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Volume 26, Number 6—June 2020
CME ACTIVITY - Research

Statin Use and Influenza Vaccine Effectiveness in Persons ≥ 65 Years of Age, Taiwan

Lung-Wen Tsai1, Yung-Tai Chen1, Chia-Jen Shih, Shuo-Ming OuComments to Author , Pei-Wen Chao, and Shih-Hsiu LoComments to Author 
Author affiliations: Taipei Medical University Hospital, Taipei, Taiwan (L.-W. Tsai, P.-W. Chao, S.-H. Lo); Taipei City Hospital, Taipei (Y.-T. Chen); University of Taipei, Taipei (Y.-T, Chen); National Yang-Ming University, Taipei (Y.-T. Chen, C.-J. Shih, S.-M. Ou); Taipei Veterans General Hospital, Taipei (S.-M. Ou)

Main Article

Table 1

Characteristics of persons >65 who received influenza vaccine versus those who did not receive influenza vaccine, Taiwan*

Characteristics Before propensity score-matching
Propensity score-matched
Vaccinated Unvaccinated Standardized difference Vaccinated Unvaccinated Standardized difference
No. patients
3,417,212
6,010,180


3,165,272
3,165,272

Mean age, y (SD)
74.3 (6.4)
73.6 (6.8)
0.100

74.2 (6.4)
74.2 (6.9)
–0.002
Sex
M 1,707,483 (50.0) 2,908,606 (48.4) 0.031 1,559,852 (49.3) 1,550,848 (49.0) 0.006
F
1,709,729 (50.0)
3,101,574 (51.6)


1,605,420 (50.7)
1,614,424 (51.0)

Monthly income, $ Taiwan
Dependent† 1,234,769 (36.1) 2,527,696 (42.1) –0.122 1,190,930 (37.6) 1,197,102 (37.8) –0.004
<19,100 794,513 (23.3) 1,365,600 (22.7) 0.013 728,908 (23.0) 721,281 (22.8) 0.006
19,100–41,999 1,367,022 (40.0) 2,054,058 (34.2) 0.121 1,224,632 (38.7) 1,226,438 (38.7) –0.001
>42,000
20,908 (0.6)
62,826 (1.0)
–0.048

20,802 (0.7)
20,451 (0.6)
0.001
Urbanization‡
Level 1 988,136 (28.9) 1,833,258 (30.5) –0.035 926,242 (29.3) 925,049 (29.2) 0.001
Level 2 2,194,465 (64.2) 3,793,218 (63.1) 0.023 2,025,556 (64.0) 2,025,109 (64.0) 0.000
Level 3 199,301 (5.8) 320,751 (5.3) 0.022 180,635 (5.7) 181,562 (5.7) –0.001
Level 4
35,310 (1.0)
62,953 (1.0)
–0.001

32,839 (1.0)
33,552 (1.1)
–0.002
No. outpatient visits in the previous 12 mo
0–10 504,028 (14.7) 1,831,616 (30.5) –0.383 504,014 (15.9) 500,316 (15.8) 0.003
11–20 869,805 (25.5) 1,598,542 (26.6) –0.026 851,438 (26.9) 854,335 (27.0) –0.002
21–30 776,389 (22.7) 1,106,821 (18.4) 0.107 719,783 (22.7) 721,771 (22.8) –0.001
31–40 522,170 (15.3) 651,142 (10.8) 0.132 462,035 (14.6) 462,408 (14.6) 0.000
>40
744,820 (21.8)
822,059 (13.7)
0.214

628,002 (19.8)
626,442 (19.8)
0.001
CCI score (SD)§
7.7 (2.8)
7.2 (2.8)
0.236

7.8 (2.8)
7.8 (2.9)
–0.006
Underlying conditions
Cerebrovascular disease 1,151,954 (33.7) 1,703,465 (28.3) 0.116 1,047,165 (33.1) 1,052,107 (33.2) –0.003
Diabetes 1,377,596 (40.3) 2,000,525 (33.3) 0.146 1,246,943 (39.4) 1,252,696 (39.6) –0.004
Hypertension 2,568,836 (75.2) 3,931,874 (65.4) 0.215 2,344,103 (74.1) 2,351,157 (74.3) –0.005
CAD 1,672,350 (48.9) 2,340,127 (38.9) 0.203 1,520,516 (48.0) 1,447,015 (45.7) 0.047
Myocardial infarction 158,688 (4.6) 228,094 (3.8) 0.042 143,777 (4.5) 144,573 (4.6) –0.001
PVD 238,514 (7.0) 324,691 (5.4) 0.065 217,314 (6.9) 210,393 (6.6) 0.009
Heart failure 555,349 (16.3) 792,171 (13.2) 0.087 503,135 (15.9) 506,674 (16.0) –0.003
Dyslipidemia 1,557,151 (45.6) 2,231,936 (37.1) 0.172 1,436,998 (45.4) 1,340,441 (42.3) 0.062
Chronic liver disease 1,067,001 (31.2) 1,460,809 (24.3) 0.155 950,911 (30.0) 951,575 (30.1) 0.000
CKD 664,324 (19.4) 917,408 (15.3) 0.110 596,302 (18.8) 597,911 (18.9) –0.001
Peptic ulcer disease 1,904,442 (55.7) 2,764,223 (46.0) 0.196 1,720,590 (54.4) 1,723,618 (54.5) –0.002
Dementia 249,766 (7.3) 370,758 (6.2) 0.045 228,856 (7.2) 231,226 (7.3) –0.003
Valvular heart disease 424,657 (12.4) 596,580 (9.9) 0.079 383,055 (12.1) 384,592 (12.2) –0.001
Drug abuse 48,591 (1.4) 74,326 (1.2) 0.016 45,499 (1.4) 45,816 (1.4) –0.001
Atrial fibrillation
160,148 (4.7)
235,626 (3.9)
0.038

146,674 (4.6)
147,989 (4.7)
–0.002
Medications
Antiplatelet agents 559,272 (16.4) 735,104 (12.2) 0.118 491,897 (15.5) 493,185 (15.6) –0.001
Insulin 42,022 (1.2) 58,973 (1.0) 0.024 38,581 (1.2) 38,823 (1.2) –0.001
Oral diabetic drugs 399,409 (11.7) 552,935 (9.2) 0.081 358,531 (11.3) 361,189 (11.4) –0.003
Diuretics 301,500 (8.8) 420,868 (7.0) 0.067 270,816 (8.6) 272,637 (8.6) –0.002
Calcium channel blockers 651,895 (19.1) 892,880 (14.9) 0.113 580,984 (18.4) 583,106 (18.4) –0.002
Beta-blockers 413,542 (12.1) 583,937 (9.7) 0.077 371,599 (11.7) 372,374 (11.8) –0.001
ACEI/ARB 508,701 (14.9) 719,943 (12.0) 0.085 459,520 (14.5) 461,934 (14.6) –0.002
Statins
167,188 (4.9)
249,822 (4.2)
0.035

155,133 (4.9)
155,624 (4.9)
–0.001
Propensity score 0.42 (0.13) 0.33 (0.14) 0.662 0.406 (0.129) 0.406 (0.129) 0.000

*Values are no. (%) except as indicated. ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; CAD, coronary artery disease; CCI, Charlson Comorbidity Index; CKD, chronic kidney disease; PVD, peripheral vascular disease.
†Dependent persons are those without an income.
‡Urbanization levels in Taiwan are divided into 4 strata according to the Taiwan National Health Research Institute publications. Level 1 designates the most urbanized areas, and level 4 designates the least urbanized areas.
§CCI score is used to determine overall systemic health. Increased CCI scores are indicative of stepwise increases in the cumulative mortality.

Main Article

1These authors contributed equally to this study.

Page created: May 15, 2020
Page updated: May 15, 2020
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