@article {Fink192, author = {G{\"u}nther Fink and Nina Orlova-Fink and Tobias Schindler and Sandra Grisi and Ana Paula S Ferrer and Claudia Daubenberger and Alexandra Brentani}, title = {Inactivated trivalent influenza vaccination is associated with lower mortality among patients with COVID-19 in Brazil}, volume = {26}, number = {4}, pages = {192--193}, year = {2021}, doi = {10.1136/bmjebm-2020-111549}, publisher = {Royal Society of Medicine}, abstract = {Objective To estimate associations between trivalent influenza vaccination and COVID-19 mortality as well as severe clinical outcomes among hospitalised patients.Design Retrospective observational study.Setting This study was conducted among hospitalised patients with COVID-19 in Brazil.Participants We analysed all hospitalised patients with COVID-19 with available vaccination information captured in Brazil{\textquoteright}s national electronic respiratory infection data system between 1 January 2020 and 23 June 2020.Main outcome measures The primary outcomes were age-specific mortality rates of hospitalised patients with COVID-19 with and without recent inactivated trivalent influenza vaccination.Results A total of 53 752 clinically confirmed COVID-19 cases were analysed. Controlling for health facility of treatment, comorbidities as well as an extensive range of sociodemographic factors, patients who received a recent influenza vaccine experienced on average 7\% lower odds of needing intensive care treatment (95\% CI 0.87 to 0.98), 17\% lower odds of requiring invasive respiratory support (95\% CI 0.77 to 0.88) and 16\% lower odds of death (95\% CI 0.78 to 0.90). Protective effects were larger when the vaccine was administered after onset of symptoms as well as among younger patients.Conclusion Patients with COVID-19 with recent inactivated influenza vaccination experience significantly better health outcomes than non-vaccinated patients in Brazil. Beneficial off-target effects of influenza vaccination through trained innate immune responses seem plausible and need to be further explored. Large-scale promotion of influenza vaccines seems advisable, especially in populations at high risk for severe COVID-19 disease progression.Data are publicly available at the Brazilian Ministry of Health website.}, issn = {2515-446X}, URL = {https://ebm.bmj.com/content/26/4/192}, eprint = {https://ebm.bmj.com/content/26/4/192.full.pdf}, journal = {BMJ Evidence-Based Medicine} }