The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Relation between Influenza Vaccination and Outpatient Visits, Hospitalization, and Mortality in Elderly Persons with Chronic Lung Disease

Kristin L. Nichol, MD, MPH; Leslie Baken, MD; and Andrew Nelson, MPH
[+] Article, Author, and Disclosure Information

From the Veterans Affairs Medical Center and the University of Minnesota Medical School, Minneapolis, Minnesota; and HealthPartners and Group Health Foundation, Bloomington, Minnesota.

Ann Intern Med. 1999;130(5):397-403. doi:10.7326/0003-4819-130-5-199903020-00003
Text Size: A A A

Background: Influenza vaccine is underused in groups targeted for vaccination.

Objective: To define the effects of influenza and the benefits of influenza vaccination in elderly persons with chronic lung disease.

Design: Retrospective, multiseason cohort study.

Setting: Large managed care organization.

Patients: All elderly members of a managed care organization who had a previous diagnosis of chronic lung disease.

Measurements: Outcomes in vaccinated and unvaccinated persons for the 1993-1994, 1994-1995, and 1995-1996 influenza seasons were compared after adjustment for baseline demographic and health characteristics. All data were obtained from administrative databases.

Results: Vaccination rates were greater than 70% for each season. Among unvaccinated persons, hospitalization rates for pneumonia and influenza were twice as high in the influenza seasons as they were in the interim (noninfluenza) periods. Influenza vaccination was associated with fewer hospitalizations for pneumonia and influenza (adjusted risk ratio, 0.48 [95% CI, 0.28 to 0.82]) and with lower risk for death (adjusted odds ratio, 0.30 [CI, 0.21 to 0.43]) during the influenza seasons. It was also associated with fewer outpatient visits for pneumonia and influenza and for all respiratory conditions.

Conclusions: For elderly persons with chronic lung disease, influenza is associated with significant adverse health effects and influenza vaccination is associated with substantial health benefits, including fewer outpatient visits, fewer hospitalizations, and fewer deaths. Health care providers should take advantage of all opportunities to immunize these high-risk patients.


Grahic Jump Location
Hospitalizations for pneumonia and influenza. Top.Bottom.

Observed annualized rates of hospitalization for pneumonia and influenza among vaccinated and unvaccinated persons for each study period. Adjusted risk ratios for hospitalization for pneumonia and influenza by study period, comparing unvaccinated with vaccinated persons. The point estimates and 95% CIs are shown.

Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.