ประสิทธิผลของวัคซีนไข้หวัดใหญ่ขนาดสูง เปรียบเทียบกับวัคซีนไข้หวัดใหญ่ขนาดมาตรฐานในผู้สูงอายุ ในช่วง 1 ปีหลังจากได้รับวัคซีน ในโรงพยาบาลนครพิงค์  ระหว่างปี พ.ศ. 2566-2568: การศึกษาย้อนหลังแบบไขว้กลุ่ม

Winita Wajatieng; Cheerrumpa Chaiwino; Tanachart Chaichana; Thanittha Dusitakom; Patchara Kunakorntumrongruk; Yuttasak Mungmart

Authors

Winita Wajatieng Department of Social Medicine, Nakornping Hospital
Cheerrumpa Chaiwino Medical Educational Center, Nakornping Hospital
Tanachart Chaichana Medical Educational Center, Nakornping Hospital
Thanittha Dusitakom Medical Education Center, Nakornping Hospital
Patchara Kunakorntumrongruk Medical Education Center, Nakornping Hospital
Yuttasak Mungmart Medical Education Center, Nakornping Hospital

Keywords:

high-dose influenza vaccine, vaccine effectiveness, elderly

Abstract

Background: Influenza is a significant public health concern and imposes a considerable disease burden among older adults. Age-related immunosenescence limits immune responses to standard-dose influenza vaccines. High-dose influenza vaccines (HD-IV) were developed to enhance protection, but real-world evidence in the Thai setting remains limited.

Objectives: To compare the effectiveness of high-dose influenza vaccine (HD-IV), standard-dose influenza vaccine (SD-IV), and no vaccination over a 1-year period in preventing medically attended respiratory illness among older adults.

Methods: A retrospective crossover cohort study was conducted using medical records of elderly individuals (≥65 years) who had received HD-IV between July 2024 and February 2025. Influenza infection rate, OPD and IPD visit rates for respiratory illnesses in the post-vaccination period were compared with those from the corresponding period one year earlier in the same individuals, during which SD-IV or no vaccination had been received. Adjusted incidence rate ratios were estimated using multilevel mixed-effects Poisson regression

Results: A total of 628 participants were included. Within the 1-year post-vaccination period, the OPD visit rates for respiratory illnesses in the HD-IV and SD-IV groups were 92.74 and 253.07 per 1,000 person-years, respectively. HD-IV significantly reduced OPD visit rates compared to SD-IV (adjusted IRR = 0.37, 95% CI: 0.18–0.76, p = 0.006) and no vaccination (adjusted IRR = 0.52, 95% CI: 0.28–0.94, p = 0.031). No significant differences were observed for inpatient admissions or laboratory-confirmed influenza infection.

Conclusion: HD-IV demonstrated superior effectiveness over SD-IV and no vaccination in reducing outpatient visits for respiratory illness among older adults in Nakornping Hospital. It serves as an effective alternative for reducing healthcare resource utilization in high-risk populations; however, further studies are needed to confirm its long-term impact on more severe outcomes.

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