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Comber L, O Murchu E, Jordan K, Hawkshaw S, Marshall L, O'Neill M, Teljeur C, Ryan M, Carnahan A, Pérez Martín JJ, Robertson AH, Johansen K, de Jonge J, Krause T, Nicolay N, Nohynek H, Pavlopoulou I, Pebody R, Penttinen P, Soler-Soneira M, Wichmann O, Harrington P. 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. Rev Med Virol 2022; 33:e2330. [PMID: 35119149 DOI: 10.1002/rmv.2330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 12/24/2022]
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.
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Affiliation(s)
- Laura Comber
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Eamon O Murchu
- Health Information and Quality Authority (HIQA), Dublin, Ireland.,Department of Health Policy & Management, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Karen Jordan
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Sarah Hawkshaw
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Liam Marshall
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Michelle O'Neill
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Conor Teljeur
- Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Máirín Ryan
- Health Information and Quality Authority (HIQA), Dublin, Ireland.,Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity Health Sciences, Dublin, Ireland
| | - AnnaSara Carnahan
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Public Health Agency of Sweden, Solna, Sweden
| | - Jaime Jesús Pérez Martín
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,General Directorate of Public Health and Addictions, IMIB-Arrixaca, Murcia University, Region of Murcia, Spain
| | - Anna Hayman Robertson
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kari Johansen
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jorgen de Jonge
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Tyra Krause
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Statens Serum Institut, Copenhagen, Denmark
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Hanna Nohynek
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ioanna Pavlopoulou
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Pediatric Research Laboratory, School of Health Sciences, Faculty of Nursing, National & Kapodistrian University of Athens, Goudi, Greece.,National Advisory Committee on Immunisation, Hellenic Ministry of Health, Athens, Greece
| | - Richard Pebody
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Institute of Epidemiology & Health, University College London, London, UK
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Marta Soler-Soneira
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Vigilancia de Enfermedades Prevenibles por Vacunación, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain
| | - Ole Wichmann
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) Collaboration on Newer and Enhanced Inactivated Seasonal Influenza Vaccines, Solna, Sweden.,Immunization Unit, Robert Koch-Institute, Berlin, Germany
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