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Rev Med Virol . Systematic review of the efficacy, effectiveness and safety of high-dose seasonal influenza vaccines for the prevention of laborator

tetano

Editor, Senior Moderator
Rev Med Virol


. 2022 Feb 4;e2330.
doi: 10.1002/rmv.2330. Online ahead of print.
Systematic review of the efficacy, effectiveness and safety of high-dose seasonal influenza vaccines for the prevention of laboratory-confirmed influenza in individuals ≥18 years of age


Laura Comber[SUP] 1 [/SUP], Eamon O Murchu[SUP] 1 2 [/SUP], Karen Jordan[SUP] 1 [/SUP], Sarah Hawkshaw[SUP] 1 [/SUP], Liam Marshall[SUP] 1 [/SUP], Michelle O'Neill[SUP] 1 [/SUP], Conor Teljeur[SUP] 1 [/SUP], Máirín Ryan[SUP] 1 3 [/SUP], AnnaSara Carnahan[SUP] 4 5 [/SUP], Jaime Jesús Pérez Martín[SUP] 4 6 [/SUP], Anna Hayman Robertson[SUP] 4 7 [/SUP], Kari Johansen[SUP] 4 8 [/SUP], Jorgen de Jonge[SUP] 4 9 [/SUP], Tyra Krause[SUP] 4 10 [/SUP], Nathalie Nicolay[SUP] 4 8 [/SUP], Hanna Nohynek[SUP] 4 11 [/SUP], Ioanna Pavlopoulou[SUP] 4 12 13 [/SUP], Richard Pebody[SUP] 4 14 [/SUP], Pasi Penttinen[SUP] 4 8 [/SUP], Marta Soler-Soneira[SUP] 4 15 [/SUP], Ole Wichmann[SUP] 4 16 [/SUP], Patricia Harrington[SUP] 1 [/SUP]



Affiliations

Abstract

This review sought to assess the efficacy, effectiveness and safety of high-dose inactivated influenza vaccines (HD-IIV) for the prevention of laboratory-confirmed influenza in individuals aged 18 years or older. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) were included. The search returned 28,846 records, of which 36 studies were included. HD-IIV was shown to have higher relative vaccine efficacy in preventing influenza compared with standard-dose influenza vaccines (SD-IIV3) in older adults (Vaccine effectiveness (VE) = 24%, 95% CI 10-37, one RCT). One NRSI demonstrated significant effect for HD-IIV3 against influenza B (VE = 89%, 95% CI 47-100), but not for influenza A(H3N2) (VE = 22%, 95% CI -82 to 66) when compared with no vaccination in older adults. HD-IIV3 showed significant relative effect compared with SD-IIV3 for influenza-related hospitalisation (VE = 11.8%, 95% CI 6.4-17.0, two NRSIs), influenza- or pneumonia-related hospitalisation (VE = 13.7%, 95% CI 9.5-17.7, three NRSIs), influenza-related hospital encounters (VE = 13.1%, 95% CI 8.4-17.7, five NRSIs), and influenza-related office visits (VE = 3.5%, 95% CI 1.5-5.5, two NRSIs). For safety, HD-IIV were associated with significantly higher rates of local and systemic adverse events compared with SD-IIV (combined local reactions, pain at injection site, swelling, induration, headache, chills and malaise). From limited data, compared with SD-IIV, HD-IIV were found to be more effective in the prevention of laboratory-confirmed influenza, for a range of proxy outcome measures, and associated with more adverse events.

Keywords: high-dose; human; influenza; influenza vaccines.
 
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