Assessment of potential adverse events following the 2022-2023 seasonal influenza vaccines among U.S. adults aged 65 years and older.

Adverse events Anaphylaxis Concomitant vaccination Influenza vaccine Vaccine safety

Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
03 May 2024
Historique:
received: 03 10 2023
revised: 11 04 2024
accepted: 16 04 2024
medline: 5 5 2024
pubmed: 5 5 2024
entrez: 4 5 2024
Statut: aheadofprint

Résumé

While safety of influenza vaccines is well-established, some studies have suggested potential associations between influenza vaccines and certain adverse events (AEs). This study examined the safety of the 2022-2023 influenza vaccines among U.S. adults ≥ 65 years. A self-controlled case series compared incidence rates of anaphylaxis, encephalitis/encephalomyelitis, Guillain-Barré Syndrome (GBS), and transverse myelitis following 2022-2023 seasonal influenza vaccinations (i.e., any, high-dose or adjuvanted) in risk and control intervals among Medicare beneficiaries ≥ 65 years. We used conditional Poisson regression to estimate incidence rate ratios (IRRs) and 95 % confidence intervals (CIs) adjusted for event-dependent observation time and seasonality. Analyses also accounted for uncertainty from outcome misclassification where feasible. For AEs with any statistically significant associations, we stratified results by concomitant vaccination status. Among 12.7 million vaccine recipients, we observed 76 anaphylaxis, 276 encephalitis/encephalomyelitis, 134 GBS and 75 transverse myelitis cases. Only rates of anaphylaxis were elevated in risk compared to control intervals. With all adjustments, an elevated, but non-statistically significant, anaphylaxis rate was observed following any (IRR: 2.40, 95% CI: 0.96-6.03), high-dose (IRR: 2.31, 95% CI: 0.67-7.91), and adjuvanted (IRR: 3.28, 95% CI: 0.71-15.08) influenza vaccination; anaphylaxis IRRs were 2.54 (95% CI: 0.49-13.05) and 1.64 (95% CI: 0.38-7.05) for persons with and without concomitant vaccination, respectively. Rates of encephalitis/encephalomyelitis, GBS, or transverse myelitis were not elevated following 2022-2023 seasonal influenza vaccinations among U.S. adults ≥ 65 years. There was an increased rate of anaphylaxis following influenza vaccination that may have been influenced by concomitant vaccination.

Sections du résumé

BACKGROUND BACKGROUND
While safety of influenza vaccines is well-established, some studies have suggested potential associations between influenza vaccines and certain adverse events (AEs). This study examined the safety of the 2022-2023 influenza vaccines among U.S. adults ≥ 65 years.
METHODS METHODS
A self-controlled case series compared incidence rates of anaphylaxis, encephalitis/encephalomyelitis, Guillain-Barré Syndrome (GBS), and transverse myelitis following 2022-2023 seasonal influenza vaccinations (i.e., any, high-dose or adjuvanted) in risk and control intervals among Medicare beneficiaries ≥ 65 years. We used conditional Poisson regression to estimate incidence rate ratios (IRRs) and 95 % confidence intervals (CIs) adjusted for event-dependent observation time and seasonality. Analyses also accounted for uncertainty from outcome misclassification where feasible. For AEs with any statistically significant associations, we stratified results by concomitant vaccination status.
RESULTS RESULTS
Among 12.7 million vaccine recipients, we observed 76 anaphylaxis, 276 encephalitis/encephalomyelitis, 134 GBS and 75 transverse myelitis cases. Only rates of anaphylaxis were elevated in risk compared to control intervals. With all adjustments, an elevated, but non-statistically significant, anaphylaxis rate was observed following any (IRR: 2.40, 95% CI: 0.96-6.03), high-dose (IRR: 2.31, 95% CI: 0.67-7.91), and adjuvanted (IRR: 3.28, 95% CI: 0.71-15.08) influenza vaccination; anaphylaxis IRRs were 2.54 (95% CI: 0.49-13.05) and 1.64 (95% CI: 0.38-7.05) for persons with and without concomitant vaccination, respectively.
CONCLUSIONS CONCLUSIONS
Rates of encephalitis/encephalomyelitis, GBS, or transverse myelitis were not elevated following 2022-2023 seasonal influenza vaccinations among U.S. adults ≥ 65 years. There was an increased rate of anaphylaxis following influenza vaccination that may have been influenced by concomitant vaccination.

Identifiants

pubmed: 38704258
pii: S0264-410X(24)00478-X
doi: 10.1016/j.vaccine.2024.04.051
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Xiangyu Chianti Shi (XC)

Acumen LLC, Burlingame, CA, USA. Electronic address: xshi@acumenllc.com.

Joann F Gruber (JF)

U.S. Food and Drug Administration, Silver Spring, MD, USA. Electronic address: Joann.Gruber@fda.hhs.gov.

Michelle Ondari (M)

Acumen LLC, Burlingame, CA, USA. Electronic address: mondari@acumenllc.com.

Patricia C Lloyd (PC)

U.S. Food and Drug Administration, Silver Spring, MD, USA. Electronic address: Patricia.Lloyd@fda.hhs.gov.

Pablo Freyria Duenas (P)

Acumen LLC, Burlingame, CA, USA. Electronic address: pduenas@acumenllc.com.

Tainya C Clarke (TC)

U.S. Food and Drug Administration, Silver Spring, MD, USA. Electronic address: Tainya.Clarke@fda.hhs.gov.

Gita Nadimpalli (G)

Acumen LLC, Burlingame, CA, USA. Electronic address: gnadimpalli@acumenllc.com.

Sylvia Cho (S)

U.S. Food and Drug Administration, Silver Spring, MD, USA. Electronic address: Sylvia.Cho@fda.hhs.gov.

Laurie Feinberg (L)

Acumen LLC, Burlingame, CA, USA. Electronic address: lfeinberg@acumenllc.com.

Mao Hu (M)

Acumen LLC, Burlingame, CA, USA. Electronic address: mhu@acumenllc.com.

Yoganand Chillarige (Y)

Acumen LLC, Burlingame, CA, USA. Electronic address: ychillarige@acumenllc.com.

Jeffrey A Kelman (JA)

Centers for Medicare & Medicaid Services, Washington, DC, USA. Electronic address: Jeffrey.Kelman@cms.hhs.gov.

Richard A Forshee (RA)

U.S. Food and Drug Administration, Silver Spring, MD, USA. Electronic address: Richard.Forshee@fda.hhs.gov.

Steven A Anderson (SA)

U.S. Food and Drug Administration, Silver Spring, MD, USA. Electronic address: Steven.Anderson@fda.hhs.gov.

Azadeh Shoaibi (A)

U.S. Food and Drug Administration, Silver Spring, MD, USA. Electronic address: Azadeh.Shoaibi@fda.hhs.gov.

Classifications MeSH