid flu tests, and delay in starting antiviral treatment,” Wolfe said. “Added to the finding of very low vaccination rates among both hospitalized and ICU admission, our observations support previous findings that vaccination reduces the severity of disease, and vaccinations should be encouraged as recommended by the US CDC.”
Disclosure: The study was funded in part by the NIH.
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