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Absence of association between 2019–20 influenza vaccination and COVID-19: results of the European I-MOVE-COVID-19 primary care project, March–August 2020
  • +18
  • Esther Kissling,
  • Mariette Hooiveld,
  • Mia Brytting,
  • Ana-Maria Vilcu,
  • Marit de Lange,
  • Iván Martínez-Baz,
  • Debbie Sigerson,
  • Theresa Enkirch,
  • Sylvie Behillil,
  • Adam Meijer,
  • Jesus Castilla,
  • Naoma William,
  • AnnaSara Carnahan,
  • Alessandra Falchi,
  • Janneke Hendriksen,
  • Itziar Casado Buesa,
  • Josie Murray,
  • Vincent ENOUF,
  • Frederika Dijkstra,
  • Diogo Marques,
  • Marta Valenciano
Esther Kissling
Epiconcept
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Mariette Hooiveld
Nivel (Netherlands Institute for Health Services Research)
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Mia Brytting
Public Health Agency of Sweden
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Ana-Maria Vilcu
Sorbonne Universités, UPMC Univ Paris 06, INSERM
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Marit de Lange
Rijksinstituut voor Volksgezondheid en Milieu
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Iván Martínez-Baz
Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP
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Debbie Sigerson
Public Health Scotland
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Theresa Enkirch
Public Health Agency of Sweden
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Sylvie Behillil
Institut Pasteur
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Adam Meijer
National Institute for Public Health and the Environment (RIVM)
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Jesus Castilla
Instituto de Salud Pública de Navarra - IdiSNA - CIBERESP
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Naoma William
Public Health Scotland
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AnnaSara Carnahan
Public Health Agency of Sweden
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Alessandra Falchi
Université de Corse-Inserm
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Janneke Hendriksen
Nivel (Netherlands Institute for Health Services Research)
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Itziar Casado Buesa
Navarra Public Health Institute, IdiSNA - CIBERESP
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Josie Murray
Public Health Scotland
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Vincent ENOUF
National Influenza Center, Paris, France
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Frederika Dijkstra
Centre for Infectious Disease Control, National Institute for Public Health and the Environment
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Diogo Marques
Health Protection Scotland
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Marta Valenciano
Epiconcept
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Abstract

Background Claims of influenza vaccination increasing COVID-19 risk are circulating. Within the I-MOVE-COVID-19 primary care multicentre study, we measured the association between 2019–20 influenza vaccination and COVID-19. Methods We conducted a multicentre test-negative case-control study at primary care level, in study sites in five European countries, from March–August 2020. Patients presenting with acute respiratory infection were swabbed, with demographic, 2019–20 influenza vaccination and clinical information documented. Using logistic regression we measured the adjusted odds ratio (aOR), adjusting for study site and age, sex, calendar time, presence of chronic conditions. The main analysis included patients swabbed ≤7 days after onset from the three countries with <15% of missing influenza vaccination. In secondary analyses, we included five countries, using multiple imputation with chained equations to account for missing data. Results We included 257 COVID-19 cases and 1631 controls in the main analysis (three countries). The overall aOR between influenza vaccination and COVID-19 was 0.93 (95% CI: 0.66–1.32). The aOR was 0.92 (95% CI: 0.58–1.46) and 0.92 (95%CI: 0.51–1.67) among those aged 20–59 and ≥60 years, respectively. In secondary analyses, we included 6457 cases and 69272 controls. The imputed aOR was 0.87 (95% CI: 0.79–0.95) among all ages and any delay between swab and symptom onset. Conclusions There was no evidence that COVID-19 cases were more likely to be vaccinated against influenza than controls. Influenza vaccination should be encouraged among target groups for vaccination. I-MOVE-COVID-19 will continue documenting influenza vaccination status in 2020-21, in order to learn about effects of recent influenza vaccination.

Peer review status:ACCEPTED

11 Dec 2020Submitted to Influenza and other respiratory viruses
23 Dec 2020Assigned to Editor
23 Dec 2020Submission Checks Completed
03 Jan 2021Editorial Decision: Accept