Multivariable adjusted risk differences for the association of immune-mediated inflammatory disease, depressive 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 depression | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Immune-mediated disease effect without depression effect | 6.08 (5.49 to 6.66) | 6.81 (5.82 to 7.80) | 5.81 (4.45 to 7.18) | 5.52 (4.65 to 6.38) |
| Depression effect without immune-mediated disease effect | 4.15 (3.75 to 4.56) | 5.11 (4.40 to 5.82) | 4.28 (3.39 to 5.17) | 3.41 (2.82 to 4.00) |
| Interaction contrast between case effect and depressive disorder effect‡ | −0.98 (−1.93 to −0.04) | −1.03 (−2.70 to 0.64) | 2.43 (0.36 to 4.49) | −2.53 (−3.88 to −1.18) |
| Age, yr | ||||
| 18–24 | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| 25–44 | 6.36 (5.83 to 6.89) | 5.87 (5.24 to 6.51) | 7.33 (5.90 to 8.77) | 5.74 (4.58 to 6.90) |
| 45–64 | 15.45 (14.90 to 16.00) | 14.36 (13.66 to 15.05) | 15.65 (14.19 to 17.11) | 15.22 (14.04 to 16.40) |
| ≥ 65 | 33.75 (33.14 to 34.35) | 34.26 (33.36 to 35.15) | 33.22 (31.59 to 34.86) | 32.60 (31.39 to 33.82) |
| Sex | ||||
| Male | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Female | 5.19 (4.87 to 5.52) | 5.12 (4.62 to 5.63) | 3.96 (3.21 to 4.72) | 4.80 (4.28 to 5.32) |
| Region | ||||
| Rural | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Urban | 2.28 (1.95 to 2.61) | 1.99 (1.47 to 2.52) | 2.47 (1.71 to 3.23) | 2.67 (2.17 to 3.16) |
| Socioeconomic status | ||||
| Quintile 1 (lowest) | −4.71 (−5.21 to −4.20) | −4.69 (−5.51 to −3.87) | −3.41 (−4.56 to −2.27) | −6.03 (−6.82 to −5.25) |
| Quintile 2 | −3.81 (−4.32 to −3.29) | −4.15 (−4.94 to −3.36) | −3.57 (−4.58 to −2.45) | −4.02 (−4.85 to −3.19) |
| Quintile 3 | −3.14 (−3.65 to −2.62) | −3.47 (−4.26 to −2.68) | −2.83 (−3.94 to −1.72) | −3.40 (−4.24 to −2.56) |
| Quintile 4 | −2.27 (−2.77 to −1.77) | −2.19 (−2.97 to −0.64) | −2.29 (−3.38 to −1.19) | −2.66 (−3.48 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 | 4.86 (4.41 to 5.31) | 3.53 (2.80 to 4.27) | 3.89 (2.79 to 4.98) | 5.73 (5.09 to 6.37) |
| ≥ 2 | 8.73 (7.65 to 9.80) | 8.65 (6.62 to 10.68) | 9.04 (6.18 to 11.90) | 8.41 (7.02 to 9.79) |
| Immune-mediated disease-specific procedure | 4.96 (4.23 to 5.69) | 6.95 (5.63 to 8.27) | – | 4.01 (3.13 to 4.89) |
| Immune therapy | ||||
| None | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) | 0 (Ref.) |
| Anti-inflammatory or immune-modulatory therapy | 3.10 (2.74 to 3.47) | 2.97 (2.40 to 3.54) | 4.40 (2.51 to 6.29) | 3.06 (2.57 to 3.55) |
| Any biologic | 9.08 (7.92 to 10.23) | 9.08 (7.06 to 11.10) | 5.54 (2.11 to 8.96) | 9.46 (7.94 to 10.98) |
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 depressive 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 depressive disorder effects.