Primary Viral Pneumonia Concomitant Assignment

Evaluation Table
Evidence-Based Project, Part 4A: Critical Appraisal of Research
References Article #1 Article #2 Article #3 Article #4
Aguado, M. T., Barratt, J.,
Beard, J. R., Blomberg,
B. B., Chen, W. H.,
Hickling, J., … Ortiz, J.
R. (2018). Report on
WHO meeting on
immunization in older
adults: Geneva,
Switzerland, 22–23
March 2017. Vaccine,
36(7), 921–931. doi:
10.1016/j.vaccine.2017.1
2.029
Heo, J. Y., Song, J. Y.,
Noh, J. Y., Choi,
M. J., Yoon, J. G.,
Lee, S. N., Cheong,
H. J., & Kim, W. J.
(2018). Effects of
influenza
immunization on
pneumonia in the
elderly. Human
Vaccines &
Immunotherapeutic
s, 14(3), 744–749.
Samuel, R., & Miller,
J. (2019). Is the
influenza vaccine
effective in
decreasing
infection,
hospitalization,
pneumonia, and
mortality in healthy
adults?. The Journal
of the Oklahoma
State Medical
Association, 112(3),
86–87.
Yeh, L.-T., Chan,
C.-H., Yang, S.-
F., Yeh, H.-W.,
Yeh, Y.-T.,
Wang, Y.-H.,
Chou, M.-C.,
Yeh, C.-B., &
Teng, Y.-H.
(2019).
Association of
Consecutive
Influenza
Vaccinations
and Pneumonia:
A Population-
Based Case-
Control Study.
International
© 2018 Laureate Education Inc. 1
Critical Appraisal Tool
Worksheet Template

Journal Of
Environmental
Research And
Public Health,
16(6).
Evidence Level *
(I, II, or III)
 Level IV Level III Level II
Conceptual Framework There was no framework but
expert reviews based on WHO
guidelines
Influenza is a common
pathogen that is linked to
respiratory infections
affecting about 20% of
the population.
Occurrence is often
exacerbated by increased
morbidities. For this
reason, vaccination is the
underlying measure for
management
The article offers a
meta-analysis reviews
on various articles
focusing on the
influenza vaccine
The theory
framework underlies
the mechanism of
influenza disease
across the elderly
populations and
underlying
complications
Design/Method Expert review analysis A meta-analysis of
influenza vaccine studies
Meta-analysis review Case-control study
Sample/Setting Participants included
academics and industry
researchers, funders, civil
society organizations,
implementers of global health
Assessed case-control
and cohort studies
The study assessed
Cochrane review
studies entailing 22
studies, systematic
review, observational
Hospital care setting
among pneumonia
patients with 7565
subjects
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interventions, and
stakeholders
case-control studies
Major Variables Studied
Topical discussion on
vaccination process
- There was an elavated
levels of pneumonia
injection with
influenza infection in
chronically ill patients
- Influenza vaccine is
effective in managing
pneumonia occurrence
Effectiveness of
influenza vaccine
Effectiveness of
influenza vaccine
Measurement Expert reviews A thematic analysis
based on the reviewed
studies
- flu vaccine
effectiveness in
preventing ILI was
OODS RATIO
-
No disease and
disease group
assessment
Vaccination
intervals between
occurrence of
pneumonia and
vaccinations
Data Analysis Statistical or
Qualitative findings
Qualitative analysis - trivalent inactivated
influenza vaccine
showed 59% efficacy
(95% CI, 51–67%)
- reduced pneumonia- or
influenza-related
hospitalizations (25–
53%) across meta-
- based on the
effectiveness level
of the studies
Patients vaccinated
for tow years
consecutive at (aOR
= 0.85, confidence
interval (CI) =
0.79⁻0.93 and aOR
= 0.75, CI =
0.67⁻0.85,
© 2018 Laureate Education Inc. 3

analyses
- high dose levels of
influenza vaccine was
essential in reducing
the risks of influenza
related infections
(relative risk 0.76,
95% CI 0.65–0.90)
respectively)
showed lower rates
of pneumonia
occurrence by
15⁻25%.
Findings and
Recommendations
There is a need for discussion
of new opportunities for
vaccination of all adults as
well as for vaccination of
older adults
- Influenza vaccine
significantly reduces
pneumonia- and
influenza-related
hospitalizations
Efficacy of influenza
vaccine was 16–59%
in healthy adults
its application in
health care practice is
essential
Influenza vaccine
has a fundamental
role in reducing the
occurrence of
pneumonia
especially with
persons who had
received
vaccination.
Appraisal and Study Quality The study is more of an
expert review and analysis to
inform guidance and way
forward through a stakeholder
approach to entrenching
vaccines practice into
adulthood. Hence cannot offer
any concrete process of
evidence-based practice.
- The study is
fundamental in
that selection of
meta-analysis
studies focusing
on vaccines in
influenza was
assessed.
- The study focused
on various studies
such as Cochrane
review, a systematic
review and
observational case-
control studies
- This obtained
evidence
demonstrates the
The study offers a
fundamental cross-
sectional review of
the influenza
vaccination process.
© 2018 Laureate Education Inc. 4

effectiveness of
between 16-59%
among healthy
adults. The vaccine
is essential in
reducing the
likelihood of
occurrence of the
disease but nor the
effectiveness of
severity compilation
arising.
Key findings
The study was majorly an
expert analysis and
recommendation on the
avenue o immunization
practices.
This review informs the road
map WHO is likely to take in
promoting healthy aging and
integrating interdisciplinary
approaches on immunization
towards improving health
care.
- Influenza
vaccines ahs a
fundamental role
in preventing
related infections
Influenza vaccine is
essential in preventing
influenza development
in adulthood though
not beyond underlying
complications
Influenza vaccine
has a role in
lowering the level of
pneumonia
occurrence between
15-25% consistent
with other studies.
This is fundamental
in health care
settings to lower the
occurrence of
getting influenza.
Outcomes
Engagement with stakeholders Influenza vaccine is
crucial to reduce related
hospitalization
Influenza vaccine has
a fundamental role to
play in reducing the
Influenza vaccine is
fundamental in
prevention purposes
© 2018 Laureate Education Inc. 5

likelihood of disease
occurrence
General Notes/Comments
The study allows for greater
broader collaborations.
It offers an avenue for
greater deliberations on
vaccine world for the
adult population.
On the application and
usage of the influenza
vaccine, no cause
mortality case was
observed.
There is a need for
the adoption of the
influenza vaccine for
the adult population.
Critical Appraisal
Influenza is a prevalent pathogen affecting the respiratory tract leading to infections affecting close to 20% of the general
population globally with pneumonia being the leading cause of the death and after infection. The development of influenza occurs in
the three types namely primary viral pneumonia, concomitant viral bacterial pneumonia, and secondary bacterial pneumonia. The
development and prospects of the influenza vaccine have been addressed and continue to be a major drive avenue. The influenza
vaccine is effective in preventing respiratory illness and reducing hospitalization of related influenza conditions. A report by Aguado
et al (2018) based on WHO review has elaborated on the need for integrating immunization avenues in a bid to improve prevention
among the adult populations. Research on influenza vaccine to address pneumonia-related influenza has shown consistent findings on
some level of effectiveness. The study by Heo et al (2017) in a meta-analysis assessment showed that the influenza vaccine has an
essence of reducing pneumonia associated hospitalization with an effective rate of between 25-53%. Similarly in a multi assessment,
© 2018 Laureate Education Inc. 6

Meta-analysis by Samuel & Miller (2019) showed an efficacy level of between 16-59% among healthy adults. Moreover, a study by
Yeh et al (2019), in a cross-sectional assessment among subjects with pneumonia showed lowered rates of incidence of pneumonia
among the vaccinated group to be between 15-25%. These assessments and analyses undertaken by these studies demonstrate that the
influenza vaccine has some level of effectiveness towards the incidence of pneumonia-related influenza occurrence. The vaccine did
not prevent the occurrence of complications from influenza disease. Based on these observations, the influenza vaccine is a vital
avenue in managing pneumonia influenza type occurrence. This calls for avenues to entrench vaccination care across the adult
population to reduce morbidity and mortality rates linked to pneumonia in influenza occurrence.
© 2018 Laureate Education Inc. 7

References
Aguado, M. T., Barratt, J., Beard, J. R., Blomberg, B. B., Chen, W. H., Hickling, J., … Ortiz, J. R. (2018). Report on WHO meeting
on immunization in older adults: Geneva, Switzerland, 22–23 March 2017. Vaccine, 36(7), 921–931. doi:
10.1016/j.vaccine.2017.12.029
Heo, J. Y., Song, J. Y., Noh, J. Y., Choi, M. J., Yoon, J. G., Lee, S. N., Cheong, H. J., & Kim, W. J. (2018). Effects of influenza
immunization on pneumonia in the elderly. Human Vaccines & Immunotherapeutics, 14(3), 744–749.
doi: 10.1080/21645515.2017.1405200
Samuel, R., & Miller, J. (2019). Is the influenza vaccine effective in decreasing infection, hospitalization, pneumonia, and mortality in
healthy adults?. The Journal of the Oklahoma State Medical Association, 112(3), 86–87.
Yeh, L.-T., Chan, C.-H., Yang, S.-F., Yeh, H.-W., Yeh, Y.-T., Wang, Y.-H., Chou, M.-C., Yeh, C.-B., & Teng, Y.-H. (2019).
Association of Consecutive Influenza Vaccinations and Pneumonia: A Population-Based Case-Control Study. International
Journal Of Environmental Research And Public Health, 16(6). DOI: 10.3390/ijerph16061078
© 2018 Laureate Education Inc. 8