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Comparative immunogenicity of enhanced seasonal influenza vaccines in older adults: a systematic review and meta-analysis

tetano

Editor, Senior Moderator
J Infect Dis. 2018 Dec 14. doi: 10.1093/infdis/jiy720. [Epub ahead of print]
[h=1]Comparative immunogenicity of enhanced seasonal influenza vaccines in older adults: a systematic review and meta-analysis.[/h] Ng TWY[SUP]1[/SUP], Cowling BJ[SUP]1[/SUP], Gao HZ[SUP]1[/SUP], Thompson MG[SUP]2[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]Introduction:[/h] A number of enhanced influenza vaccines have been developed for use in older adults, including the high-dose, MF59-adjuvanted, and intradermal vaccines.
[h=4]Methods:[/h] We conducted a systematic review examining the improvements in antibody responses measured by the hemagglutination inhibition (HAI) assay associated with these enhanced vaccines, compared to each other, and compared to standard-dose vaccine using random effects models.
[h=4]Results:[/h] Thirty-nine trials were included. Compared to adults aged 60 years receiving standard-dose vaccines, those receiving enhanced vaccines had significantly higher post-vaccination titers (for all vaccine strains) and higher proportions with elevated titers ≥40 (for most vaccine strains). High-dose vaccine elicited 82% higher post-vaccination titer to A(H3N2) compared to standard-dose vaccine; this was significantly higher than 52% estimated for MF59-adjuvanted versus standard-dose vaccines (p=0.04), which was higher than 32% estimated for intradermal versus standard-dose vaccines (p<0.01).
[h=4]Conclusions:[/h] Overall, by summarizing current evidence, we found enhanced vaccines had greater antibody responses than standard-dose vaccine. Indications of differences among enhanced vaccines highlight that further research is needed in order to compare new vaccine options; this is especially needed during seasons with mismatched circulating strains and for immune outcomes other than HAI titers as well as vaccine efficacy.


PMID: 30551178 DOI: 10.1093/infdis/jiy720
 
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