Clinical efficacy and safety of high dose trivalent influenza vaccine in adults and immunosuppressed populations - A systematic review and meta-analysis
Autor: | Dafna Yahav, Lisa Cooper, Liat Ashkenazi-Hoffnung, Neta Sternbach, Yaara Leibovici Weissman |
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Rok vydání: | 2019 |
Předmět: |
Microbiology (medical)
medicine.medical_specialty Antibodies Viral law.invention Immunocompromised Host Randomized controlled trial law Internal medicine Influenza Human Medicine Humans Clinical efficacy Adverse effect Aged business.industry Influenza A Virus H3N2 Subtype Confidence interval Infectious Diseases Vaccine Potency Treatment Outcome Vaccines Inactivated Influenza Vaccines Meta-analysis Relative risk business High-Dose Trivalent Influenza Vaccine |
Zdroj: | The Journal of infection. 83(4) |
ISSN: | 1532-2742 |
Popis: | Objectives Influenza is associated with significant morbidity and mortality, especially in older and immunocompromised patients. Few data are available on the clinical benefit of high dose trivalent influenza vaccine (TIV). We aimed to assess the clinical efficacy and safety of high dose TIV. Methods We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), evaluating high dose versus standard dose TIV for prevention of seasonal influenza in adult population. Primary outcome was laboratory-confirmed influenza. Subgroups analyses included older adults and immunocompromised patients. Results We included 16 trials, 47,857 patients; 10 included older adults and three immunocompromised patients. Laboratory confirmed influenza was significantly reduced with high dose TIV (relative risk 0.76, 95% confidence interval 0.64 to 0.9). This outcome stemmed mainly from one trial in older adults. Specifically, A(H3N2) laboratory confirmed influenza, but not A(H1N1) or B lineages, was reduced. No difference in mortality or hospitalizations was demonstrated. Immunological response was significantly higher with high dose vaccine. Serious adverse events were significantly less common in the high dose group. Conclusions High dose TIV lowers the rates of laboratory confirmed influenza, mainly A (H3N2), in older adults vs. standard dose. Further studies should address immunocompromised patients and report clinical outcomes. |
Databáze: | OpenAIRE |
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