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Abstract
Numerous studies confirm higher rates of systemic adverse events in people receiving influenza vaccine than in those receiving a placebo [23], but there are no studies on the recurrence of systemic adverse events nor the effect that recurring systemic adverse events have on healthcare workers’ decisions to be vaccinated again. Since annual revaccination is necessary due to the drifting and shifting of the circulating strains of influenza, these vaccines are distinct from other vaccination programs making the adverse events of particular importance. Statistical analysis Response rates by invitation mode (i.e., post vs. email) were calculated based on the final disposition codes defined by the American Association for Public Opinion Research (AAPOR) using response rate 2 (RR2), which counts both complete and partial responses in the numerator [27]. $$ RR2=\frac{\left(I+P\right)}{\left(I+P\right)+\left(R+ NC+O\right)+\left( UH+ UO\right)} $$ (Abbreviation: RR, response rate; I, complete interview; P, partial interview; R, refusal and break-off; NC, non-contact; O, other; UH, unknown if household/occupied HU; UO, unknown, other.) Adverse events following influenza vaccination were categorized into four groups: no adverse event, local adverse event only, systemic adverse event (most recent only), and recurrent systemic adverse event. Regression diagnostics were performed to identify influential observations and outliers using Pearson residuals, deviance residuals and Pregibon leverage graphs. Since effect modification by sex was detected, sex-specific regression analyses were carried out adjusted for age. Table 4 Adverse events following influenza vaccination by age group, sex and reaction to non-influenza vaccines Adverse event after influenza vaccine Total No AE Local AE only Systemic AE Recurrent systemic AE p-value Overall 386 (100.0)a 287 (74.4) 29 (7.5) 48 (12.4) 22 (5.7) Invitation Mode Email 218 (56.5) 153 (70.2) 15 (6.9) 34 (15.6) 16 (7.3) Post 168 (43.5) 134 (79.8) 14 (8.3) 14 (8.3) 6 (3.6) 0.05 Length Short version 180 (46.6) 121 (67.2) 18 (10.0) 31 (17.2) 10 (5.6) Longer version 206 (53.4) 166 (80.6) 11 (5.3) 17 (8.3) 12 (5.8) 0.01 Format Closed-ended 187 (48.4) 141 (75.1) 15 (8.0) 18 (9.6) 13 (7.0) Open-ended 199 (51.6) 146 (73.4) 14 (7.0) 30 (15.1) 9 (4.5) 0.32 Ageb 18–49 yrs 155 (40.3) 106 (68.4) 11 (7.1) 28 (18.1) 10 (6.5) ≥ 50 yrs 230 (59.7) 180 (78.3) 18 (7.8) 20 (8.7) 12 (5.2) 0.05 Sex Female 303 (78.5) 224 (74.0) 23 (7.6) 35 (11.6) 21 (6.9) Male 83 (21.5) 63 (75.9) 6 (7.2) 13 (15.7) 1 (1.2) 0.17 Ageb and Sex Female 18–49 yrs 123 (32.0) 85 (69.1) 9 (7.3) 19 (15.5) 10 (8.1) Male 18–49 yrs 32 (8.3) 21 (65.6) 2 (6.3) 9 (28.1) 0 Female ≥50 yrs 180 (46.8) 139 (77.2) 14 (7.8) 16 (8.9) 11 (6.1) Male ≥50 yrs 50 (13.0) 41 (82.0) 4 (8.0) 4 (8.0) 1 (2.0) 0.11 AE after non-influenza vaccines Yes 58 (15.0) 33 (56.9) 11 (19.0) 7 (12.1) 7 (12.1) No 248 (64.3) 208 (83.9) 10 (4.0) 21 (8.5) 9 (3.6) Don’t recall/No answer 80 (20.7) 46 (57.5) 8 (10.0) 20 (25.0) 6 (7.5) < 0.001 Abbreviations: AE:
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