Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct 15;214(8):1150-8.
doi: 10.1093/infdis/jiw335. Epub 2016 Jul 28.

Effect of Statin Use on Influenza Vaccine Effectiveness

Huong Q McLean  1 , Brian D W Chow  1 , Jeffrey J VanWormer  1 , Jennifer P King  1 , Edward A Belongia  1
Affiliations

Effect of Statin Use on Influenza Vaccine Effectiveness

Huong Q McLean et al. J Infect Dis. .

Abstract

Background: Recent studies suggest that statin use may reduce influenza vaccine effectiveness (VE), but laboratory-confirmed influenza was not assessed.

Methods: Patients ≥45 years old presenting with acute respiratory illness were prospectively enrolled during the 2004-2005 through 2014-2015 influenza seasons. Vaccination and statin use were extracted from electronic records. Respiratory samples were tested for influenza virus.

Results: The analysis included 3285 adults: 1217 statin nonusers (37%), 903 unvaccinated statin nonusers (27%), 847 vaccinated statin users (26%), and 318 unvaccinated statin users (10%). Statin use modified VE and the risk of influenza A(H3N2) virus infection (P = .002) but not 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) or influenza B virus infection (P = .2 and .4, respectively). VE against influenza A(H3N2) was 45% (95% confidence interval [CI], 27%-59%) among statin nonusers and -21% (95% CI, -84% to 20%) among statin users. Vaccinated statin users had significant protection against influenza A(H1N1)pdm09 (VE, 68%; 95% CI, 19%-87%) and influenza B (VE, 48%; 95% CI, 1%-73%). Statin use did not significantly modify VE when stratified by prior season vaccination. In validation analyses, the use of other cardiovascular medications did not modify influenza VE.

Conclusions: Statin use was associated with reduced VE against influenza A(H3N2) but not influenza A(H1N1)pdm09 or influenza B. Further research is needed to assess biologic plausibility and confirm these results.

Keywords: influenza; influenza vaccine; statin; vaccine effectiveness.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Characteristics of individuals enrolled from the 2004–2005 through 2014–2015 influenza seasons, excluding the 2009–2010 season.
Figure 2.
Figure 2.
Adjusted vaccine effectiveness (aVE) and adjusted odd ratios (aORs), by influenza virus subtype. Models were adjusted for age, diabetes, cardiovascular disease, chronic pulmonary disease, prior pneumococcal vaccination, and influenza season. A, Influenza A(H3N2) virus. Seasons included 2004–2005, 2007–2008, 2011–2012, 2012–2013, and 2014–2015. B, 2009 Pandemic influenza A(H1N1) virus. Season included 2013–2014. C, Influenza B virus. Seasons included 2007–2008, 2012–2013, and 2014–2015. Abbreviation: CI, confidence interval.
Figure 3.
Figure 3.
Adjusted vaccine effectiveness (aVE) and adjusted odd ratios (aORs), by prior season vaccination status for influenza A(H3N2) virus. Influenza seasons included 2004–2005, 2007–2008, 2011–2012, 2012–2013, and 2014–2015. Models adjusted for age, diabetes, cardiovascular disease, chronic pulmonary disease, prior pneumococcal vaccination, and influenza season. A, No prior season vaccination. B, Prior season vaccination. Abbreviation: CI, confidence interval.
Figure 4.
Figure 4.
Adjusted vaccine effectiveness (aVE) and adjusted odd ratios (aORs) for influenza A(H3N2) virus, by statin type. Influenza seasons included 2004–2005, 2007–2008, 2011–2012, 2012–2013, and 2014–2015. Models were adjusted for age, diabetes, cardiovascular disease, chronic pulmonary disease, prior pneumococcal vaccination, and influenza season. A, Synthetic statin. B, Nonsynthetic statin. Abbreviation: CI, confidence interval.
See this image and copyright information in PMC

Comment in

References

    1. Black S, Nicolay U, Del Giudice G, Rappuoli R. Influence of Statins on Influenza Vaccine Response in Elderly Individuals. J Infect Dis 2016; 213:1224–8. - PubMed
    1. Omer SB, Phadke VK, Bednarczyk RA, Chamberlain AT, Brosseau JL, Orenstein WA. Impact of Statins on Influenza Vaccine Effectiveness Against Medically Attended Acute Respiratory Illness. J Infect Dis 2016; 213:1216–23. - PMC - PubMed
    1. VanWormer JJ, Bateman AC, Irving SA, Kieke BA, Shay DK, Belongia EA. Reply to Fedson. J Infect Dis 2014; 209:1301–2. - PubMed
    1. Belongia EA, Kieke BA, Donahue JG et al. . Effectiveness of inactivated influenza vaccines varied substantially with antigenic match from the 2004–2005 season to the 2006–2007 season. J Infect Dis 2009; 199:159–67. - PubMed
    1. Belongia EA, Kieke BA, Donahue JG et al. . Influenza vaccine effectiveness in Wisconsin during the 2007–08 season: comparison of interim and final results. Vaccine 2011; 29:6558–63. - PubMed

Publication types

Substances