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Multicenter Study
. 2021 Jul;15(4):429-438.
doi: 10.1111/irv.12839. Epub 2021 Jan 22.

Absence of association between 2019-20 influenza vaccination and COVID-19: Results of the European I-MOVE-COVID-19 primary care project, March-August 2020

Esther Kissling  1 , Mariëtte Hooiveld  2 , Mia Brytting  3 , Ana-Maria Vilcu  4 , Marit de Lange  5 , Iván Martínez-Baz  6 , Debbie Sigerson  7 , Theresa Enkirch  3 , Sylvie Belhillil  8 , Adam Meijer  5 , Jesus Castilla  6 , Naoma William  7 , AnnaSara Carnahan  3 , Alessandra Falchi  9 , Janneke Hendriksen  2 , Itziar Casado  6 , Josie Murray  7 , Vincent Enouf  8 , Frederika Dijkstra  5 , Diogo F P Marques  1   7 , Marta Valenciano  1
Affiliations
Multicenter Study

Absence of association between 2019-20 influenza vaccination and COVID-19: Results of the European I-MOVE-COVID-19 primary care project, March-August 2020

Esther Kissling et al. Influenza Other Respir Viruses. 2021 Jul.

Abstract

Background: Claims of influenza vaccination increasing COVID-19 risk are circulating. Within the I-MOVE-COVID-19 primary care multicentre study, we measured the association between 2019-20 influenza vaccination and COVID-19.

Methods: We conducted a multicentre test-negative case-control study at primary care level, in study sites in five European countries, from March to August 2020. Patients presenting with acute respiratory infection were swabbed, with demographic, 2019-20 influenza vaccination and clinical information documented. Using logistic regression, we measured the adjusted odds ratio (aOR), adjusting for study site and age, sex, calendar time, presence of chronic conditions. The main analysis included patients swabbed ≤7 days after onset from the three countries with <15% of missing influenza vaccination. In secondary analyses, we included five countries, using multiple imputation with chained equations to account for missing data.

Results: We included 257 COVID-19 cases and 1631 controls in the main analysis (three countries). The overall aOR between influenza vaccination and COVID-19 was 0.93 (95% CI: 0.66-1.32). The aOR was 0.92 (95% CI: 0.58-1.46) and 0.92 (95% CI: 0.51-1.67) among those aged 20-59 and ≥60 years, respectively. In secondary analyses, we included 6457 cases and 69 272 controls. The imputed aOR was 0.87 (95% CI: 0.79-0.95) among all ages and any delay between swab and symptom onset.

Conclusions: There was no evidence that COVID-19 cases were more likely to be vaccinated against influenza than controls. Influenza vaccination should be encouraged among target groups for vaccination. I-MOVE-COVID-19 will continue documenting influenza vaccination status in 2020-21, in order to learn about effects of recent influenza vaccination.

Keywords: COVID-19; SARS-CoV-2; case-control study; influenza vaccination; multicentre study; test-negative design.

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Conflict of interest statement

No conflict of interest declared from any author/co‐author.

Figures

FIGURE 1
FIGURE 1
Flowchart of data exclusion of ARI patients for the pooled analysis, I‐MOVE‐COVID‐19 primary care study, primary analysis (FR, NL and SE), Europe, March‐August 2020. ARI, acute respiratory infection; FR, France; NL, The Netherlands; SE, Sweden. †Data from France were only included until 17 May 2020 (date of swab), as the data collection system after that date did not include influenza vaccination
FIGURE 2
FIGURE 2
Number of ARI patients by SARS‐CoV‐2 status (test‐negative controls and SARS‐CoV‐2 cases) and week of swab, I‐MOVE‐COVID‐19 primary care study, primary analysis (FR, NL and SE), Europe, March‐August 2020. ARI, acute respiratory infection; FR, France; NL, The Netherlands; SE, Sweden
FIGURE 3
FIGURE 3
Adjusted odds ratio by 5‐y age group (y‐axis on logarithmic scale), I‐MOVE‐COVID‐19 primary care study, primary analysis (FR, NL and SE), Europe, March‐August 2020. CI, confidence intervals; FR, France; NL, The Netherlands; OR, odds ratio; SE, Sweden
See this image and copyright information in PMC

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