Absence of association between 2019–20 influenza vaccination and COVID-19: results of the European I-MOVE-COVID-19 primary care project, March–August 2020

Abstract

Background Claims of influenza vaccination increasing COVID-19 risk are circulating. Within the I-MOVE-COVID-19 primary care multicentre study, we measured the association between 2019–20 influenza vaccination and COVID-19. Methods We conducted a multicentre test-negative case-control study at primary care level, in study sites in five European countries, from March–August 2020. Patients presenting with acute respiratory infection were swabbed, with demographic, 2019–20 influenza vaccination and clinical information documented. Using logistic regression we measured the adjusted odds ratio (aOR), adjusting for study site and age, sex, calendar time, presence of chronic conditions. The main analysis included patients swabbed ≤7 days after onset from the three countries with <15% of missing influenza vaccination. In secondary analyses, we included five countries, using multiple imputation with chained equations to account for missing data. Results We included 257 COVID-19 cases and 1631 controls in the main analysis (three countries). The overall aOR between influenza vaccination and COVID-19 was 0.93 (95% CI: 0.66–1.32). The aOR was 0.92 (95% CI: 0.58–1.46) and 0.92 (95%CI: 0.51–1.67) among those aged 20–59 and ≥60 years, respectively. In secondary analyses, we included 6457 cases and 69272 controls. The imputed aOR was 0.87 (95% CI: 0.79–0.95) among all ages and any delay between swab and symptom onset. Conclusions There was no evidence that COVID-19 cases were more likely to be vaccinated against influenza than controls. Influenza vaccination should be encouraged among target groups for vaccination. I-MOVE-COVID-19 will continue documenting influenza vaccination status in 2020-21, in order to learn about effects of recent influenza vaccination.

Association between influenza vaccination and SARS-CoV-2 infection and its outcomes: systematic review and meta-analysis

“…Of the 92 full-text articles identified, 58 were excluded because they did not meet the inclusion criteria, and two others were obtained from the references. The remaining 36 articles reported on 55,996,841 subjects outcomes were included in this analysis [21–56] . None of the participants had received COVID-19 vaccination during the study period.…”

Influenza and pneumococcal vaccination and the risk of COVID-19: A systematic review and meta-analysis

“…Influenza and COVID-19 are different respiratory viral diseases that can be clinically indistinguishable and co-exist at the same period. Some preliminary studies suggest some protection against SARS-CoV-2 to be conferred from vaccination to other pathogens such as influenza [14] while others have produced contrasting result [39]. There is also a limited number of studies that examined the association of the pneumococcal vaccine with the risk of developing SARS-CoV-2 infection and disease severity or risk of death on COVID-19 patients.…”

“…The booster Bacillus Calmette-Guérin (BCG) vaccine was suggested, by many studies and even by a meta-analysis, to have beneficial effects on preventing COVID-19 infection [11][12][13]. Some preliminary studies suggest some protection against SARS-CoV-2 to be conferred from vaccination to other pathogens such as influenza [14] while others have produced contrasting results [15]. In this regard, we conducted a systematic review and meta-analysis to assess the overall association between influenza and pneumococcal vaccination and SARS-CoV-2 infection.…”

Recombinant adjuvanted zoster vaccine and reduced risk of COVID-19 diagnosis and hospitalization in older adults

“…A similar reduction in risk of COVID-19 infection and severe disease has been reported following receipt of influenza vaccine in several studies [16][17][18], although this association was not observed in other studies. [19][20][21][22][23] A prior study at KPSC found a reduction in risk of COVID-19 diagnosis and severe disease associated with receipt of 13-valent pneumococcal conjugate vaccine (PCV13) but not with receipt of influenza vaccine. [24] Interestingly, in a sensitivity analysis among the subset of individuals who received influenza vaccine but no other vaccines, we found that receipt of RZV was still associated with a similar reduction in risk of COVID-19 diagnosis and hospitalization, suggesting that influenza vaccination or healthy vaccinee bias had minimal impact on our findings.…”