Effect of Influenza Vaccination on Hospitalization in Sakon Nakhon Province, Thailand
Article Sidebar
Main Article Content
Abstract
This study aimed to analyze risk factors for hospitalization and compare the length of hospital stay among influenza patients by conducting a secondary analysis of data from 10,187 patients in Sakon Nakhon Province between 2022 and 2024, Data were analyzed by using descriptive statistics, Multiple logistic regression, and Poisson regression analyses. The results showed that most patients were children aged 6–14 years (45.3%), and the vaccination rate was low at only 15.8%. Vaccination status was not associated with the likelihood of hospitalization (p=0.610). However, Poisson regression analysis revealed that unvaccinated patients had a hospital stay duration 2.07 times longer than vaccinated patients (Adj. IRR = 2.07, 95% CI: 1.89–2.26, p<0.001). Risk factors for hospitalization included having diabetes (AdjOR=1.35, 95% CI: 1.00–1.82, p=0.050), kidney disease (AdjOR=1.88, 95% CI: 1.05–3.36, p=0.033), and having at least one underlying disease (AdjOR=1.48, 95% CI: 1.28–1.71, p=0.001). Factors associated with longer hospitalization included diabetes (AdjIRR=1.30, p<0.001), kidney disease (AdjIRR=1.34, p=0.007), chronic obstructive pulmonary disease (AdjIRR=1.41, p=0.017), and immunocompromised conditions (AdjIRR=1.76, p=0.002). In conclusion, not receiving influenza vaccination is a significant factor prolonging hospital stay, while having underlying diseases increases both the risk of hospitalization and its duration. These findings support policies promoting influenza vaccination, especially among high-risk groups with comorbidities, to reduce disease severity and healthcare system burden.
Article Details
References
World Health Organization. Influenza (seasonal) [Internet]. 2023 [cited 2024 Oct 30]. Available from: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
Mettelman RC, Thomas PG. Human susceptibility to influenza infection and severe disease. Cold Spring Harb Perspect Med 2021; 11(5): a038711.
World Health Organization. Up to 650 000 people die of respiratory diseases linked to seasonal flu each year [Internet]. 2017 [cited 2024 Oct 30]. Available from: https://www.who.int/news/item/13-12-2017-up-to-650-000-people-die-of-respiratory-diseases-linked-to-seasonal-flu-each-year
Mertz D, Lo CK, Lytvyn L, Ortiz JR, Loeb M. Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis. BMC Infect Dis. 2019; 19(1): 683.
Bureau of Epidemiology, Department of Disease Control. Annual epidemiological surveillance report 2023. Nonthaburi: Department of Disease Control; 2024 [cited 2024 May 9]. Available from: https://apps-doe.moph.go.th/boeeng/annual/Annual/Annual%20Report%202023.pdf (in Thai)
Division of Epidemiology, Department of Disease Control. Influenza surveillance situation report, week 13 (March 24-30, 2024). Nonthaburi: Department of Disease Control; 2024 [cited 2024 May 9]. Available from: https://ddc.moph.go.th/uploads/ckeditor2//files/DOE_flu_51.2567.pdf (in Thai)
Sakon Nakhon Provincial Public Health Office. Event-based surveillance system for provinces [Internet]. 2024 [cited 2024 Oct 30]. Available from: https://ebs-ddce.ddc.moph.go.th/eventbase_prov/event/showevent/event_id/6494 (in Thai)
Courville C, Cadarette SM, Wissinger E, Alvarez FP. The economic burden of influenza among adults aged 18 to 64: a systematic literature review. Influenza Other Respir Viruses 2022; 16(3): 376-85.
Samsudin EZ, Yasin SM, Ruslan NH, Abdullah NN, Noor AFA, Hair AFA. Socioeconomic impacts of airborne and droplet-borne infectious diseases on industries: a systematic review. BMC Infect Dis 2024; 24(1): 93.
Grohskopf LA, Ferdinands JM, Blanton LH, Broder KR, Loehr J. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices - United States, 2024-25 influenza season. MMWR Recomm Rep 2024; 73(5): 1-25.
National Health Security Office. Influenza vaccination program report [Internet]. 2024 [cited 2024 Oct 30]. Available from: https://ddc.moph.go.th/uploads/publish/1530720240213072811.pdf (in Thai)
Ferdinands JM, Thompson MG, Blanton L, Spencer S, Grant L, Fry AM. Does influenza vaccination attenuate the severity of breakthrough infections? A narrative review and recommendations for further research. Vaccine 2021; 39(28): 3678-95.
World Health Organization. Clinical practice guidelines for influenza [Internet]. Geneva: World Health Organization; 2024 [cited 2024 Oct 15]. 62 p. Available from: https://iris.who.int/bitstream/handle/10665/378872/9789240097759-eng.pdf?sequence=1
Sakon Nakhon Provincial Public Health Office. 43-files database of Sakon Nakhon province: health service data and disease surveillance system;2024. (in Thai)
World Health Organization. Influenza (Seasonal) [Internet]. Geneva: WHO; 2023 [cited 2024 Jan 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
Ministry of Public Health. Guidelines for the implementation of the influenza vaccination immunization program. Nonthaburi: Division of General Communicable Diseases, Department of Disease Control; 2023. (in Thai)
Allard R, Leclerc P, Tremblay C, Tannenbaum TN. Diabetes and the severity of pandemic influenza A (H1N1) infection. Diabetes Care 2010; 33(7): 1491-3.
Gilbertson DT, Unruh M, McBean AM, Kausz AT, Snyder JJ, Collins AJ. Influenza vaccine delivery and effectiveness in end-stage renal disease. Kidney Int. 2003; 63(2): 738-43.
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: f5061.
Mulpuru S, Li L, Ye L, Hatchette T, Andrew MK, Ambrose A, et al. Effectiveness of influenza vaccination on hospitalizations and risk factors for severe outcomes in hospitalized patients with COPD. Chest 2019; 155(1): 69-78.
Miron VD, Sândulescu O, Streinu-Cercel A, Chiru A, Demetrian A, Bar G, et al. Age, comorbidity burden and late presentation are significant predictors of hospitalization length and acute respiratory failure in patients with influenza. Sci Rep 2024; 14(1): 15563.
Kuo S, Fleming J, Grosso J, et al. Predictors of influenza diagnosis among patients with laboratory- confirmed influenza. BMC Infect Dis 2021; 21: 1092.
Pelosi P, Ball L, Barbas CSV, Belliato M, Berger D, Bover-Bauza C, et al. Early management of patients with influenza-like syndrome in the Global Hospital Influenza Network: a multinational, observational study. BMC Infect Dis 2020; 20: 200.
Lee N, Choi KW, Chan PKS, et al. Outcomes of adults hospitalized with severe influenza. Thorax. 2020; 75(8): 654-62.
Restivo V, Costantino C, Bono S, Maniglia M, Marchese V, Ventura G, et al. Influenza vaccine effectiveness in reducing severe outcomes over six influenza seasons, a case-case analysis, Italy, 2011/12 to 2016/17. Euro Surveill 2018; 23(43): 1800401.
Praphasiri P, Ditsungnoen D, Greenbaum A, et al. Effectiveness of influenza vaccine against influenza- associated hospitalizations among elderly adults in Thailand, 2016-2018. Vaccine 2020; 38(33): 5199-5207.
Jackson ML, Nelson JC. The test-negative design for estimating influenza vaccine effectiveness. Vaccine 2013; 31(17): 2165-8.
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(8): 942-51.
