tetano
Editor, Senior Moderator
J Infect
. 2024 May 23;89(1):106187.
doi: 10.1016/j.jinf.2024.106187. Online ahead of print. The relative vaccine effectiveness of high-dose vs standard-dose influenza vaccines in preventing hospitalization and mortality: A meta-analysis of evidence from randomized trials
Kristoffer Grundtvig Skaarup[SUP] 1 [/SUP], Mats Christian Højbjerg Lassen[SUP] 2 [/SUP], Daniel Modin[SUP] 2 [/SUP], Niklas Dyrby Johansen[SUP] 2 [/SUP], Matthew M Loiacono[SUP] 3 [/SUP], Rebecca C Harris[SUP] 4 [/SUP], Jason K H Lee[SUP] 5 [/SUP], Marine Dufournet[SUP] 6 [/SUP], Orly Vardeny[SUP] 7 [/SUP], Alexander Peikert[SUP] 8 [/SUP], Brian Claggett[SUP] 8 [/SUP], Scott D Solomon[SUP] 8 [/SUP], Jens Ulrik Stæhr Jensen[SUP] 9 [/SUP], Tor Biering-Sørensen[SUP] 10 [/SUP]
Affiliations
Objectives: To summarize current evidence of high-dose influenza vaccine (HD-IV) vs standard-dose (SD-IV) regarding severe clinical outcomes.
Methods: A prespecified meta-analysis was conducted to assess relative vaccine effectiveness (rVE) of HD-IV vs SD-IV in reducing the rates of (1) pneumonia and influenza (P&I) hospitalization, (2) all hospitalizations, and (3) all-cause death in adults ≥ 65 years in randomized controlled trials. Pooled effect sizes were estimated using fixed-effects models with the inverse variance method.
Results: Five randomized trials were included encompassing 105,685 individuals. HD-IV vs SD-IV reduced P&I hospitalizations (rVE: 23.5 %, [95 %CI: 12.3 to 33.2]). HD-IV vs SD-IV also reduced rate of all-cause hospitalizations (rVE: 7.3 %, [95 %CI: 4.5 to 10.0]). No significant differences were observed in death rates (rVE = 1.6 % ([95 %CI: -2.0 to 5.0]) in HD-IV vs SD-IV. Sensitivity analyses omitting trials with participants sharing the same comorbidity, trials with ≥ 100 events, and random-effects models provided comparable estimates for all outcomes.
Conclusions: HD-IV reduced the incidence of P&I and all-cause hospitalization vs SD-IV in adults ≥ 65 years in randomized trials, through no significant difference was observed in all-cause death rates. These findings, supported by evidence from several randomized studies, can benefit from replication in a fully powered, individually randomized trial.
Keywords: High-dose influenza vaccine; Meta-analysis; Randomized trials; Severe clinical endpoints.
. 2024 May 23;89(1):106187.
doi: 10.1016/j.jinf.2024.106187. Online ahead of print. The relative vaccine effectiveness of high-dose vs standard-dose influenza vaccines in preventing hospitalization and mortality: A meta-analysis of evidence from randomized trials
Kristoffer Grundtvig Skaarup[SUP] 1 [/SUP], Mats Christian Højbjerg Lassen[SUP] 2 [/SUP], Daniel Modin[SUP] 2 [/SUP], Niklas Dyrby Johansen[SUP] 2 [/SUP], Matthew M Loiacono[SUP] 3 [/SUP], Rebecca C Harris[SUP] 4 [/SUP], Jason K H Lee[SUP] 5 [/SUP], Marine Dufournet[SUP] 6 [/SUP], Orly Vardeny[SUP] 7 [/SUP], Alexander Peikert[SUP] 8 [/SUP], Brian Claggett[SUP] 8 [/SUP], Scott D Solomon[SUP] 8 [/SUP], Jens Ulrik Stæhr Jensen[SUP] 9 [/SUP], Tor Biering-Sørensen[SUP] 10 [/SUP]
Affiliations
- PMID: 38795774
- DOI: 10.1016/j.jinf.2024.106187
Objectives: To summarize current evidence of high-dose influenza vaccine (HD-IV) vs standard-dose (SD-IV) regarding severe clinical outcomes.
Methods: A prespecified meta-analysis was conducted to assess relative vaccine effectiveness (rVE) of HD-IV vs SD-IV in reducing the rates of (1) pneumonia and influenza (P&I) hospitalization, (2) all hospitalizations, and (3) all-cause death in adults ≥ 65 years in randomized controlled trials. Pooled effect sizes were estimated using fixed-effects models with the inverse variance method.
Results: Five randomized trials were included encompassing 105,685 individuals. HD-IV vs SD-IV reduced P&I hospitalizations (rVE: 23.5 %, [95 %CI: 12.3 to 33.2]). HD-IV vs SD-IV also reduced rate of all-cause hospitalizations (rVE: 7.3 %, [95 %CI: 4.5 to 10.0]). No significant differences were observed in death rates (rVE = 1.6 % ([95 %CI: -2.0 to 5.0]) in HD-IV vs SD-IV. Sensitivity analyses omitting trials with participants sharing the same comorbidity, trials with ≥ 100 events, and random-effects models provided comparable estimates for all outcomes.
Conclusions: HD-IV reduced the incidence of P&I and all-cause hospitalization vs SD-IV in adults ≥ 65 years in randomized trials, through no significant difference was observed in all-cause death rates. These findings, supported by evidence from several randomized studies, can benefit from replication in a fully powered, individually randomized trial.
Keywords: High-dose influenza vaccine; Meta-analysis; Randomized trials; Severe clinical endpoints.