The impact of influenza, pneumococcal and herpes zoster vaccinations on hospital presentations for acute heart failure exacerbations in a cohort of patients with chronic heart failure

Abstract

BACKGROUND: Vaccination is a cheap and effective intervention that may prevent infection, a recognized trigger for cardiovascular events, thus proposed to reduce hospitalisations for acute decompensation of heart failure (ADHF). OUR AIM: was to assess the impact of influenza, pneumococcal and herpes zoster (HZ) vaccinations in patients with chronic (HF) on frequency of hospitalisations for ADHF. METHODS: Consecutive patients with LVEF ,50% attending the outpatient HF clinic at Blacktown Hospital between 2015-2018 and whose vaccination status for influenza, pneumococcal and HZ was verified with their general practitioner were examined. They were followed up for hospitalisations for ADHF in the subsequent 12 months (influenza) or 5 years (pneumococcal and HZ) postvaccination. RESULTS: Of the 190 participants (67615 years; 37% female) examined over four years from 2015-2018, 51% (383/760) received the annual influenza, 22% pneumococcal and 5% HZ vaccinations. There was no significant reduction (36% vs 32%; p=0.27) in those with 1 or more hospitalisations for ADHF within 1 year for those who received annual influenza vaccination compared to those who did not. Similarly, the proportion of patients who did not experience ADHF within 5 years of vaccination was consistently higher amongst those who received pneumococcal (14% vs 10%; p=0.15) and HZ (18% vs 10%; p=0.14) vaccinations. HZ vaccination was associated with a significant reduction in the number of admissions for ADHF in a 5 year period after vaccination (2.3 vs 1.6, p=0.00). CONCLUSION: Influenza, pneumococcal and HZ vaccinations did not demonstrate a clear reduction in the number of hospitalisations for ADHF.