Clinical efficacy of seasonal influenza vaccination : characteristics of two outbreaks of influenza A(H1N1) in immunocompromised patients

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http://hdl.handle.net/10138/302409

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Helanterä , I , Janes , R & Anttila , V-J 2018 , ' Clinical efficacy of seasonal influenza vaccination : characteristics of two outbreaks of influenza A(H1N1) in immunocompromised patients ' , Journal of Hospital Infection , vol. 99 , no. 2 , pp. 169-174 . https://doi.org/10.1016/j.jhin.2017.12.003

Title: Clinical efficacy of seasonal influenza vaccination : characteristics of two outbreaks of influenza A(H1N1) in immunocompromised patients
Author: Helanterä, I.; Janes, R.; Anttila, V-J
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Oncology
University of Helsinki, Clinicum
Date: 2018-06
Language: eng
Number of pages: 6
Belongs to series: Journal of Hospital Infection
ISSN: 0195-6701
URI: http://hdl.handle.net/10138/302409
Abstract: Background: Influenza A(H1N1) causes serious complications in immunocompromised patients. The efficacy of seasonal vaccination in these patients has been questioned. Aim: To describe two outbreaks of influenza A(H1N1) in immunocompromised patients. Methods: Two outbreaks of influenza A(H1N1) occurred in our institution: on the kidney transplant ward in 2014 including patients early after kidney or simultaneous pancreas-kidney transplantation, and on the oncology ward in 2016 including patients receiving chemotherapy for malignant tumours. Factors leading to these outbreaks and the clinical efficacy of seasonal influenza vaccination were analysed. Findings: Altogether 86 patients were exposed to influenza A(H1N1) during the outbreaks, among whom the seasonal influenza vaccination status was unknown in 10. Only three out of 38 vaccinated patients were infected with influenza A(H1N1), compared with 20 out of 38 unvaccinated patients (P = 0.02). The death of one out of 38 vaccinated patients was associated with influenza, compared with seven out of 38 unvaccinated patients (P = 0.06). Shared factors behind the two outbreaks included outdated facilities not designed for the treatment of immunosuppressed patients. Vaccination coverage among patients was low, between 40% and 70% despite vaccination being offered to all patients free of charge. Vaccination coverage of healthcare workers on the transplant ward was low (46%), but, despite high coverage on the oncology ward (92%), the outbreak occurred. Conclusion: Seasonal influenza vaccination was clinically effective with both a reduced risk of influenza infection and a trend towards reduced mortality in these immunocompromised patients. Several possible causes were identified behind these two outbreaks, requiring continuous awareness in healthcare professionals to prevent further outbreaks. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Subject: Influenza A(H1N1)
Outbreak
Seasonal
Vaccination
Epidemiology
Healthcare workers
PANDEMIC H1N1 INFLUENZA
STEM-CELL TRANSPLANT
A H1N1
KIDNEY-TRANSPLANT
HEMODIALYSIS-PATIENTS
IMMUNE-RESPONSE
RECIPIENTS
COVERAGE
CHEMOTHERAPY
INFECTIONS
3142 Public health care science, environmental and occupational health
3121 Internal medicine
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