Immunogenicity, duration of protection, effectiveness and safety of rubella containing vaccines: A systematic literature review and meta-analysis
| Autor: | Hester E. de Melker, Irene K. Veldhuijzen, Jossy Van den Boogaard, Priscila de Oliveira Bressane Lima, Shalini Desai, Susan Hahné, Brechje de Gier |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Adolescent Rubella Syndrome Congenital Effectiveness Review medicine.disease_cause Rubella law.invention Rubella vaccine Randomized controlled trial law Pregnancy Internal medicine medicine Humans Rubella Vaccine Seroconversion Child Congenital rubella syndrome General Veterinary General Immunology and Microbiology business.industry Immunogenicity Public Health Environmental and Occupational Health Infant Rubella virus medicine.disease Meta-analysis Infectious Diseases Duration of protection Rubella containing vaccine Molecular Medicine Female Pregnant Women Safety business medicine.drug |
| Popis: | Background Rubella containing vaccines (RCV) prevent rubella virus infection and subsequent congenital rubella syndrome (CRS). To update the evidence on immunogenicity, duration of protection, effectiveness and safety of RCV, we conducted a systematic literature review. Methods We searched EMBASE and SCOPUS, using keywords for rubella vaccine in combination with immunogenicity (seroconversion and seropositivity), duration of protection, efficacy/effectiveness, and safety. Original research papers involving at least one dose of RCV (at any age), published between 1-1-2010 and 17-5-2019 were included. Where appropriate, meta-analyses were performed. Quality of included studies was assessed using GRADE methodology. Results We included 36 papers (32 randomized controlled trials (RCTs) and 4 observational studies) on immunogenicity (RA27/3 strain) in children and adolescent girls, 14 papers (5 RCTs and 9 observational studies) on duration of protection, one paper on vaccine effectiveness (VE) (BRDII strain), and 74 studies on safety, including three on safety in pregnancy. Meta-analysis of immunogenicity data showed 99% seroconversion (95% CI: 98–99%) after a single dose of RCV in children, independent of co-administration with other vaccines. Seroconversion after RCV1 below 9 months of age (BRDII strain, at 8 months) was 93% (95% CI: 92–95%). For duration of protection, the included studies showed a seropositivity of 88%-100% measured 1–20 years after one or two RCV doses. The single study on VE of BRDII strain, reported 100% VE after one and two doses. Among 34,332 individuals participating in the RCTs, 140 severe adverse events (SAEs) were reported as possibly related to RCV. Among the case reports on SAEs, the association with RCV was confirmed in one report (on fulminant encephalitis). Among 3,000 pregnant women who were inadvertently vaccinated, no SAEs were reported. Conclusions One and two doses of RCV are highly immunogenic for a long period of time, effective in preventing rubella and CRS, and safe. |
| Databáze: | OpenAIRE |
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