Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
The recommendation to provide inactivated influenza vaccine (IIV) to pregnant women is based on observed protection against influenza-related morbidity in mother and infant. Non-live vaccines may have non-specific effects (NSEs), increasing the risk of non-targeted infections in females. We reviewed...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/9/12/1452 |
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| author | Katrine Pedersbæk Hansen Christine Stabell Benn Thomas Aamand Martin Buus Isaquel da Silva Peter Aaby Ane Bærent Fisker Sanne Marie Thysen |
| author_facet | Katrine Pedersbæk Hansen Christine Stabell Benn Thomas Aamand Martin Buus Isaquel da Silva Peter Aaby Ane Bærent Fisker Sanne Marie Thysen |
| author_sort | Katrine Pedersbæk Hansen |
| collection | DOAJ |
| description | The recommendation to provide inactivated influenza vaccine (IIV) to pregnant women is based on observed protection against influenza-related morbidity in mother and infant. Non-live vaccines may have non-specific effects (NSEs), increasing the risk of non-targeted infections in females. We reviewed the evidence from available randomised controlled trials (RCTs) of IIV to pregnant women, to assess whether IIV may have NSEs. Four RCTs, all conducted in low- and middle-income settings, were identified. We extracted information on all-cause and infectious mortality and adverse events in women and their infants. We conducted meta-analyses providing risk ratios (RR). The meta-analysis for maternal all-cause mortality provided a RR of 1.48 (95% CI = 0.52–4.16). The estimates for miscarriage/stillbirth and infant all-cause mortality up to 6 months of age were 1.06 (0.78–1.44) and 1.11 (0.87–1.41), respectively. IIV was associated with a higher risk of non-influenza infectious adverse events, with meta-estimates of 2.01 (1.15–3.50) in women and 1.36 (1.12–1.67) in infants up to 6 months of age. Thus, following a pattern seen for other non-live vaccines, IIV was associated with a higher risk of non-influenza infectious adverse events. To ensure that scarce resources are used well, and no harm is inflicted, further RCTs are warranted. |
| first_indexed | 2024-03-10T03:56:01Z |
| format | Article |
| id | doaj.art-51f20563b16848eeb96567ec37f9201b |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-10T03:56:01Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-51f20563b16848eeb96567ec37f9201b2023-11-23T10:54:33ZengMDPI AGVaccines2076-393X2021-12-01912145210.3390/vaccines9121452Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled TrialsKatrine Pedersbæk Hansen0Christine Stabell Benn1Thomas Aamand2Martin Buus3Isaquel da Silva4Peter Aaby5Ane Bærent Fisker6Sanne Marie Thysen7Bandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, DenmarkBandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, DenmarkBandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, DenmarkBandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, DenmarkBandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-BissauBandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, DenmarkBandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, DenmarkBandim Health Project, OPEN, Department of Clinical Research, Odense University Hospital/University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, DenmarkThe recommendation to provide inactivated influenza vaccine (IIV) to pregnant women is based on observed protection against influenza-related morbidity in mother and infant. Non-live vaccines may have non-specific effects (NSEs), increasing the risk of non-targeted infections in females. We reviewed the evidence from available randomised controlled trials (RCTs) of IIV to pregnant women, to assess whether IIV may have NSEs. Four RCTs, all conducted in low- and middle-income settings, were identified. We extracted information on all-cause and infectious mortality and adverse events in women and their infants. We conducted meta-analyses providing risk ratios (RR). The meta-analysis for maternal all-cause mortality provided a RR of 1.48 (95% CI = 0.52–4.16). The estimates for miscarriage/stillbirth and infant all-cause mortality up to 6 months of age were 1.06 (0.78–1.44) and 1.11 (0.87–1.41), respectively. IIV was associated with a higher risk of non-influenza infectious adverse events, with meta-estimates of 2.01 (1.15–3.50) in women and 1.36 (1.12–1.67) in infants up to 6 months of age. Thus, following a pattern seen for other non-live vaccines, IIV was associated with a higher risk of non-influenza infectious adverse events. To ensure that scarce resources are used well, and no harm is inflicted, further RCTs are warranted.https://www.mdpi.com/2076-393X/9/12/1452non-specific effectsvaccinationimmune systeminfluenza vaccinepregnancyall-cause mortality |
| spellingShingle | Katrine Pedersbæk Hansen Christine Stabell Benn Thomas Aamand Martin Buus Isaquel da Silva Peter Aaby Ane Bærent Fisker Sanne Marie Thysen Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials Vaccines non-specific effects vaccination immune system influenza vaccine pregnancy all-cause mortality |
| title | Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials |
| title_full | Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials |
| title_fullStr | Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials |
| title_full_unstemmed | Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials |
| title_short | Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials |
| title_sort | does influenza vaccination during pregnancy have effects on non influenza infectious morbidity a systematic review and meta analysis of randomised controlled trials |
| topic | non-specific effects vaccination immune system influenza vaccine pregnancy all-cause mortality |
| url | https://www.mdpi.com/2076-393X/9/12/1452 |
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