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. 2022 Nov 30;18(6):2115751.
doi: 10.1080/21645515.2022.2115751. Epub 2022 Oct 27.

The effectiveness of influenza vaccine among elderly Chinese: A regression discontinuity design based on Yinzhou regional health information platform

Guangxu Liu  1 , Zhike Liu  1 , Houyu Zhao  1 , Yexiang Sun  2 , Peng Shen  2 , Hongbo Lin  2 , Siyan Zhan  1   3   4
Affiliations

The effectiveness of influenza vaccine among elderly Chinese: A regression discontinuity design based on Yinzhou regional health information platform

Guangxu Liu et al. Hum Vaccin Immunother. .

Abstract

In China, a free influenza vaccination policy is being implemented among individuals aged 70 years and over in Zhejiang province during the COVID-19 pandemic. The objective was to assess the effectiveness of influenza vaccine in reducing hospitalization and mortality in the elderly. We used data from the Regional Health Information Platform in Yinzhou located in Zhejiang province and applied a regression discontinuity design to estimate the intention-to-treat effect on admission and mortality rates by month of age in the population who was near the age of 70 years threshold. At age 70 years, the influenza vaccination rate increased by 29.1% (95% CI, 28.2% to 29.9%) compared to those under 70 in the study population. When turning age 70 years, the potential effectiveness of receiving influenza vaccine was 8.2% (95% CI, -36.8% to 51.3%) for total hospitalization and the evaluation of vaccine effectiveness was 13.1% (95% CI, -34.2 to 61.8) for the all-cause mortality. An increase in the influenza vaccination rate was associated with a weak decline in most outcomes, but no significance was found for all outcomes. Influenza vaccination had a limited effect on hospital admission and mortality for the free influenza vaccination program that can be related to the low vaccination rate among the Chinese elderly. Supplementation strategies and future studies may be needed to expand immunization coverage and validate this finding, and further provide a reference for other cities to promote the free influenza vaccination policy in China, especially under circumstances of the COVID-19 pandemic.

Keywords: Influenza vaccine; Regression discontinuity design; free vaccination program; hospitalization; mortality.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Influenza vaccination rate following age profile.
Figure 2.
Figure 2.
Change in hospital admission rate following age profile.
Figure 3.
Figure 3.
Change in mortality rate following age profile.
See this image and copyright information in PMC

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