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Meta-Analysis
. 2025 May 16;104(20):e42463.
doi: 10.1097/MD.0000000000042463.

The protective efficacy of inactivated vaccine against hemorrhagic fever with renal syndrome: A meta-analysis

Weiting Wu  1   2   3 , Jie Liu  1   4   5 , Shicheng Guo  4   5 , Han Zhao  1   2   3 , Xuli Yang  6
Affiliations
Meta-Analysis

The protective efficacy of inactivated vaccine against hemorrhagic fever with renal syndrome: A meta-analysis

Weiting Wu et al. Medicine (Baltimore). .

Abstract

Background: Hemorrhagic fever with renal syndrome (HFRS) is a kind of natural epidemic diseases with rodents as the main source of infection. The main clinical manifestations of HFRS are fever, hemorrhage, congestion, hypotensive shock and kidney damage. Some studies showed that vaccination populations in infected areas with inactivated vaccines can reduce the incidence of the disease, but there are variations in protection rates among these studies. The aim of this study is to systematically evaluate the protective effect of inactivated vaccines against HFRS.

Methods: Web of Science, PubMed, SinoMed, Proquest, China National Knowledge Infrastructure Database, Wanfang Database, VIP Database were searched from their inception to December 2024. Newcastle-Ottawa Scale (NOS) was used to assess the quality of evidence, and a random-effects meta-analysis was done to calculate pooled risk ratios for vaccination uptake. All the relevant data were analyzed by using STATA 15.0.

Results: A total of 15 articles were included, all of which explicitly reported the total number of vaccinated and unvaccinated people in the vaccination group, and the number of cases that developed during the observation period. Six of these articles reported positive antibody transfer rates. The protection rate of the inactivated HFRS vaccine reached 86%, and a subgroup analysis showed that there was a significant difference in the protection rate of the inactivated vaccine between Korea and China. The positive IgG antibody transfer rate was 97%, and neutralizing antibody transfer rate was 37%.

Conclusion: The results indicated that inactivated vaccine has a good protective effect against HFRS and should be universally administered to populations in high prevalence areas to control the harm caused by HFRS epidemics.

Keywords: inactivated vaccination; meta-analysis; protection rate; vaccine effectiveness.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Screening literature process.
Figure 2.
Figure 2.
Forest plot for meta-analysis of the protective effect of HFRS inactivated vaccine. HFRS = hemorrhagic fever with renal syndrome. 95% CI = 95% confidence interval.
Figure 3.
Figure 3.
Funnel plot for meta-analysis of the protective effect of HFRS inactivated vaccine. HFRS = hemorrhagic fever with renal syndrome.
Figure 4.
Figure 4.
Publication bias was corrected through trim and filling method.
Figure 5.
Figure 5.
Sensitivity analysis plot of protective efficiency of HFRS inactivated vaccine. HFRS = hemorrhagic fever with renal syndrome.
Figure 6.
Figure 6.
Forest plot of positive transfer rate of IgG antibodies. 95% CI = 95% confidence interval.
Figure 7.
Figure 7.
Forest plot of neutralizing antibody positivity. 95% CI = 95% confidence interval.
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