Self-reported influenza vaccination and protective serum antibody titers in a cohort of COPD patients
| Autor: | Åsne Jul-Larsen, Jon A. Hardie, Rebecca Jane Cox, Thomas Blix Grydeland, Tomas Mikal Eagan, Per Bakke |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Exacerbation Comorbidity Antibodies Viral Cohort Studies Pulmonary Disease Chronic Obstructive 03 medical and health sciences Influenza A Virus H1N1 Subtype 0302 clinical medicine Internal medicine Influenza Human medicine Humans 030212 general & internal medicine Mortality Aged COPD Norway Proportional hazards model business.industry Influenza A Virus H3N2 Subtype Smoking Vaccination Hazard ratio Antibody titer Hemagglutination Inhibition Tests Middle Aged medicine.disease respiratory tract diseases 030228 respiratory system Influenza Vaccines Cohort Immunology Female Seasons Self Report business Cohort study |
| Zdroj: | Europe PubMed Central |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/j.rmed.2016.04.008 |
| Popis: | Background COPD patients are advised vaccination against seasonal influenza, yet few studies have evaluated the protective antibody titers obtained in this patient group. Aims 1) To describe protective titers in COPD patients who self-reported influenza vaccination compared with vaccinated subjects without COPD and unvaccinated COPD patients, 2) analyze whether clinical parameters predicted influenza-specific antibody titers, and 3) whether antibody titers to influenza A at baseline could predict exacerbation risk or 5 years all-cause mortality. Methods Influenza A (H1N1 and H3N2) titers were measured by haemagglutination inhibition assay in serum from 432 COPD patients and 77 controls in the Bergen COPD Cohort Study, at yearly visits between 2006/09. Titers of 40 or above were considered protective. We examined the variables sex, age, body composition, smoking, GOLD stage, yearly exacerbations, inhaled steroids, and Charlson score as predictive of titers, both univariately and in a multivariable model estimated by generalized estimating equations. The exacerbation incidence rate ratios and mortality hazard ratios were assessed by negative binominal and cox regression models respectively. Results At baseline, 59% of COPD patients reported influenza vaccination during the last season. Levels of predictive titers varied considerably each season, but trended lower in COPD patients compared with controls. Neither sex, age, body composition, smoking, comorbidities, GOLD stage nor use of inhaled steroids consistently predicted titers. Having high titers at baseline did not impact later risk for exacerbations, but seemed to be associated with higher all-cause mortality, even after adjustment for COPD disease characteristics. Conclusion Vaccination coverage for influenza is imperfect for COPD patients in Norway, and there is a concern that immunization is suboptimal. |
| Databáze: | OpenAIRE |
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