Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis
Background: Influenza is responsible for a significant disease burden annually, especially in older adults. This study reviews the relative vaccine efficacy or effectiveness (rVE) of high-dose inactivated trivalent influenza vaccine (HD-IIV3) compared to standard-dose influenza vaccines (SD-IIV3) in...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2018-05-01
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| Series: | Expert Review of Vaccines |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/14760584.2018.1471989 |
| _version_ | 1797680454635094016 |
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| author | Jason K. H. Lee Gary K. L. Lam Thomas Shin Jiyeon Kim Anish Krishnan David P. Greenberg Ayman Chit |
| author_facet | Jason K. H. Lee Gary K. L. Lam Thomas Shin Jiyeon Kim Anish Krishnan David P. Greenberg Ayman Chit |
| author_sort | Jason K. H. Lee |
| collection | DOAJ |
| description | Background: Influenza is responsible for a significant disease burden annually, especially in older adults. This study reviews the relative vaccine efficacy or effectiveness (rVE) of high-dose inactivated trivalent influenza vaccine (HD-IIV3) compared to standard-dose influenza vaccines (SD-IIV3) in adults ≥65 against influenza-associated outcomes to inform evidence-based decision-making to shift clinical practice and standard of care in this population. Methods: A systematic review was conducted for studies assessing the rVE of HD-IIV3 against probable/laboratory-confirmed influenza-like illness (ILI), hospital admissions, and death in adults ≥65. Results from individual seasons were meta-analyzed and a random-effects model was used to estimate pooled rVEs. Results: After screening 992 studies, seven studies were meta-analyzed. HD-IIV3 demonstrated better protection against ILI compared to SD-IIV3 (rVE = 19.5%; 95% CI: 8.6–29.0%). HD-IIV3 was also more effective at preventing hospital admissions from all-causes (rVE = 9.1%; 95% CI: 2.4–15.3%), as well as from influenza (rVE = 17.8%; 95% CI: 8.1–26.5%), pneumonia (rVE = 24.3%, 95% CI: 13.9–33.4%), and cardiorespiratory events (rVE = 18.2%; 95% CI: 6.8–28.1%). rVE against post-influenza mortality was 22.2% (95% CI: -18.2–48.8%) and 2.5% (95% CI: -5.2–9.5%) against all-cause mortality. Conclusions: Available evidence suggests HD-IIV3 is more effective than SD-IIV3 at reducing the clinical outcomes associated with influenza infection in older adults and should be considered for routine use in the 65+ population. |
| first_indexed | 2024-03-11T23:29:16Z |
| format | Article |
| id | doaj.art-da749b86b992421daa46d756b0a661b7 |
| institution | Directory Open Access Journal |
| issn | 1476-0584 1744-8395 |
| language | English |
| last_indexed | 2024-03-11T23:29:16Z |
| publishDate | 2018-05-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Expert Review of Vaccines |
| spelling | doaj.art-da749b86b992421daa46d756b0a661b72023-09-20T10:18:03ZengTaylor & Francis GroupExpert Review of Vaccines1476-05841744-83952018-05-0117543544310.1080/14760584.2018.14719891471989Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysisJason K. H. Lee0Gary K. L. Lam1Thomas Shin2Jiyeon Kim3Anish Krishnan4David P. Greenberg5Ayman Chit6University of TorontoUniversity of TorontoSanofi PasteurUniversity of TorontoUniversity of TorontoSanofi PasteurUniversity of TorontoBackground: Influenza is responsible for a significant disease burden annually, especially in older adults. This study reviews the relative vaccine efficacy or effectiveness (rVE) of high-dose inactivated trivalent influenza vaccine (HD-IIV3) compared to standard-dose influenza vaccines (SD-IIV3) in adults ≥65 against influenza-associated outcomes to inform evidence-based decision-making to shift clinical practice and standard of care in this population. Methods: A systematic review was conducted for studies assessing the rVE of HD-IIV3 against probable/laboratory-confirmed influenza-like illness (ILI), hospital admissions, and death in adults ≥65. Results from individual seasons were meta-analyzed and a random-effects model was used to estimate pooled rVEs. Results: After screening 992 studies, seven studies were meta-analyzed. HD-IIV3 demonstrated better protection against ILI compared to SD-IIV3 (rVE = 19.5%; 95% CI: 8.6–29.0%). HD-IIV3 was also more effective at preventing hospital admissions from all-causes (rVE = 9.1%; 95% CI: 2.4–15.3%), as well as from influenza (rVE = 17.8%; 95% CI: 8.1–26.5%), pneumonia (rVE = 24.3%, 95% CI: 13.9–33.4%), and cardiorespiratory events (rVE = 18.2%; 95% CI: 6.8–28.1%). rVE against post-influenza mortality was 22.2% (95% CI: -18.2–48.8%) and 2.5% (95% CI: -5.2–9.5%) against all-cause mortality. Conclusions: Available evidence suggests HD-IIV3 is more effective than SD-IIV3 at reducing the clinical outcomes associated with influenza infection in older adults and should be considered for routine use in the 65+ population.http://dx.doi.org/10.1080/14760584.2018.1471989high dose influenza vaccineinfluenzaseniorselderlyefficacyeffectivenesshospitalizationdeathsystematic reviewmeta-analysis |
| spellingShingle | Jason K. H. Lee Gary K. L. Lam Thomas Shin Jiyeon Kim Anish Krishnan David P. Greenberg Ayman Chit Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis Expert Review of Vaccines high dose influenza vaccine influenza seniors elderly efficacy effectiveness hospitalization death systematic review meta-analysis |
| title | Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis |
| title_full | Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis |
| title_fullStr | Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis |
| title_short | Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis |
| title_sort | efficacy and effectiveness of high dose versus standard dose influenza vaccination for older adults a systematic review and meta analysis |
| topic | high dose influenza vaccine influenza seniors elderly efficacy effectiveness hospitalization death systematic review meta-analysis |
| url | http://dx.doi.org/10.1080/14760584.2018.1471989 |
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