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. 2016 Apr 15;213(8):1216-23.
doi: 10.1093/infdis/jiv457. Epub 2015 Oct 28.

Impact of Statins on Influenza Vaccine Effectiveness Against Medically Attended Acute Respiratory Illness

Saad B Omer  1 , Varun K Phadke  2 , Robert A Bednarczyk  3 , Allison T Chamberlain  4 , Jennifer L Brosseau  4 , Walter A Orenstein  5
Affiliations

Impact of Statins on Influenza Vaccine Effectiveness Against Medically Attended Acute Respiratory Illness

Saad B Omer et al. J Infect Dis. .

Abstract

Background: Statins have antiinflammatory effects that may impact vaccine-induced immune responses. We investigated the impact of statin therapy on influenza vaccine effectiveness (VE) against medically attended acute respiratory illness (MAARI).

Methods: We conducted a retrospective cohort study over nine influenza seasons using research databases of a large managed care organization in the United States. Influenza vaccination and statin prescription statuses of cohort members and MAARI cases were ascertained on a per-season basis. Incidence rate ratios (IRRs) of MAARI were estimated using Poisson regression and stratified by statin use. Using a ratio of ratios approach, we compared IRRs from periods during to IRRs from periods before influenza circulation and then used relative IRRs to compute VE.

Results: After adjustment for multiple prespecified covariates, the influenza VE against MAARI was lower among statin users than nonusers during periods of local (14.1% vs 22.9%; mean difference, 11.4%; 95% confidence interval [CI], -1.7% to 26.1%) and widespread (12.6% vs 26.2%; mean difference, 18.4%; 95% CI, 2.9%-36.2%) influenza circulation.

Conclusions: In this study, statin therapy was associated with reduced influenza VE against MAARI. Since many cases of MAARI are not caused by influenza, studies of the impact of statins on influenza VE against laboratory-confirmed influenza are needed.

Keywords: inflammation; influenza; medically attended acute respiratory illness; statin; vaccine effectiveness.

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Figures

Figure 1.
Figure 1.
Vaccine effectiveness (VE), stratified by period of influenza circulation and statin (S) exposure status. A, Unadjusted estimates for VE among S users (S+) and non–S users (S–). B, Mean difference in unadjusted VE between S– and S+, by period of influenza circulation. C, Adjusted estimates for VE among S+ and S–. D, Mean difference in adjusted VE between S– and S+, by period of influenza circulation.
Figure 2.
Figure 2.
Effect of sex on vaccine effectiveness (VE), stratified by period of influenza circulation and statin (S) use. A, Unadjusted estimates for VE among S users (S+) and non–S users (S–). B, Mean difference in unadjusted VE between S– and S+, by period of influenza circulation. C, Adjusted estimates for VE among S+ and S–. D, Mean difference in adjusted VE between S– and S+, by period of influenza circulation.
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