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A large study published in JAMA Internal Medicine shows that the high-dose influenza vaccine offers better protection against hospital visits for heart and lung issues compared to the standard-dose vaccine in adults aged 65 and older, and this benefit is the same for those with or without diabetes.
The DANFLU-2 trial enrolled 332,438 participants across three influenza seasons in Denmark, including 43,881 adults with diabetes. Researchers found that high-dose vaccines reduced cardiorespiratory hospitalizations by 7.4 percent in people with diabetes and 5.3 percent in those without diabetes. Cardiovascular hospitalizations decreased by 12 percent among participants with diabetes and 6 percent in those without. Heart failure hospitalizations declined by approximately 19 percent in both groups, while influenza hospitalizations dropped by more than 40 percent regardless of diabetes status.
The number needed to vaccinate to prevent one cardiorespiratory hospitalization was 371 for individuals with diabetes compared with 861 for those without, reflecting the higher baseline risk in the diabetes population. The number of people who needed to be vaccinated to prevent cardiovascular hospitalization was 402 and 1,284, respectively. These findings suggest greater absolute benefit in higher-risk populations.
In groups of people with diabetes, those who had the disease for more than five years seemed to get more benefit from the high-dose vaccine for heart and lung health and serious heart problems Those with diabetes-related complications showed more pronounced protection against heart failure hospitalization.
The study's pragmatic design utilized nationwide Danish health registries for outcome ascertainment, minimizing bias from open-label treatment allocation. Although the analysis wasn't specifically designed to focus on diabetes groups and should be considered preliminary, the consistent treatment effects observed in almost 44,000 diabetes patients provide the largest randomized evidence for influenza vaccination in this high-risk group.
