High-dose vs standard-dose influenza vaccine in heart failure: the FLUNITY-HD pooled analysis

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"Influenza is a known trigger of cardiovascular (CV) morbidity, including incident and worsening heart failure (HF),1 and patients with HF are at increased risk of suffering severe non-CV complications from influenza infection.2 Despite this, the results of prior randomized trials investigating the potential role of influenza vaccination in preventing severe clinical events in various HF populations have been mixed.3,4 Among 466 320 older adults in the largest influenza vaccine effectiveness study of individually randomized older adults to date, FLUNITY-HD, the high-dose inactivated influenza vaccine (HD-IIV) demonstrated superior protection against severe outcomes, including hospitalization for influenza or pneumonia, cardiorespiratory hospitalization, laboratory-confirmed influenza hospitalization, and all-cause hospitalization compared with standard-dose (SD-IIV).5 Of note, the incidence of HF hospitalization—an exploratory endpoint—was 21% lower in the HD-IIV group compared with SD-IIV.6 However, whether the observed protective effects of HD-IIV were consistent among individuals with and without HF is currently unknown..."