In the Journals

Flu vaccine does not increase risk for surgical patients

Recent findings published in Annals of Internal Medicine showed that influenza vaccination did not increase the risk for post-discharge fever in surgical patients, nor did it significantly increase most health care utilization among these patients.

“Historically, there has been concern among surgeons that vaccinating patients while they are in the hospital can contribute to increased risk of vaccine-related fever or muscle pain, which might be incorrectly attributed to surgical complications,” Sara Y. Tartof, PhD, MPH, at Kaiser Permanente Southern California, told Infectious Disease News. “Our study findings show hospital stays are an opportune time to vaccinate patients, particularly those who are older and at high risk for complications due to the flu.”

Sara Y. Tartof

Sara Y. Tartof

Most surveyed pediatric anesthetists recommended that surgeries be postponed by 1 to 6 weeks after vaccination, likely due to concerns over vaccine-associated adverse events. They believed that incidents such as fever or myalgia could lead to unnecessary evaluations, the researchers wrote.

Although the CDC recommends that all eligible hospitalized patients be vaccinated for influenza before discharge, in this study 34% of eligible patients were not vaccinated against influenza.

In a retrospective cohort study, Tartof and colleagues assessed whether the influenza vaccine, when given in the perioperative period, would increase health care utilization and evaluation for postsurgical infection after discharge. They studied 42,777 patients aged 6 months and older who had inpatient surgery during the three influenza seasons from 2010 to 2013. The investigators recorded rates of fever, readmissions, ED visits, outpatient visits and clinical laboratory evaluations for infection.

The researchers found no differences in risk between the vaccinated and unvaccinated groups for fever, readmission, ED visits and laboratory evaluations for infection. They did observe a small but significant increase in risk for outpatient visits (RR = 1.05; 95% CI, 1-1.1).

“Our data support the rationale for increasing vaccination rates among surgical inpatients, and other studies have shown the success of hospital-based vaccination promotion strategies,” Tartof and colleagues wrote. “This evidence base can inform strategies to improve vaccination rates where needed.” – by Will Offit

Reference:

Grohskopf LA et al. MMWR Morb Mortal Wkly Rep. 2015;64:818-825.

Disclosure: Tartof reports receiving grants from the CDC during the conduct of the study and grants from Merck outside of the submitted work. Please see the full study for a list of all other authors’ relevant financial disclosures.

Recent findings published in Annals of Internal Medicine showed that influenza vaccination did not increase the risk for post-discharge fever in surgical patients, nor did it significantly increase most health care utilization among these patients.

“Historically, there has been concern among surgeons that vaccinating patients while they are in the hospital can contribute to increased risk of vaccine-related fever or muscle pain, which might be incorrectly attributed to surgical complications,” Sara Y. Tartof, PhD, MPH, at Kaiser Permanente Southern California, told Infectious Disease News. “Our study findings show hospital stays are an opportune time to vaccinate patients, particularly those who are older and at high risk for complications due to the flu.”

Sara Y. Tartof

Sara Y. Tartof

Most surveyed pediatric anesthetists recommended that surgeries be postponed by 1 to 6 weeks after vaccination, likely due to concerns over vaccine-associated adverse events. They believed that incidents such as fever or myalgia could lead to unnecessary evaluations, the researchers wrote.

Although the CDC recommends that all eligible hospitalized patients be vaccinated for influenza before discharge, in this study 34% of eligible patients were not vaccinated against influenza.

In a retrospective cohort study, Tartof and colleagues assessed whether the influenza vaccine, when given in the perioperative period, would increase health care utilization and evaluation for postsurgical infection after discharge. They studied 42,777 patients aged 6 months and older who had inpatient surgery during the three influenza seasons from 2010 to 2013. The investigators recorded rates of fever, readmissions, ED visits, outpatient visits and clinical laboratory evaluations for infection.

The researchers found no differences in risk between the vaccinated and unvaccinated groups for fever, readmission, ED visits and laboratory evaluations for infection. They did observe a small but significant increase in risk for outpatient visits (RR = 1.05; 95% CI, 1-1.1).

“Our data support the rationale for increasing vaccination rates among surgical inpatients, and other studies have shown the success of hospital-based vaccination promotion strategies,” Tartof and colleagues wrote. “This evidence base can inform strategies to improve vaccination rates where needed.” – by Will Offit

Reference:

Grohskopf LA et al. MMWR Morb Mortal Wkly Rep. 2015;64:818-825.

Disclosure: Tartof reports receiving grants from the CDC during the conduct of the study and grants from Merck outside of the submitted work. Please see the full study for a list of all other authors’ relevant financial disclosures.