Epidemiological evidence for association between higher influenza vaccine uptake in the elderly and lower COVID‐19 deaths in Italy

Marín‐Hernández, Daniela; Schwartz, Robert E.; Nixon, Douglas F.

doi:10.1002/jmv.26120

Cited by 165 publications

(194 citation statements)

References 4 publications

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“…Contrary to expectations, the present worldwide analysis and European sub-analysis do not support the previously reported negative association between COVID-19 deaths (DPMI) and IVR in elderly people, observed in studies in Brazil and Italy (Fink et al, 2020;Marín-Hernández, Schwartz & Nixon, 2020). Previous studies attributed the beneficial effect of influenza vaccination in reducing severity of COVID-19 disease to better Table 4 Spearman correlations (r s ) of COVID-19 deaths per million inhabitants (DPMI) with nine predictor variables.…”

Section: Discussioncontrasting

confidence: 99%

“…Arokiaraj (2020) reported a negative correlation between influenza vaccination rates (IVRs) and COVID-19 related mortality and morbidity. Marín-Hernández, Schwartz & Nixon (2020) also showed epidemiological evidence of an association between higher influenza vaccine uptake by elderly people and lower percentage of COVID-19 deaths in Italy. In a study analyzing 92,664 clinically and molecularly confirmed COVID-19 cases in Brazil, Fink et al (2020) reported that patients who received a recent flu vaccine experienced on average 17% lower odds of death.…”

Section: Introductionmentioning

confidence: 85%

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Positive association between COVID-19 deaths and influenza vaccination rates in elderly people worldwide

Wehenkel¹

2020

PeerJ

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Background The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing global health crisis, directly and indirectly impacting all spheres of human life. Some pharmacological measures have been proposed to prevent COVID-19 or reduce its severity, such as vaccinations. Previous reports indicate that influenza vaccination appears to be negatively correlated with COVID-19-associated mortality, perhaps as a result of heterologous immunity or changes in innate immunity. The understanding of such trends in correlations could prevent deaths from COVID-19 in the future. The aim of this study was therefore to analyze the association between COVID-19 related deaths and influenza vaccination rate (IVR) in elderly people worldwide. Methods To determine the association between COVID-19 deaths and influenza vaccination, available data sets from countries with more than 0.5 million inhabitants were analyzed (in total 39 countries). To accurately estimate the influence of IVR on COVID-19 deaths and mitigate effects of confounding variables, a sophisticated ranking of the importance of different variables was performed, including as predictor variables IVR and some potentially important geographical and socioeconomic variables as well as variables related to non-pharmaceutical intervention. The associations were measured by non-parametric Spearman rank correlation coefficients and random forest functions. Results The results showed a positive association between COVID-19 deaths and IVR of people ≥65 years-old. There is a significant increase in COVID-19 deaths from eastern to western regions in the world. Further exploration is needed to explain these findings, and additional work on this line of research may lead to prevention of deaths associated with COVID-19.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 85%

Positive association between COVID-19 deaths and influenza vaccination rates in elderly people worldwide

Wehenkel¹

2020

PeerJ

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“…In an ecological study carried out at a county-level in the American elderly population, an inverse association between influenza vaccination coverage rate and deaths attributable to COVID-19 was reported [33]. A similar association was found in an Italian ecological study, although through performing an unadjusted analysis [34]. In our study, we corroborate and extend these observations by showing, in the Italian population, a potential protective role of influenza vaccination on COVID-19 mortality also after adjusting the data for a variety of potential confounders.…”

Section: Discussionsupporting

confidence: 61%

“…To the best of our knowledge, only a few studies have examined the relationship between influenza vaccination and COVID-19 outcomes [32][33][34]. In an ecological study carried out at a county-level in the American elderly population, an inverse association between influenza vaccination coverage rate and deaths attributable to COVID-19 was reported [33].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Influenza Vaccination Coverage Rate and COVID-19 Outbreak: An Italian Ecological Study

et al. 2020

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Background: The lack of specific vaccines or drugs against coronavirus disease 2019 (COVID-19) warrants studies focusing on alternative clinical approaches to reduce the spread of this pandemic disease. In this study, we investigated whether anti-influenza vaccination plays a role in minimizing the diffusion of COVID-19 in the Italian population aged 65 and over. Methods: Four COVID-19 outcomes were used: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence, hospitalizations for COVID-19 symptoms, admissions to intensive care units for reasons related to SARS-CoV-2, and deaths attributable to COVID-19. Results: At univariate analyses, the influenza vaccination coverage rates correlated negatively with all COVID-19 outcomes (Beta ranging from −134 to −0.61; all p < 0.01). At multivariable analyses, influenza vaccination coverage rates correlated independently with SARS-CoV-2 seroprevalence (Beta (95% C.I.): −130 (−198, −62); p = 0.001), hospitalizations for COVID-19 symptoms (Beta (95% C.I.): −4.16 (−6.27, −2.05); p = 0.001), admission to intensive care units for reasons related to SARS-CoV-2 (Beta (95% C.I.): −0.58 (−1.05, −0.12); p = 0.017), and number of deaths attributable to COVID-19 (Beta (95% C.I.): −3.29 (−5.66, −0.93); p = 0.010). The R2 observed in the unadjusted analysis increased from 82% to 159% for all the considered outcomes after multivariable analyses. Conclusions: In the Italian population, the coverage rate of the influenza vaccination in people aged 65 and over is associated with a reduced spread and a less severe clinical expression of COVID-19. This finding warrants ad hoc studies to investigate the role of influenza vaccination in preventing the spread of COVID-19.

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“…To be eligible for inclusion, an article had to be an original report based on individual-level data; studies relying on aggregated data (e.g. ecological studies reporting correlations [2][3]) were not retained because of their higher proneness to bias and confounding. Letters and commentaries with no original data were discarded as well.…”

Section: Manuscript Textmentioning

confidence: 99%

The association between influenza vaccination and the risk of SARS-CoV-2 infection, severe illness, and death: a systematic review of the literature

Riccio

Lorini

Bonaccorsi

et al. 2020

Preprint

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We reviewed the association between seasonal influenza vaccination and the risk of SARS-CoV-2 infection or complicated illness or poor outcome (e.g. severe disease, need for hospitalization or ventilatory support, or death) among COVID-19 patients. None of the studies that were reviewed (n=12) found a significant increase in the risk of infection or in the illness severity or lethality, while some reported significantly inverse associations. Our findings support measures aimed at raising influenza vaccination coverage in the coming months.

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Epidemiological evidence for association between higher influenza vaccine uptake in the elderly and lower COVID‐19 deaths in Italy

Cited by 165 publications

References 4 publications

Positive association between COVID-19 deaths and influenza vaccination rates in elderly people worldwide

Positive association between COVID-19 deaths and influenza vaccination rates in elderly people worldwide

Relationship between Influenza Vaccination Coverage Rate and COVID-19 Outbreak: An Italian Ecological Study

The association between influenza vaccination and the risk of SARS-CoV-2 infection, severe illness, and death: a systematic review of the literature

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