New research shows that surgical inpatients who receive seasonal flu vaccines have no worse outcomes than those who are not, which supports the recommendation of the Centers for Disease Control and Prevention (CDC) to vaccinate hospitalized patients. The researchers compared outcomes among almost 43,000 surgical inpatients who were and were not vaccinated during several influenza seasons and found no difference in the incidence of infection, fever, and emergency department visits in the 7 days after discharge among the two groups.
According to the Medpage Today report, vaccinated patients did, however, have a slightly higher rate of outpatient, nonemergency physician visits. Sara Y. Tartof, PhD, wrote, “This small increased risk should be weighed against the protective benefits of vaccination.” The CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that eligible hospitalized patients receive the influenza vaccine during flu season, but vaccination rates among surgical inpatients remain low, Tartof says.
The retrospective cohort study, which included all patients who had inpatient surgery between September 1 and March 31 annually from 2010 to 2013 at 14 hospitals in the Kaiser Permanente Southern California integrated healthcare system. The analysis identified all influenza vaccinations administered between the first of August and the end of April in the 2010-2011, 2011-2012, and 2012-2013 influenza seasons.
The outcomes included readmission, outpatient visits, fever, emergency department visits, and clinical laboratory evaluations for infection in the week following hospital discharge. A total of 80% who were vaccinated received their flu shots on the day of discharge. The Medpage Today report notes that out of about 43,000 surgeries included in the analysis, only 6,420 admissions included a record of flu vaccinations.
In regards to the limitations of the study, the researchers wrote, “This study was not able to evaluate overall benefits of influenza vaccination in hospitalized patients because we assessed outcomes only in the 7 days after discharge, which is not long enough for the immune system to respond to vaccination.”
Tartof says the day of discharge appears to be an optimal time to vaccinate patients who have had surgery. Tartof says, “Before surgery patients tend to be fairly nervous, so this may not be the best time to bring it up. I would think the best time for the patient and surgery would be on the day of discharge.”
Source: Medpage Today