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Research Article

The Effect of Universal Influenza Immunization on Mortality and Health Care Use

  • Jeffrey C Kwong mail,

    To whom correspondence should be addressed. E-mail: jeff.kwong@utoronto.ca

    Affiliations: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada

    X
  • Thérèse A Stukel,

    Affiliations: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    X
  • Jenny Lim,

    Affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada

    X
  • Allison J McGeer,

    Affiliations: Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada, Mount Sinai Hospital, Department of Microbiology, Toronto, Ontario, Canada

    X
  • Ross E. G Upshur,

    Affiliations: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada, Sunnybrook Health Sciences Centre Primary Care Research Unit, Toronto, Ontario, Canada

    X
  • Helen Johansen,

    Affiliation: Health Information and Research Division, Statistics Canada, Ottawa, Ontario, Canada

    X
  • Christie Sambell,

    Affiliation: Health Statistics Division, Statistics Canada, Ottawa, Ontario, Canada

    X
  • William W Thompson,

    Affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

    X
  • Deva Thiruchelvam,

    Affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada

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  • Fawziah Marra,

    Affiliation: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada

    X
  • Lawrence W Svenson,

    Affiliations: Alberta Health and Wellness, Edmonton, Alberta, Canada, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada

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  • Douglas G Manuel

    Affiliations: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

    X
  • Published: October 28, 2008
  • DOI: 10.1371/journal.pmed.0050211

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News Coverage

Posted by plosmedicine on 31 Mar 2009 at 00:32 GMT

Author: Nisha Doshi
Position: Publications Assistant
Institution: PLoS Medicine
E-mail: PLoSMedicine@plos.org
Additional Authors: Andrew Hyde
Submitted Date: October 30, 2008
Published Date: October 30, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

PLoS Medicine published three papers on influenza vaccination this week. Jeffrey Kwong and colleagues compared influenza-related mortality and health care use between Ontario and other Canadian provinces, finding that Ontario's universal vaccination program has reduced the burden of influenza. This vaccination program offered everyone in Ontario a free flu shot, rather than simply targeting those most at risk. The study shows that the program is associated with reductions in flu-related deaths, hospitalizations, and visits to emergency departments and doctors’ offices (although the results also suggest that increasing immunization rates may not be as effective in reducing mortality and health care use in older people than in younger people). Jeffrey Kwong produced a SciVee pubcast about his research, which we included in the press release.

Not surprisingly the findings were reported in the Canadian media. It was one of CTV’s top stories (you can watch the item on the Canadian national news, which has an interview with Jeffrey Kwong and with one of the other authors, Allison McGreer). Their online coverage quotes one of the other authors of the paper, Alison McGreer, as saying that this year would be a good year to receive the vaccine - only 38% of the estimated household population in Ontario has received it so far - because the formulation contains three new flu strains that WHO experts feel will be most prominent during this flu season. The coverage reproduces the abstract and links to the full paper. Other coverage in Canada came in the Toronto Star, the Victoria Star and the London Free Press. In the United States, the Washington Post picked up the report from HealthDay News.

The paper was also covered in the Scientific American podcast, alongside another PLoS Medicine paper on influenza vaccination by Carline van den Dool and colleagues. This research, conducted in the Netherlands, used a mathematical model to simulate influenza transmission in nursing homes. It found that each additional staff member in the nursing home vaccinated further reduces the risk to patients. The Dutch study was covered by nu.nl, the biggest news site in the Netherlands, as well as Brabants Dagblad and Nieuws.nl.

The third flu paper is a perspective by Celine Viboud and Mark Miller – uninvolved in either of the studies – that discusses both papers.

No competing interests declared.