Multivariable adjusted risk differences for the association of immune-mediated disease, any mood or anxiety disorder and uptake of influenza vaccination
| Variable | Cohort; adjusted risk difference,* % (95% CI)† | |||
|---|---|---|---|---|
| Immune-mediated disease | Inflammatory bowel disease | Multiple sclerosis | Rheumatoid arthritis | |
| No. flu shots/PYs at risk | 402 542/1 235 712 | 111 983/401 123.6 | 72 424/248 553.6 | 223 725/601 042.5 |
| Controls without a mood/anxiety disorder | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Immune-mediated disease effect without mood/anxiety disorder effect | 6.44 (5.79 to 7.10) | 7.19 (6.12 to 8.26) | 6.70 (5.13 to 8.27) | 5.61 (4.64 to 6.59) |
| Mood/anxiety disorder effect without an immune-mediated disease effect | 4.54 (4.20 to 4.89) | 5.10 (4.52 to 5.68) | 5.31 (4.53 to 6.09) | 3.74 (3.23 to 4.26) |
| Interaction contrast between case effect and mood/anxiety disorder effect‡ | −1.38 (−2.26 to −0.50) | −1.43 (−2.90 to 0.05) | 0.08 (−1.97 to 2.13) | −1.89 (−3.16 to −0.63) |
| Age, yr | ||||
| 18–24 | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| 25–44 | 6.12 (5.59 to 6.64) | 5.61 (4.98 to 6.24) | 6.94 (5.47 to 8.40) | 5.56 (4.41 to 6.71) |
| 45–64 | 15.10 (14.55 to 15.65) | 13.97 (13.28 to 14.67) | 15.15 (13.65 to 16.64) | 14.96 (13.79 to 16.14) |
| ≥ 65 | 33.33 (32.73 to 33.94) | 33.77 (32.87 to 34.67) | 32.61 (30.95 to 34.27) | 32.32 (31.11 to 33.53) |
| Sex | ||||
| Male | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Female | 4.97 (4.64 to 5.29) | 4.92 (4.41 to 5.43) | 3.66 (2.90 to 4.42) | 4.61 (4.09 to 5.13) |
| Region | ||||
| Rural | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Urban | 2.16 (1.83 to 2.49) | 1.88 (1.35 to 2.40) | 2.28 (1.52 to 3.04) | 2.56 (2.06 to 3.06) |
| Socioeconomic status | ||||
| Quintile 1 (lowest) | −4.69 (−5.19 to −4.19) | −4.66 (−5.48 to −3.84) | −3.38 (−4.52 to −2.23) | −6.03 (−6.82 to −5.25) |
| Quintile 2 | −3.74 (−4.25 to −3.23) | −4.00 (−4.79 to −3.22) | −3.45 (−4.57 to −2.34) | −4.01 (−4.83 to −3.18) |
| Quintile 3 | −3.09 (−3.61 to −2.58) | −3.40 (−4.18 to −2.61) | −2.74 (−3.85 to −1.63) | −3.39 (−4.23 to −2.55) |
| Quintile 4 | −2.25 (−2.75 to −1.75) | −2.16 (−2.93 to −1.39) | −2.21 (−3.30 to −1.12) | −2.66 (−3.49 to −1.84) |
| Quintile 5 (highest) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Comorbidity | ||||
| 0 | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| 1 | 4.77 (4.32 to 5.22) | 3.43 (2.69 to 4.16) | 3.78 (2.68 to 4.87) | 5.66 (5.01 to 6.30) |
| ≥ 2 | 8.67 (7.60 to 9.74) | 8.64 (6.61 to 10.7) | 8.96 (6.10 to 11.81) | 8.34 (6.95 to 9.72) |
| Immune-mediated disease-specific procedure | 4.94 (4.21 to 5.67) | 6.90 (5.58 to 8.22) | – | 4.00 (3.12 to 4.88) |
| Immune therapy | ||||
| None | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Anti-inflammatory or immune-modulatory therapy | 3.09 (2.73 to 3.46) | 2.95 (2.39 to 3.52) | 4.43 (2.53 to 6.32) | 3.07 (2.58 to 3.56) |
| Any biologic | 9.08 (7.92 to 10.23) | 9.11 (7.09 to 11.13) | 5.60 (2.17 to 9.03) | 9.45 (7.93 to 10.97) |
Note: CI = confidence interval, PY = person-year, Ref. = reference category.
↵* Adjusted for all other variables included in table.
↵† Except where indicated otherwise.
↵‡ A negative interaction contrast with a 95% CI that does not encompass 0 indicates a subadditive effect; that is, the joint effect of immune-mediated disease and a mood or anxiety disorder is less than the sum of their individual effects. A positive interaction with a 95% CI that does not encompass 0 indicates a superadditive effective that is greater than the sum of the individual immune-mediated disease and mood or anxiety disorder effects.