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Comparison of influenza disease burden in older populations of Hong Kong and Brisbane: the impact of influenza and pneumococcal vaccination

Yang, Lin; Chan, King Pan; Wong, Chit Ming; Chiu, Susan Shui Seng; Magalhaes, Ricardo J. Soares; Thach, Thuan Quoc; Peiris, Joseph Syrial Malik; Clements, Archie; Hu, Wenbiao

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Background: Influenza and pneumococcal vaccine uptake in the older population aged 65 years or over of Hong Kong dramatically increased since the 2003 SARS outbreak. This study is aimed to evaluate the impact of increased coverage of influenza and pneumococcal vaccines by comparing the change of disease burden in the older population of Hong Kong, with the burden in the older population of Brisbane with relatively high vaccine coverage in the past fifteen years. Methods: Time series...[Show more]

dc.contributor.authorYang, Lin
dc.contributor.authorChan, King Pan
dc.contributor.authorWong, Chit Ming
dc.contributor.authorChiu, Susan Shui Seng
dc.contributor.authorMagalhaes, Ricardo J. Soares
dc.contributor.authorThach, Thuan Quoc
dc.contributor.authorPeiris, Joseph Syrial Malik
dc.contributor.authorClements, Archie
dc.contributor.authorHu, Wenbiao
dc.date.accessioned2019-02-27T00:15:40Z
dc.date.available2019-02-27T00:15:40Z
dc.identifier.urihttp://hdl.handle.net/1885/156517
dc.description.abstractBackground: Influenza and pneumococcal vaccine uptake in the older population aged 65 years or over of Hong Kong dramatically increased since the 2003 SARS outbreak. This study is aimed to evaluate the impact of increased coverage of influenza and pneumococcal vaccines by comparing the change of disease burden in the older population of Hong Kong, with the burden in the older population of Brisbane with relatively high vaccine coverage in the past fifteen years. Methods: Time series segmented regression models were applied to weekly numbers of cause-specific mortality or hospitalization of Hong Kong and Brisbane. Annual excess rates of mortality or hospitalization associated with influenza in the older population were estimated for the pre-SARS (reference period), post-SARS and post-pandemic period, respectively. The rate ratios (RRs) between these periods were also calculated to assess the relative change of disease burden. Results: Compared to the pre-SARS period, excess rates of mortality associated with influenza during the post-SARS period in Hong Kong decreased for cardiorespiratory diseases (RR = 0.90, 95% CI 0.80, 1.01), stroke (RR = 0.74, 95% CI 0.50, 1.09), and ischemic heart diseases (RR = 0.45, 95% CI 0.34, 0.58). The corresponding RRs in Brisbane were 0.79 (95% CI 0.54, 1.15), 0.33 (0.13, 0.80), and 1.09 (0.62, 1.90), respectively. Only the mortality of ischemic heart diseases showed a greater reduction in Hong Kong than in Brisbane. During the post-pandemic period, excess rates of all-cause mortality increased in Hong Kong, but to a lesser extent than in Brisbane (RR = 1.41 vs 2.39). Conclusion: A relative decrease (or less of an increase) of influenza disease burden was observed in the older population of Hong Kong after increased coverage of influenza and pneumococcal vaccines in this population, as compared to those of Brisbane where vaccination rates remained stable. The lack of significant findings in some disease categories highlights the challenges of evaluating the benefits of vaccination at the population level.
dc.description.sponsorshipThis study was supported by Health and Medical Research Fund (grant number:13121282), from the Research Fund Secretariat, Food and Health Bureau, the Government of the Hong Kong Special Administrative Region.
dc.format7 pages
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBioMed Central
dc.rightsThe Author(s)
dc.rights.uri(http://creativecommons.org/licenses/by/4.0/)
dc.sourceBMC Infectious Diseases
dc.subjectInfluenza
dc.subjectDisease burden
dc.subjectMortality
dc.subjectMorbidity
dc.subjectElderly
dc.subjectVaccine
dc.titleComparison of influenza disease burden in older populations of Hong Kong and Brisbane: the impact of influenza and pneumococcal vaccination
dc.typeJournal article
local.description.notesImported from Springer Nature
local.identifier.citationvolume19
dcterms.dateAccepted2019-01-21
dc.date.issued2019-02-14
local.identifier.ariespublicationu3102795xPUB743
local.publisher.urlhttps://www.biomedcentral.com/
local.type.statusPublished Version
local.contributor.affiliationYang, Lin, GH515, School of Nursing, The Hong Kong Polytechnic University
local.contributor.affiliationChan, King Pan, School of Public Health, The University of Hong Kong
local.contributor.affiliationWong, Chit Ming, School of Public Health, The University of Hong Kong
local.contributor.affiliationChiu, Susan Shui Seng, Department of Pediatrics and Adolescent Medicine, The University of Hong Kong
local.contributor.affiliationMagalhaes, Ricardo J. Soares, School of Veterinary Science, University of Queensland
local.contributor.affiliationThach, Thuan Quoc, School of Public Health, The University of Hong Kong
local.contributor.affiliationPeiris, Joseph Syrial Malik, School of Public Health, The University of Hong Kong
local.contributor.affiliationClements, Archie C. A., Research School of Population Health, The Australian National University
local.contributor.affiliationHu, Wenbiao, School of Public Health and Social Work, Queensland University of Technology
dc.relationhttp://purl.org/au-research/grants/nhmrc/13121282
local.identifier.essn1471-2334
local.bibliographicCitation.issue1
local.bibliographicCitation.startpage162
local.identifier.doi10.1186/s12879-019-3735-7
dc.date.updated2019-02-17T09:06:07Z
dcterms.accessRightsOpen Access
dc.rights.licenseThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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