Evidence map›Paper›PMID 32565346›Full record

ArticleVaccine2020

Comparative safety of high-dose versus standard-dose influenza vaccination in patients with end-stage renal disease.

J Bradley Layton, Leah J McGrath, John M Sahrmann, Yinjiao Ma, Vikas R Dharnidharka, Caroline O'Neil, David J Weber, Anne M Butler

Open access · greenAbstract read
In one paragraph

Article in Vaccine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Comparative Safety of Different Antibiotic Regimens for the Treatment of Outpatient Community-Acquired Pneumonia Among Otherwise Healthy Adults.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

J Bradley LaytonRTI Health Solutions, Research Triangle Park, NC, USA. Electronic address: jblayton@rti.org.
Leah J McGrathNoviSci, Durham, NC, USA. Electronic address: lmcgrath@novisci.com.
John M SahrmannDivision of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: jsahrmann@wustl.edu.
Yinjiao MaDivision of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: mayinjiao@wustl.edu.
Vikas R DharnidharkaDivision of Pediatric Nephrology, Hypertension and Pheresis, Departments of Pediatrics and Nephrology, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: vikasd@wustl.edu.
Caroline O'NeilDivision of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: oneilc@wustl.edu.
David J WeberDivision of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: dweber@unch.unc.edu.
Anne M ButlerDivision of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: anne.butler@wustl.edu.
Washington University in St. Louis · USNovelis (Canada) · CARTI Health Solutions · USUniversity of North Carolina at Chapel Hill · US

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
Washington University Institute of Clinical and Translational Sciences (KL2) KL2TR002346 · NCATS · WASHINGTON UNIVERSITY · PI Dominic N Reeds · 2017 to 2026
$14.0M
WASHINGTON UNIVERSITY COMPARATIVE EFFECTIVENESS ADMINISTRATIVE DATA REPOSITORYR24HS019455 · AHRQ · WASHINGTON UNIVERSITY · PI FRASER, VICTORIA J. · 2010 to 2010
$969k
Comparative Effectiveness and Safety of Influenza Immunization Strategies in the Dialysis PopulationR21AI138385 · NIAID · WASHINGTON UNIVERSITY · PI BUTLER, ANNE MOBLEY · 2018 to 2019
$442k
AHRQ HHS R24 HS019455NCATS NIH HHS KL2 TR002346NCATS NIH HHS UL1 TR002345NIAID NIH HHS R21 AI138385
6 · The paper itself

Abstract

backgroundHigh-dose influenza vaccine (HDV) is an alternative vaccination strategy in patients with end-stage renal disease (ESRD), though the safety of HDV has not been evaluated in this population. The objective of this study was to estimate the relative occurrence of adverse vaccine reactions in patients with ESRD following vaccination with HDV compared with standard-dose influenza vaccine (SDV).

methodsUsing data from the United States Renal Data System, we identified patients with ESRD aged ≥ 65 years at influenza vaccination during yearly influenza seasons from 2010 through 2016. Patients were followed after vaccination to observe serious (anaphylaxis, angioedema, seizure, encephalopathy, Guillain-Barré syndrome [GBS], and short-term, all-cause mortality) and milder (urticaria/hives, rash, pain in limb, cellulitis, myalgia/myositis, fever, nausea and vomiting, diarrhea, and syncope) adverse events. Propensity score-weighted hazard ratios (HRs) and 95% confidence intervals (CIs) for HDV versus SDV were estimated with Cox proportional hazards models.

resultsOf 520,876 vaccinations observed (mean age = 74.7 years at vaccination; 63% white race), 7.4% were HDV. For serious events, the weighted HRs were null for seizure, encephalopathy, and mortality and inestimable due to too few cases for anaphylaxis, angioedema, and GBS. For milder vaccine reactions, the weighted HRs demonstrated generally increased risks in the HDV group, including rash (HR = 1.86; 95% CI, 1.34-2.57), diarrhea (HR = 1.26; 95% CI, 1.07-1.50), pain in limb (HR = 1.23; 95% CI, 1.12-1.34), and myalgia/myositis (HR = 1.16; 95% CI, 1.04-1.30).

conclusionsThe risks of serious adverse events were low and similar between treatment groups; however, HDV recipients had increased risks of several milder adverse events compared with SDV recipients, consistent with clinical trial findings in the general population of older adults. These results add important information to inform the risk-benefit tradeoff of the use of HDV versus SDV in patients with ESRD.

Indexed as

Influenza, HumanInfluenza VaccinesKidney Failure, ChronicAgedHumansReference StandardsUnited StatesVaccinationInfluenza VaccinesAdverse reactionsHemodialysisHigh-doseInfluenza vaccinesSafety

Identifiers

PMID32565346
PMCPMC7332402
OpenAlexW3036081126

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.