tetano
Editor, Senior Moderator
Am J Med
. 2021 Sep 23;S0002-9343(21)00608-2.
doi: 10.1016/j.amjmed.2021.08.038. Online ahead of print.
Influenza vaccination in Systemic Lupus Erythematosus: Efficacy, Effectiveness, Safety, Utilization and Barriers
Jackie Jia Lin Sim[SUP] 1 [/SUP], Cynthia Ciwei Lim[SUP] 2 [/SUP]
Affiliations
Abstract
Influenza increases morbidity and mortality in systemic lupus erythematosus and lupus nephritis but is preventable through vaccination. This systematic review of PubMed, Embase, CENTRAL, WHO Clinical Trials and ClinicalTrials.gov publications until August 2021 identified 45 reports (16596 patients), including 8.5% with renal involvement or lupus nephritis: 9 studies (10446 patients) on clinical effectiveness, 20 studies (1327 patients) on vaccine efficacy, 22 studies (1116 patients) on vaccine safety, 14 studies (4619 patients) on utilization rates and 5 studies (3220 patients) on barriers. Pooled seroconversion rates ranged 46-56% while seroprotection rates ranged 68-73% and was significantly associated with age and disease duration. Influenza infection was lower in vaccinated systemic lupus erythematosus patients compared to unvaccinated patients. Disease activity scores did not change significantly after vaccination and reported flares were mild to moderate. Pooled current vaccination rate was 40.0% (95% CI: 33.7-46.5%) with significant heterogeneity and associated with the gross domestic product (p=0.002) and disease duration (p=0.001). Barriers to vaccination were the lack of doctor recommendation (57.4%) and concerns over the safety or efficacy of the vaccine (12.7%).
Keywords: Systemic lupus erythematosus; effectiveness; influenza vaccine; lupus nephritis; meta-analysis; safety; systematic review.
. 2021 Sep 23;S0002-9343(21)00608-2.
doi: 10.1016/j.amjmed.2021.08.038. Online ahead of print.
Influenza vaccination in Systemic Lupus Erythematosus: Efficacy, Effectiveness, Safety, Utilization and Barriers
Jackie Jia Lin Sim[SUP] 1 [/SUP], Cynthia Ciwei Lim[SUP] 2 [/SUP]
Affiliations
- PMID: 34563493
- DOI: 10.1016/j.amjmed.2021.08.038
Abstract
Influenza increases morbidity and mortality in systemic lupus erythematosus and lupus nephritis but is preventable through vaccination. This systematic review of PubMed, Embase, CENTRAL, WHO Clinical Trials and ClinicalTrials.gov publications until August 2021 identified 45 reports (16596 patients), including 8.5% with renal involvement or lupus nephritis: 9 studies (10446 patients) on clinical effectiveness, 20 studies (1327 patients) on vaccine efficacy, 22 studies (1116 patients) on vaccine safety, 14 studies (4619 patients) on utilization rates and 5 studies (3220 patients) on barriers. Pooled seroconversion rates ranged 46-56% while seroprotection rates ranged 68-73% and was significantly associated with age and disease duration. Influenza infection was lower in vaccinated systemic lupus erythematosus patients compared to unvaccinated patients. Disease activity scores did not change significantly after vaccination and reported flares were mild to moderate. Pooled current vaccination rate was 40.0% (95% CI: 33.7-46.5%) with significant heterogeneity and associated with the gross domestic product (p=0.002) and disease duration (p=0.001). Barriers to vaccination were the lack of doctor recommendation (57.4%) and concerns over the safety or efficacy of the vaccine (12.7%).
Keywords: Systemic lupus erythematosus; effectiveness; influenza vaccine; lupus nephritis; meta-analysis; safety; systematic review.