ArticleHuman vaccines & immunotherapeutics2026
Influenza vaccination associates with reduced risk of incident ischemic stroke among older adults with diabetes: A population-based retrospective cohort study.
Article in Human vaccines & immunotherapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Evidence suggests that a substantial part of influenza-related morbidity and mortality is due to cardiovascular events. Limited population-level evidence exists regarding whether seasonal influenza vaccination is associated with a lower risk of ischemic stroke (IS) in older adults with diabetes. We conducted a retrospective cohort study using data from the Regional Health Information Platform. Among 143,841 diabetic adults aged ≥ 60 y alive and free of prior IS as of January 1, 2022, 131,045 met inclusion criteria and were followed until IS occurrence, death, or July 31, 2022. The primary outcome was first-ever IS. Vaccination exposure was receipt of the 2021/22 seasonal inactivated influenza vaccine. Subdistribution hazard ratios (sHR) and 95% confidence intervals (CI) were estimated using Fine-Gray competing risk models, with death as a competing risk. Pneumococcal vaccination served as a negative control. Of 131,045 participants, 54,617 (41.7%) received influenza vaccination. During 75,593 person-years of follow-up over approximately 7 months, 1,427 IS cases occurred (incidence rate: 18.9 per 1,000 person-years). After multivariable adjustment, influenza vaccination was associated with a 15% reduced IS risk within 7 months of follow-up (adjusted sHR = 0.85; 95% CI: 0.76-0.95). This inverse association was consistent across influenza activity phases and was most pronounced during high antigenic similarity epidemic periods (sHR = 0.74; 95% CI: 0.61-0.89) and among patients with coronary heart disease (sHR = 0.46; 95% CI: 0.25-0.86; interaction
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