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Meta-Analysis
. 2019 Apr 19;219(10):1525-1535.
doi: 10.1093/infdis/jiy720.

Comparative Immunogenicity of Enhanced Seasonal Influenza Vaccines in Older Adults: A Systematic Review and Meta-analysis

Tiffany W Y Ng  1 , Benjamin J Cowling  1 , Hui Zhi Gao  1 , Mark G Thompson  2
Affiliations
Meta-Analysis

Comparative Immunogenicity of Enhanced Seasonal Influenza Vaccines in Older Adults: A Systematic Review and Meta-analysis

Tiffany W Y Ng et al. J Infect Dis. .

Abstract

Background: A number of enhanced influenza vaccines have been developed for use in older adults, including high-dose, MF59-adjuvanted, and intradermal vaccines.

Methods: We conducted a systematic review examining the improvements in antibody responses measured by the hemagglutination inhibition assay associated with these enhanced vaccines, compared with each other and with the standard-dose (SD) vaccine using random effects models.

Results: Thirty-nine trials were included. Compared with adults aged ≥60 years receiving SD vaccines, those receiving enhanced vaccines had significantly higher postvaccination titers (for all vaccine strains) and higher proportions with elevated titers ≥40 (for most vaccine strains). High-dose vaccine elicited 82% higher postvaccination titer to A(H3N2) compared with SD vaccine; this was significantly higher than the 52% estimated for MF59-adjuvanted versus SD vaccines (P = .04), which was higher than the 32% estimated for intradermal versus SD vaccines (P < .01).

Conclusions: Overall, by summarizing current evidence, we found that enhanced vaccines had greater antibody responses than the SD vaccine. Indications of differences among enhanced vaccines highlight the fact that further research is needed to compare new vaccine options, especially during seasons with mismatched circulating strains and for immune outcomes other than hemagglutination inhibition titers as well as vaccine efficacy.

Keywords: Immunogenicity; influenza; vaccine.

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Figures

Figure 1.
Figure 1.
Flow chart of study selection in the systematic review. Outcome 1 was mean fold rise; outcome 2, postvaccination titers ratios of enhanced versus standard-dose vaccines; outcome 3, absolute differences in proportion with elevated titers between enhanced and standard-dose vaccines. Abbreviation: HAI, hemagglutination inhibition.
See this image and copyright information in PMC

References

    1. Hannoun C. The evolving history of influenza viruses and influenza vaccines. Expert Rev Vaccines 2013; 12:1085–94. - PubMed
    1. Hayward AC, Fragaszy EB, Bermingham A, et al. ; Flu Watch Group Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med 2014; 2:445–54. - PMC - PubMed
    1. Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003; 289:179–86. - PubMed
    1. Thompson WW, Shay DK, Weintraub E, et al. Influenza-associated hospitalizations in the United States. JAMA 2004; 292:1333–40. - PubMed
    1. Grohskopf LA, Shay DK, Shimabukuro TT, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2013–2014. MMWR Recomm Rep 2013; 62:1–43. - PubMed

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