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Reduced Hospitalizations and Death Associated With Influenza Vaccination Among Patients With and Without Diabetes

  1. Anthony D. Heymann, MB, MHA12,
  2. Yonaton Shapiro, MD1,
  3. Gabriel Chodick, PHD, MHA12,
  4. Varda Shalev, MD1,
  5. Ehud Kokia, MD, MHA12,
  6. Eyal Kramer, MD1 and
  7. Joshua Shemer, MD, MHA12
  1. 1Maccabi Health Services, Tel Aviv, Israel
  2. 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  1. Address correspondence and reprint requests to Dr. A.D. Heymann, BSc, MB, MS, MRCGP, MHA, Maccabi Healthcare Services, 27 HaMered St., Tel Aviv, Israel. E-mail: heymann_t{at}mac.org.il

Abstract

OBJECTIVE—To assess whether the influenza vaccination of community-dwelling, diabetic, elderly individuals is associated with reduced rates of hospitalization and death.

RESEARCH DESIGN AND METHODS—In this outcome-research study, we compared mortality and hospitalization rates of 15,556 patients aged ≥65 years followed using a diabetes registry in a large health maintenance organization to that of 69,097 members not suffering from chronic disease who were considered as a reference group. The study outcomes included all-cause death and hospitalization in internal medicine or geriatric wards for any reason over winter and summer (control) periods.

RESULTS—Vaccination rates were 48.8 and 42.0% among patients with diabetes and the reference population, respectively. Influenza vaccination was associated with a 12.3% reduction in hospitalization rates for patients with diabetes compared with 23.0% in the reference group (P = 0.08). The reduction in hospitalization rates was similar in both sexes among patients with diabetes. In addition, there was a significant reduction in mortality for the vaccinated group of patients with diabetes when compared with the nonvaccinated group except for female patients aged ≥85 years.

CONCLUSIONS—The study results support the use of influenza vaccine among an elderly population. However, there does not appear to be an additional benefit for patients with diabetes.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted August 2, 2004.
    • Received March 4, 2004.
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