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Outcomes of COVID-19 Infection in People Previously Vaccinated Against Influenza: Population-Based Cohort Study Using Primary Health Care Electronic Records de Dios, Vanessa Morros, Rosa Giner-Soriano, Maria Ouchi, Dan Vilaplana-Carnerero, Carles Monteagudo, Mònica [Giner-Soriano, Ouchi D, Vilaplana-Carnerero C, Monteagudo M] Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [de Dios V] Department of Clinical Pharmacology, Medicines Area, Hospital Clinic of Barcelona, Barcelona, Spain. [Morros R] Universitat Autònoma de Barcelona, Bellaterra, Spain. Plataforma Spanish Clinical Research Network, Unidad de Investigación Clínica, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Institut Català de la Salut (ICS), Barcelona, Spain IDIAP Jordi Gol COVID-19 (Malaltia) Farmacoepidemiologia Grip - Vacunació DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections DISCIPLINES AND OCCUPATIONS::Natural Science Disciplines::Biological Science Disciplines::Pharmacology::Pharmacoepidemiology CHEMICALS AND DRUGS::Complex Mixtures::Biological Products::Vaccines::Viral Vaccines::Influenza Vaccines ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus DISCIPLINAS Y OCUPACIONES::disciplinas de las ciencias naturales::disciplinas de las ciencias biológicas::farmacología::farmacoepidemiología COMPUESTOS QUÍMICOS Y DROGAS::mezclas complejas::productos biológicos::vacunas::vacunas víricas::vacunas de la gripe COVID-19; SARS-CoV-2; Electronic health records; Influenza vaccines; Primary health care COVID-19; SARS-CoV-2; Registres sanitaris electrònics; Vacunes contra la grip; Atenció primària de salut COVID-19; SARS-CoV-2; Registros de salud electrónicos; Vacunas contra la gripe; Atención primaria de salud Background: A possible link between influenza immunization and susceptibility to the complications of COVID-19 infection has been previously suggested owing to a boost in the immunity against SARS-CoV-2. Objective: This study aimed to investigate whether individuals with COVID-19 could have benefited from vaccination against influenza. We hypothesized that the immunity resulting from the previous influenza vaccination would boost part of the immunity against SARS-CoV-2. Methods: We performed a population-based cohort study including all patients with COVID-19 with registered entries in the primary health care (PHC) electronic records during the first wave of the COVID-19 pandemic (March 1 to June 30, 2020) in Catalonia, Spain. We compared individuals who took an influenza vaccine before being infected with COVID-19, with those who had not taken one. Data were obtained from Information System for Research in Primary Care, capturing PHC information of 5.8 million people from Catalonia. The main outcomes assessed during follow-up were a diagnosis of pneumonia, hospital admission, and mortality. Results: We included 309,039 individuals with COVID-19 and compared them on the basis of their influenza immunization status, with 114,181 (36.9%) having been vaccinated at least once and 194,858 (63.1%) having never been vaccinated. In total, 21,721 (19%) vaccinated individuals and 11,000 (5.7%) unvaccinated individuals had at least one of their outcomes assessed. Those vaccinated against influenza at any time (odds ratio [OR] 1.14, 95% CI 1.10-1.19), recently (OR 1.13, 95% CI 1.10-1.18), or recurrently (OR 1.10, 95% CI 1.05-1.15) before being infected with COVID-19 had a higher risk of presenting at least one of the outcomes than did unvaccinated individuals. When we excluded people living in long-term care facilities, the results were similar. Conclusions: We could not establish a protective role of the immunity conferred by the influenza vaccine on the outcomes of COVID-19 infection, as the risk of COVID-19 complications was higher in vaccinated than in unvaccinated individuals. Our results correspond to the first wave of the COVID-19 pandemic, where more complications and mortalities due to COVID-19 had occurred. Despite that, our study adds more evidence for the analysis of a possible link between the quality of immunity and COVID-19 outcomes, particularly in the PHC setting. 2022-11-14T11:46:03Z 2022-11-14T11:46:03Z 2022-11-11 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Giner-Soriano M, de Dios V, Ouchi D, Vilaplana-Carnerero C, Monteagudo M, Morros R. Outcomes of COVID-19 Infection in People Previously Vaccinated Against Influenza: Population-Based Cohort Study Using Primary Health Care Electronic Records. JMIR Public Health Surveill. 2022 Nov 11;8(11):e36712. 2369-2960 https://hdl.handle.net/11351/8458 10.2196/36712 36265160 http://hdl.handle.net/11351/8458 eng JMIR Public Health and Surveillance;8(11) https://doi.org/10.2196/36712 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf JMIR Publications Scientia