Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 26, Number 8—August 2020
Research

Analysis of MarketScan Data for Immunosuppressive Conditions and Hospitalizations for Acute Respiratory Illness, United States

Manish PatelComments to Author , Jufu Chen, Sara Kim, Shikha Garg, Brendan Flannery, Zaid Haddadin, Danielle Rankin, Natasha Halasa, H. Keipp Talbot, and Carrie Reed
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M. Patel, J. Chen, S. Kim, S. Garg, B. Flannery, C. Reed); Vanderbilt University, Nashville, Tennessee, USA (Z. Haddadin, D. Rankin, N. Halasa, H. Keipp Talbot)

Main Article

Table 6

Age-specific influenza vaccination coverage and relative rates of coverage in enrollees with and without immunosuppressive conditions in MarketScan database, United States, July 2012–-August 2017

Age, y* Vaccine coverage, %
 Relative rate of vaccination, immunosuppressed versus nonimmunosuppressed, % (95% CI)
Immunosuppressed Nonimmunosuppressed
>1–8 60.1 58.3 1.24 (1.23–1.25)
9–17 47.2 40.5 1.30 (1.29–1.30)
18–49 20.9 14.7 1.72 (1.71–1.73)
50–64 28.9 23.9 1.47 (1.46–1.48)
>65 30.3 27.9 1.27 (1.26–1.28)

*MarketScan vaccination data probably underestimate true influenza vaccine coverage in the population particularly for persons >65 years of age because not all vaccinations are billed to insurance companies (24). Relative rates of vaccination between immunosuppressed and nonimmunosuppressed should not be affected.

Main Article

References
  1. Rolfes  MA, Flannery  B, Chung  JR, O’Halloran  A, Garg  S, Belongia  EA, et al.; US Influenza Vaccine Effectiveness (Flu VE) Network, the Influenza Hospitalization Surveillance Network, and the Assessment Branch, Immunization Services Division, Centers for Disease Control and Prevention. Effects of Influenza Vaccination in the United States During the 2017-2018 Influenza Season. Clin Infect Dis. 2019;69:1845–53. DOIPubMedGoogle Scholar
  2. Vilchez  RA, McCurry  K, Dauber  J, Lacono  A, Griffith  B, Fung  J, et al. Influenza virus infection in adult solid organ transplant recipients. Am J Transplant. 2002;2:287–91. DOIPubMedGoogle Scholar
  3. Memoli  MJ, Athota  R, Reed  S, Czajkowski  L, Bristol  T, Proudfoot  K, et al. The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts. Clin Infect Dis. 2014;58:214–24. DOIPubMedGoogle Scholar
  4. Bersanelli  M, Buti  S, De Giorgi  U, Di Maio  M, Giannarelli  D, Pignata  S, et al. State of the art about influenza vaccination for advanced cancer patients receiving immune checkpoint inhibitors: When common sense is not enough. Crit Rev Oncol Hematol. 2019;139:87–90. DOIPubMedGoogle Scholar
  5. Rubin  LG, Levin  MJ, Ljungman  P, Davies  EG, Avery  R, Tomblyn  M, et al.; Infectious Diseases Society of America. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58:309–18. DOIPubMedGoogle Scholar
  6. Harpaz  R, Dahl  RM, Dooling  KL. Prevalence of immunosuppression among US adults, 2013. JAMA. 2016;316:2547–8. DOIPubMedGoogle Scholar
  7. Satcher Johnson  A, Song  R, Hall  HI. Estimated HIV incidence, prevalence, and undiagnosed infections in US states and Washington, DC, 2010–2014. J Acquir Immune Defic Syndr. 2017;76:116–22. DOIPubMedGoogle Scholar
  8. Miller  KD, Nogueira  L, Mariotto  AB, Rowland  JH, Yabroff  KR, Alfano  CM, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69:363–85. DOIPubMedGoogle Scholar
  9. Grohskopf  LA, Sokolow  LZ, Broder  KR, Walter  EB, Fry  AM, Jernigan  DB. Prevention and control of seasonal influenza with vaccines: recommendations of the advisory committee on immunization practices—United States, 2018–19 influenza season. MMWR Recomm Rep. 2018;67:1–20. DOIPubMedGoogle Scholar
  10. Belongia  EA, Simpson  MD, King  JP, Sundaram  ME, Kelley  NS, Osterholm  MT, et al. Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. Lancet Infect Dis. 2016;16:942–51. DOIPubMedGoogle Scholar
  11. Beck  CR, McKenzie  BC, Hashim  AB, Harris  RC, Nguyen-Van-Tam  JS; University of Nottingham Influenza and the ImmunoCompromised (UNIIC) Study Group. Influenza vaccination for immunocompromised patients: systematic review and meta-analysis by etiology. J Infect Dis. 2012;206:1250–9. DOIPubMedGoogle Scholar
  12. Blanchette  PS, Chung  H, Pritchard  KI, Earle  CC, Campitelli  MA, Buchan  SA, et al. Influenza vaccine effectiveness among patients with cancer: a population-based study using health administrative and laboratory testing data From Ontario, Canada. J Clin Oncol. 2019;37:2795–804. DOIPubMedGoogle Scholar
  13. Nichols  MK, Andrew  MK, Hatchette  TF, Ambrose  A, Boivin  G, Bowie  W, et al.; Serious Outcomes Surveillance Network of the Canadian Immunization Research Network (CIRN), the Toronto Invasive Bacterial Diseases Network (TIBDN). Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: A pooled analysis from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS Network). Vaccine. 2018;36:2166–75. DOIPubMedGoogle Scholar
  14. Vaccines against influenza WHO position paper – November 2012. Wkly Epidemiol Rec. 2012;87:461–76.PubMedGoogle Scholar
  15. DiazGranados  CA, Dunning  AJ, Kimmel  M, Kirby  D, Treanor  J, Collins  A, et al. Efficacy of high-dose versus standard-dose influenza vaccine in older adults. N Engl J Med. 2014;371:635–45. DOIPubMedGoogle Scholar
  16. Durando  P, Icardi  G, Ansaldi  F. MF59-adjuvanted vaccine: a safe and useful tool to enhance and broaden protection against seasonal influenza viruses in subjects at risk. Expert Opin Biol Ther. 2010;10:639–51. DOIPubMedGoogle Scholar
  17. Food and Drug Administration. October 29, 2014 clinical review—fluzone high-dose [cited 2019 Oct 21]. https://www.fda.gov/vaccines-blood-biologics/vaccines/fluzone-fluzone-high-dose-and-fluzone-intradermal
  18. Halasa  NB, Savani  BN, Asokan  I, Kassim  A, Simons  R, Summers  C, et al. Randomized double-blind study of the safety and immunogenicity of standard-dose trivalent inactivated influenza vaccine versus high-dose trivalent inactivated influenza vaccine in adult hematopoietic stem cell transplantation patients. Biol Blood Marrow Transplant. 2016;22:528–35. DOIPubMedGoogle Scholar
  19. Natori  Y, Humar  A, Lipton  J, Kim  DD, Ashton  P, Hoschler  K, et al. A pilot randomized trial of adjuvanted influenza vaccine in adult allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant. 2017;52:1016–21. DOIPubMedGoogle Scholar
  20. Greenberg  JA, Hohmann  SF, Hall  JB, Kress  JP, David  MZ. Validation of a method to identify immunocompromised patients with severe sepsis in administrative databases. Ann Am Thorac Soc. 2016;13:253–8.PubMedGoogle Scholar
  21. Corporation  IBM. IBM Watson Health. Truven Health Analytics, 2020 [cited 2019 Oct 21]. https://truvenhealth.com/portals/0/assets/2017_MarketScan_Databases_Health_Services_Researchers.pdf
  22. Barber  C, Lacaille  D, Fortin  PR. Systematic review of validation studies of the use of administrative data to identify serious infections. Arthritis Care Res (Hoboken). 2013;65:1343–57. DOIPubMedGoogle Scholar
  23. Xu  X, Blanton  L, Elal  AIA, Alabi  N, Barnes  J, Biggerstaff  M, et al. Update: influenza activity in the United States during the 2018–19 season and composition of the 2019–20 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2019;68:544–51. DOIPubMedGoogle Scholar
  24. Havers  FP, Fry  AM, Peacock  G, Chen  J, Reed  C. Influenza vaccination coverage in children with neurologic disorders and their siblings, July 2006 to June 2014. Pediatr Infect Dis J. 2018;37:814–6. DOIPubMedGoogle Scholar
  25. Chen  DS, Mellman  I. Oncology meets immunology: the cancer-immunity cycle. Immunity. 2013;39:1–10. DOIPubMedGoogle Scholar
  26. Mok  MY, Shoenfeld  Y. Recent advances and current state of immunotherapy in systemic lupus erythematosus. Expert Opin Biol Ther. 2016;16:927–39. DOIPubMedGoogle Scholar
  27. Reynolds  G, Cooles  FA, Isaacs  JD, Hilkens  CM. Emerging immunotherapies for rheumatoid arthritis. Hum Vaccin Immunother. 2014;10:822–37. DOIPubMedGoogle Scholar
  28. Monaco  C, Nanchahal  J, Taylor  P, Feldmann  M. Anti-TNF therapy: past, present and future. Int Immunol. 2015;27:55–62. DOIPubMedGoogle Scholar
  29. Kaiser Family Foundation. State health facts, 2020 [cited 2017 Aug 21]. https://wwwkfforg/other/state-indicator/distribution-by-age/?dataView=1&currentTimeframe=0&selectedDistributions=adults-19-25–adults-26-34–adults-35-54–adults-55-64&selectedRows=%7B%22wrapups%22:%7B%22united-states%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
  30. Hijano  DR, Maron  G, Hayden  RT. Respiratory viral infections in patients with cancer or undergoing hematopoietic cell transplant. Front Microbiol. 2018;9:3097. DOIPubMedGoogle Scholar
  31. Joshi  AY, Iyer  VN, Hagan  JB, St Sauver  JL, Boyce  TG. Incidence and temporal trends of primary immunodeficiency: a population-based cohort study. Mayo Clin Proc. 2009;84:16–22. DOIPubMedGoogle Scholar
  32. Bongartz  T, Sutton  AJ, Sweeting  MJ, Buchan  I, Matteson  EL, Montori  V. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA. 2006;295:2275–85. DOIPubMedGoogle Scholar
  33. Koo  S, Marty  FM, Baden  LR. Infectious complications associated with immunomodulating biologic agents. Infect Dis Clin North Am. 2010;24:285–306. DOIPubMedGoogle Scholar
  34. Dixon  WG, Suissa  S, Hudson  M. The association between systemic glucocorticoid therapy and the risk of infection in patients with rheumatoid arthritis: systematic review and meta-analyses. Arthritis Res Ther. 2011;13:R139. DOIPubMedGoogle Scholar
  35. Radwan  HM, Cheeseman  SH, Lai  KK, Ellison  RT III. Influenza in human immunodeficiency virus-infected patients during the 1997-1998 influenza season. Clin Infect Dis. 2000;31:604–6. DOIPubMedGoogle Scholar
  36. Bosaeed  M, Kumar  D. Seasonal influenza vaccine in immunocompromised persons. Hum Vaccin Immunother. 2018;14:1311–22. DOIPubMedGoogle Scholar
  37. Hakim  H, Allison  KJ, Van de Velde  LA, Tang  L, Sun  Y, Flynn  PM, et al. Immunogenicity and safety of high-dose trivalent inactivated influenza vaccine compared to standard-dose vaccine in children and young adults with cancer or HIV infection. Vaccine. 2016;34:3141–8. DOIPubMedGoogle Scholar
  38. Jamshed  S, Walsh  EE, Dimitroff  LJ, Santelli  JS, Falsey  AR. Improved immunogenicity of high-dose influenza vaccine compared to standard-dose influenza vaccine in adult oncology patients younger than 65 years receiving chemotherapy: A pilot randomized clinical trial. Vaccine. 2016;34:630–5. DOIPubMedGoogle Scholar
  39. McKittrick  N, Frank  I, Jacobson  JM, White  CJ, Kim  D, Kappes  R, et al. Improved immunogenicity with high-dose seasonal influenza vaccine in HIV-infected persons: a single-center, parallel, randomized trial. Ann Intern Med. 2013;158:19–26. DOIPubMedGoogle Scholar
  40. McManus  M, Frangoul  H, McCullers  JA, Wang  L, O’Shea  A, Halasa  N. Safety of high dose trivalent inactivated influenza vaccine in pediatric patients with acute lymphoblastic leukemia. Pediatr Blood Cancer. 2014;61:815–20. DOIPubMedGoogle Scholar
  41. Natori  Y, Shiotsuka  M, Slomovic  J, Hoschler  K, Ferreira  V, Ashton  P, et al. A double-blind, randomized trial of high-dose vs standard-dose influenza vaccine in adult solid-organ transplant recipients. Clin Infect Dis. 2018;66:1698–704. DOIPubMedGoogle Scholar
  42. Kumar  D, Campbell  P, Hoschler  K, Hidalgo  L, Al-Dabbagh  M, Wilson  L, et al. Randomized controlled trial of adjuvanted versus nonadjuvanted influenza vaccine in kidney transplant recipients. Transplantation. 2016;100:662–9. DOIPubMedGoogle Scholar
  43. Magnani  G, Falchetti  E, Pollini  G, Reggiani  LB, Grigioni  F, Coccolo  F, et al. Safety and efficacy of two types of influenza vaccination in heart transplant recipients: a prospective randomised controlled study. J Heart Lung Transplant. 2005;24:588–92. DOIPubMedGoogle Scholar
  44. Ambati  A, Einarsdottir  S, Magalhaes  I, Poiret  T, Bodenstein  R, LeBlanc  K, et al. Immunogenicity of virosomal adjuvanted trivalent influenza vaccination in allogeneic stem cell transplant recipients. Transpl Infect Dis. 2015;17:371–9. DOIPubMedGoogle Scholar
  45. Beyer  WE, Versluis  DJ, Kramer  P, Diderich  PP, Weimar  W, Masurel  N. Trivalent influenza vaccine in patients on haemodialysis: impaired seroresponse with differences for A-H3N2 and A-H1N1 vaccine components. Vaccine. 1987;5:43–8. DOIPubMedGoogle Scholar
  46. Mertz  D, Kim  TH, Johnstone  J, Lam  PP, Science  M, Kuster  SP, et al. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. BMJ. 2013;347(aug23 1):f5061. DOIPubMedGoogle Scholar
  47. Shang  M, Chung  JR, Jackson  ML, Jackson  LA, Monto  AS, Martin  ET, et al. Influenza vaccine effectiveness among patients with high-risk medical conditions in the United States, 2012-2016. Vaccine. 2018;36:8047–53. DOIPubMedGoogle Scholar
  48. Buchan  SA, Hottes  TS, Rosella  LC, Crowcroft  NS, Tran  D, Kwong  JC. Contribution of influenza viruses to medically attended acute respiratory illnesses in children in high-income countries: a meta-analysis. Influenza Other Respir Viruses. 2016;10:444–54. DOIPubMedGoogle Scholar
  49. Kim  SC, Solomon  DH, Rogers  JR, Gale  S, Klearman  M, Sarsour  K, et al. Cardiovascular safety of tocilizumab versus tumor necrosis factor inhibitors in patients with rheumatoid arthritis: a multi-database cohort study. Arthritis Rheumatol. 2017;69:1154–64. DOIPubMedGoogle Scholar
  50. Jensen  ET, Cook  SF, Allen  JK, Logie  J, Brookhart  MA, Kappelman  MD, et al. Enrollment factors and bias of disease prevalence estimates in administrative claims data. Ann Epidemiol. 2015;25:519–525.e2. DOIPubMedGoogle Scholar

Main Article

Page created: April 29, 2020
Page updated: July 17, 2020
Page reviewed: July 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external