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Primary Prevention of Acute CV Events by Influenza Vaccine
Quick Takes
- Individuals with both raised and low cardiovascular (CV) risk had a reduced incidence of a first acute CV event after influenza vaccination.
- The reduced incidence was largest in the 15–28 days after vaccination but persisted to 120 days.
- These and other available data suggest that improved influenza vaccine uptake could help reduce the risk of first acute CV events.
Study Questions:
What is the association between influenza vaccination and acute cardiovascular (CV) events, considering individual CV risk?
Methods:
The investigators used linked Clinical Practice Research Datalink, Hospital Episode Statistics Admitted Patient Care, and Office for National Statistics mortality data from England between September 1, 2008–August 31, 2019. From the data, individuals aged 40–84 years with a first acute CV event and influenza vaccination occurring within 12 months of each September were selected. Using a self-controlled case series analysis, season-adjusted CV risk stratified incidence ratios (IRs) for CV events after vaccination compared with baseline time before and >120 days after vaccination were generated. The authors calculated IRs using conditional Poisson regression for acute CV events occurring within each risk period stratum compared with baseline and adjusted for season using the binary classification of warm months (April–September) and cool months (October–March).
Results:
A total of 193,900 individuals with a first acute CV event and influenza vaccine were included. 105,539 had hypertension and 172,050 had a QRISK2 score ≥10%. In the main analysis, acute CV event risk was reduced in the 15–28 days after vaccination (IR, 0.72; 95% confidence interval, 0.70–0.74) and, while the effect size tapered, remained reduced to 91–120 days after vaccination (0.83 [0.81–0.88]). Reduced CV events were seen after vaccination among individuals of all age groups and with raised and low CV risk.
Conclusions:
The authors report that the influenza vaccine may offer CV benefit among individuals at varying CV risk.
Perspective:
This study reports that individuals with both raised and low CV risk had a reduced incidence of a first acute CV event after influenza vaccination after adjusting for season. Of note, the reduced incidence was largest in the 15–28 days after vaccination but persisted to 120 days. Furthermore, the protective effect was evident across all age groups in the main analyses but was confined to those ≥65 years in the final sensitivity analysis with follow-up from vaccination date. These and other available data suggest that improved influenza vaccine uptake could help reduce the risk of first acute CV events among those eligible to receive the seasonal influenza vaccine.
Clinical Topics: Geriatric Cardiology, Prevention, Hypertension
Keywords: Cardiovascular Diseases, Geriatrics, Hypertension, Influenza Vaccines, Influenza, Human, Primary Prevention, Risk Factors, Seasons, Vaccination, Vascular Diseases
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