System Complexity in Influenza Infection and Vaccination: Effects upon Excess Winter Mortality
Abstract
:1. The Excess Winter Mortality (EWM) Calculation
2. Introduction
3. Materials and Methods
3.1. Sources of the Data
3.2. Adjusting EWM for Each Country to a US-Equivalent
3.3. Method for Excluding Outlying EWM Values
3.4. Adjustment of EWM for Obesity Relative to the USA
3.5. EWM in US States since 2008
3.6. Data Manipulation
4. Results
4.1. EWM Shows Extreme Spatiotemporal Volatility
4.2. Influenza Vaccination in the Elderly
- Data from all available countries
- The 50 countries with the highest number of years of available data
- #1 plus data from US states (available for 2007/08 onward) [26]
4.3. Comparison with a Previous Study
4.4. Further Validation of the Results
4.5. The Values for the Slope Follow an Extreme Value Distribution
5. Discussion
5.1. What Is the “Real” Long-Term Effect?
5.2. Limitations of Our Earlier Hypothesis
5.3. Adjustment for Obesity
5.4. Implications of High International Variation
5.5. 2014/15 as an Example of Poor Vaccine Matching
5.6. Roles for Pathogen Interference
5.7. Could Vaccine Effectiveness Be an Illusion Created by Pathogen Interference?
5.8. Heliobiology and Additional Hidden Complexity
5.9. Implications of an Extreme Value Distribution for the Slope
5.10. Minimum Value of the Slope
5.11. Biochemical and Immune Health
5.12. A Potential Basis for Extreme Variation in the Net Effects of Influenza Vaccination
6. Pragmatic Implications to Health Care Services
7. Implications to Influenza Policy
8. Limitations and Future Research
9. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
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Jones, R.P.; Ponomarenko, A. System Complexity in Influenza Infection and Vaccination: Effects upon Excess Winter Mortality. Infect. Dis. Rep. 2022, 14, 287-309. https://doi.org/10.3390/idr14030035
Jones RP, Ponomarenko A. System Complexity in Influenza Infection and Vaccination: Effects upon Excess Winter Mortality. Infectious Disease Reports. 2022; 14(3):287-309. https://doi.org/10.3390/idr14030035
Chicago/Turabian StyleJones, Rodney P., and Andriy Ponomarenko. 2022. "System Complexity in Influenza Infection and Vaccination: Effects upon Excess Winter Mortality" Infectious Disease Reports 14, no. 3: 287-309. https://doi.org/10.3390/idr14030035