Influenza in the elderly: report of an outbreak and a review of vaccine effectiveness reports

Strassburg, Marc A.; Greenland, Sander; Sorvillo, Frank; Lieb, Loren; Habel, Laurel A.

doi:10.1016/s0264-410x(86)80002-0

Cited by 151 publications

(45 citation statements)

References 21 publications

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“…34 Additionally, it has been demonstrated that older age individuals tend to have a weaker immune response than younger individuals. [35][36][37] This study selected a homogenous group of patients with a hematologic malignancy (lymphoma) and confirmed the low incidence of response or efficacy of the influenza vaccine administered during the fall of 2003 (October 1 through December 20). Our sample size of lymphoma patients is too small to comment on the degree of immunosuppression caused by the various chemotherapeutic regimens used to treat this group of patients, however, given the low percentage of response it would appear that the immunosuppression, as is determined by the antibody titers measured subsequent to the vaccination, was not related to a specific regimen or agent used in treatment.…”

Section: Discussionmentioning

confidence: 75%

Efficacy of the Influenza Vaccine in Patients with Malignant Lymphoma

Mazza¹,

Yale²,

Arrowood³

et al. 2005

Clinical Medicine & Research

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Section: Discussionmentioning

confidence: 75%

Efficacy of the Influenza Vaccine in Patients with Malignant Lymphoma

Mazza¹,

Yale²,

Arrowood³

et al. 2005

Clinical Medicine & Research

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“…Two reviews and a metanalysis supp o rt this conclusion (79,80), but none of these re p o rts mentions people with diabetes as a specific population group or as part of an at-risk gro u p .…”

Section: Vaccine Effectivenessmentioning

confidence: 99%

Use of influenza and pneumococcal vaccines in people with diabetes.

2000

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R e v i e w s / C o m m e n t a r i e s / P o s i t i o n S t a t e m e n t s 96DIABETES CARE, VOLUME 23, NUMBER 1, JANUARY 2000 Technical Review that results from bacterial and viral infections such as influenza and pneumococcus.Poor antibody response has been shown to be a marker of immunologic susceptibility to infection and its sequelae (17). Immunity (as measured by in vitro opsonic activity of serum from vaccinated patients), howe v e r, has not always been correlated with level of antibody measured by radioimmunoassay (18,19). Antibody responses to the pneumococcal vaccine in people with diabetes have been examined and have been shown to be no diff e rent than in people without diabetes (20)(21)(22). Observations of i m p a i red antibody response to the influenza vaccine, in particular when there is poor metabolic control, has led some to question the value of the influenza vaccination in people with diabetes (23)(24)(25)(26).Cell-mediated abnormalities (and related humoral responses), such as d e c reased CD4/CD8 lymphocyte ratios, changes in natural killer cell function, reduced lymphocyte blastogenesis, acquire d defects in interleukin-2 production, and a reduced phagocytic function of monocytes, have all been re p o rted in people with diabetes (27-30) and could account for an i n c reased risk of infection (both bacterial and viral) and poor antibody response to vaccination. It has also been proposed that cell-mediated immunity may be a more re l iable predictor of adequate immune re s p o n s e as it relates to viral infections such as influenza infection (25).Leukocyte function is important in the p r i m a ry immune response to bacterial infections (both primary and secondary infections complicating viral infections). Poorly c o n t rolled diabetes has been associated with a l t e red granulocyte function (31-33). It appears from these studies that the complex cellular processes of bacteria engulfment and killing could be influenced by glycemic cont rol independent of active infection. Bacterial colonization, if significant, could contribute to patients' risks for complicating nosocomial infection from primary infections. Patients with diabetes have been shown to have a higher incidence of positive s u rveillance cultures (and carrier rates) for coagulase-positive S t a p h y l o c o c c u s and Gro u p B streptococci (34), whereas others have re p o rted a colonization rate for people with diabetes that is no higher than that expected for other individuals (35). Carrier status appears to be associated with glycemic cont rol (34,36). While it is tempting to speculate how colonization may have contributed to Leonard Thompson' s complicating s t a p h ylococcal pneumonia (1), it is difficult to assess colonization' s specific impact on the morbidity and mortality of disease for people with diabetes. Epidemiological evidenceT h e re are limited studies re p o rting the incidence, morbidity, and mortality of viral and bacterial infections specifically in patients with diabetes. Tables 1 and 2 summ...

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“…Influenza vaccination has been shown to be effective in 33% of vaccinated elderly persons for preventing clinical infection and in 74% for preventing mortality (4). The results of a study conducted in a nursing home demonstrated that influenza vaccination decreases significantly the gravity of infections (5).…”

mentioning

confidence: 99%