Volume 18, Number 8—August 2012
CME ACTIVITY
Vaccination of Health Care Workers to Protect Patients at Increased Risk for Acute Respiratory Disease
Gayle P. Dolan
, Rebecca C. Harris, Mandy Clarkson, Rachel Sokal, Gemma Morgan, Mitsuru Mukaigawara, Hiroshi Horiuchi, Rachel Hale, Laura Stormont, Laura Béchard-Evans, Yi-Sheng Chao, Sergey Eremin, Sara Martins, John S. Tam, Javier Peñalver, Arina Zanuzdana, and Jonathan S. Nguyen-Van-Tam
, Rebecca C. Harris, Mandy Clarkson, Rachel Sokal, Gemma Morgan, Mitsuru Mukaigawara, Hiroshi Horiuchi, Rachel Hale, Laura Stormont, Laura Béchard-Evans, Yi-Sheng Chao, Sergey Eremin, Sara Martins, John S. Tam, Javier Peñalver, Arina Zanuzdana, and Jonathan S. Nguyen-Van-TamTable 5
Measures of death in a review of the vaccination of health care workers to protect patients at risk for acute respiratory disease*
| Outcome measure and study | Study design | Method of assessment | Measure of effect in patient population | Effect estimate (95% CI), p value |
|---|---|---|---|---|
| All-cause mortality | ||||
| Potter et al. (25) | Cluster RCT | Death certificate | OR, vaccinated and nonvaccinated patients | 0.56 (0.40–0.80)† |
| OR, vaccinated patients | 0.57 (0.35–0.91)† | |||
| OR, nonvaccinated patients | 0.56 (0.34–0.94)† | |||
| Carman et al. (24) | Cluster RCT | Not stated | OR | 0.62 (0.36–1.04), p = 0.092 |
| Hayward et al. (27) | Cluster RCT | Reporting by lead nurse | Rate difference, epidemic period 1 | –0.05 (–0.07 to –0.02), p = 0.002 |
| Rate difference, epidemic period 2 | –0.01 (–0.04 to 0.02), p = 0.49 | |||
| Rate difference, nonepidemic period 1 | 0.00 (–0.03 to 0.03), p = 0.93 | |||
| Rate difference, nonepidemic period 2 | 0.01 (–0.03 to 0.04), p = 0.70 | |||
| Lemaitre et al. (26) | Cluster RCT | Not stated | OR | 0.86 (0.72–1.02), p = 0.08 |
| Thomas et al. (19) | Pooled data | OR, adjusted for clustering | 0.68 (0.55–0.84), p<0.001 | |
| Respiratory deaths: Lemaitre et al. (26) | Cluster RCT | Reporting by study nurses | OR | 1.55 (0.59–4.10), p = 0.38 |
| Pneumonia-associated deaths | ||||
| Potter et al. (25) | Cluster RCT | Reporting by lead nurse | OR, vaccinated and nonvaccinated patients | 0.60 (0.37–0.97)† |
| OR, vaccinated patients | 0.56 (0.28–1.13)† | |||
| OR, nonvaccinated patients | 0.64 (0.33–1.23)† | |||
| Thomas et al. (19) | Pooled data | Risk ratio, adjusted for clustering | 0.87 (0.47–1.64), p = 0.67 | |
| Death with influenza-like illness | ||||
| Hayward et al. (27) | Cluster RCT | Reporting by lead nurse | Rate difference, epidemic period 1 | –0.01 (–0.02 to 0.01), p = 0.24 |
| Rate difference, epidemic period 2 | –0.01 (–0.03 to 0.00), p = 0.08 | |||
| Rate difference, nonepidemic period 1 | –0.01 (–0.04 to 0.02), p = 0.59 | |||
| Rate difference, nonepidemic period 2 | 0.01 (–0.01 to 0.02), p = 0.35 | |||
| Thomas et al. (19) | Pooled data | OR, adjusted for clustering | 0.72 (0.31–1.70), p = 0.45 | |
| Laboratory-diagnosed influenza at death: Carman et al. (24) | Cluster RCT | Nasal swab within 12 h before death | Difference in proportions, influenza positive at death | 20%, p = 0.055 |
*RCT, randomized controlled trial; OR, odds ratio. Boldface indicates statistical significance. Shaded fields represent pooled data.
†p value not reported.
