Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.
<h4>Background</h4>Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influ...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2011
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/9254262274364996bb42aaf0ac64d226 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:9254262274364996bb42aaf0ac64d226 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:9254262274364996bb42aaf0ac64d2262021-11-18T07:31:36ZInfluenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.1932-620310.1371/journal.pone.0029249https://doaj.org/article/9254262274364996bb42aaf0ac64d2262011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22216224/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events.<h4>Methodology/principal findings</h4>Electronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I(2) and publication bias was assessed using Begg's funnel plot and Egger's regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR]=0.23; 95% confidence interval [CI]=0.16-0.34; p<0.001) and laboratory confirmed influenza infection (OR=0.15; 95% CI=0.03-0.63; p=0.01) through vaccinating immunocompromised patie nts compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1), A(H3N2) and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified.<h4>Conclusions/significance</h4>Infection prevention and control strategies should recommend vaccinating immunocompromised patients. Potential for bias and confounding and the presence of heterogeneity mean the evidence reviewed is generally weak, although the directions of effects are consistent. Areas for further research are identified.Charles R BeckBruce C McKenzieAhmed B HashimRebecca C HarrisArina ZanuzdanaGabriel AgboadoElizabeth OrtonLaura Béchard-EvansGemma MorganCharlotte StevensonRachel WestonMitsuru MukaigawaraJoanne EnstoneGlenda AugustineMobasher ButtSophie KimRichard PulestonGirija DabkeRobert HowardJulie O'BoyleMary O'BrienLauren AhyowHelene DennessSiobhan FarmerJose FigureroaPaul FisherFelix GreavesMunib HaroonSophie HaroonCaroline HirdRachel IsbaDavid A IsholaMarko KeracVivienne ParishJonathan RobertsJulia RosserSarah TheakerDean WallaceNeil WigglesworthLiz LingardYana VinogradovaHiroshi HoriuchiJavier PeñalverJonathan S Nguyen-Van-TamPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 12, p e29249 (2011) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Charles R Beck Bruce C McKenzie Ahmed B Hashim Rebecca C Harris Arina Zanuzdana Gabriel Agboado Elizabeth Orton Laura Béchard-Evans Gemma Morgan Charlotte Stevenson Rachel Weston Mitsuru Mukaigawara Joanne Enstone Glenda Augustine Mobasher Butt Sophie Kim Richard Puleston Girija Dabke Robert Howard Julie O'Boyle Mary O'Brien Lauren Ahyow Helene Denness Siobhan Farmer Jose Figureroa Paul Fisher Felix Greaves Munib Haroon Sophie Haroon Caroline Hird Rachel Isba David A Ishola Marko Kerac Vivienne Parish Jonathan Roberts Julia Rosser Sarah Theaker Dean Wallace Neil Wigglesworth Liz Lingard Yana Vinogradova Hiroshi Horiuchi Javier Peñalver Jonathan S Nguyen-Van-Tam Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective. |
| description |
<h4>Background</h4>Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events.<h4>Methodology/principal findings</h4>Electronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I(2) and publication bias was assessed using Begg's funnel plot and Egger's regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR]=0.23; 95% confidence interval [CI]=0.16-0.34; p<0.001) and laboratory confirmed influenza infection (OR=0.15; 95% CI=0.03-0.63; p=0.01) through vaccinating immunocompromised patie nts compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1), A(H3N2) and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified.<h4>Conclusions/significance</h4>Infection prevention and control strategies should recommend vaccinating immunocompromised patients. Potential for bias and confounding and the presence of heterogeneity mean the evidence reviewed is generally weak, although the directions of effects are consistent. Areas for further research are identified. |
| format |
article |
| author |
Charles R Beck Bruce C McKenzie Ahmed B Hashim Rebecca C Harris Arina Zanuzdana Gabriel Agboado Elizabeth Orton Laura Béchard-Evans Gemma Morgan Charlotte Stevenson Rachel Weston Mitsuru Mukaigawara Joanne Enstone Glenda Augustine Mobasher Butt Sophie Kim Richard Puleston Girija Dabke Robert Howard Julie O'Boyle Mary O'Brien Lauren Ahyow Helene Denness Siobhan Farmer Jose Figureroa Paul Fisher Felix Greaves Munib Haroon Sophie Haroon Caroline Hird Rachel Isba David A Ishola Marko Kerac Vivienne Parish Jonathan Roberts Julia Rosser Sarah Theaker Dean Wallace Neil Wigglesworth Liz Lingard Yana Vinogradova Hiroshi Horiuchi Javier Peñalver Jonathan S Nguyen-Van-Tam |
| author_facet |
Charles R Beck Bruce C McKenzie Ahmed B Hashim Rebecca C Harris Arina Zanuzdana Gabriel Agboado Elizabeth Orton Laura Béchard-Evans Gemma Morgan Charlotte Stevenson Rachel Weston Mitsuru Mukaigawara Joanne Enstone Glenda Augustine Mobasher Butt Sophie Kim Richard Puleston Girija Dabke Robert Howard Julie O'Boyle Mary O'Brien Lauren Ahyow Helene Denness Siobhan Farmer Jose Figureroa Paul Fisher Felix Greaves Munib Haroon Sophie Haroon Caroline Hird Rachel Isba David A Ishola Marko Kerac Vivienne Parish Jonathan Roberts Julia Rosser Sarah Theaker Dean Wallace Neil Wigglesworth Liz Lingard Yana Vinogradova Hiroshi Horiuchi Javier Peñalver Jonathan S Nguyen-Van-Tam |
| author_sort |
Charles R Beck |
| title |
Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective. |
| title_short |
Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective. |
| title_full |
Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective. |
| title_fullStr |
Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective. |
| title_full_unstemmed |
Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective. |
| title_sort |
influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2011 |
| url |
https://doaj.org/article/9254262274364996bb42aaf0ac64d226 |
| work_keys_str_mv |
AT charlesrbeck influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT brucecmckenzie influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT ahmedbhashim influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT rebeccacharris influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT arinazanuzdana influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT gabrielagboado influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT elizabethorton influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT laurabechardevans influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT gemmamorgan influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT charlottestevenson influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT rachelweston influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT mitsurumukaigawara influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT joanneenstone influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT glendaaugustine influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT mobasherbutt influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT sophiekim influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT richardpuleston influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT girijadabke influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT roberthoward influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT julieoboyle influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT maryobrien influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT laurenahyow influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT helenedenness influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT siobhanfarmer influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT josefigureroa influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT paulfisher influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT felixgreaves influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT munibharoon influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT sophieharoon influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT carolinehird influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT rachelisba influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT davidaishola influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT markokerac influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT vivienneparish influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT jonathanroberts influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT juliarosser influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT sarahtheaker influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT deanwallace influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT neilwigglesworth influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT lizlingard influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT yanavinogradova influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT hiroshihoriuchi influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT javierpenalver influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective AT jonathansnguyenvantam influenzavaccinationforimmunocompromisedpatientssystematicreviewandmetaanalysisfromapublichealthpolicyperspective |
| _version_ |
1718423360409436160 |