Priming with MF59 adjuvanted versus nonadjuvanted seasonal influenza vaccines in children - A systematic review and a meta-analysis.
Vaccine
; 38(3): 608-619, 2020 01 16.
Article
em En
| MEDLINE
| ID: mdl-31735505
ABSTRACT
BACKGROUND:
Identifying optimal priming strategies for children <2â¯years could substantially improve the public health benefits of influenza vaccines. Adjuvanted seasonal influenza vaccines were designed to promote a better immune response among young vaccine-naïve children.METHODS:
We systematically reviewed randomized trials to assess hemagglutination inhibition (HAI) antibody response to MF59-adjuvanted inactivated influenza vaccine (aIIV) versus nonadjuvanted IIV among children. We estimated pooled ratios of post-vaccination HAI geometric mean titer (GMT) for aIIV versus IIV and confidence intervals (CIs) using the pooled variances derived from reported CIs.RESULTS:
Mean age was 28â¯months (range, 6-72â¯months). Children received vaccines with either 7.5⯵g (6-35â¯months) or 15⯵g (≥36â¯months) hemagglutinin of each strain depending on age. Seven of eight trials administered trivalent vaccines and one used quadrivalent vaccine. Pooled post-vaccination GMT ratios against the three influenza vaccine strains were 2.5-3.5 fold higher after 2-dose-aIIV versus 2-dose-IIV among children 6-72â¯months, and point estimates were higher among children 6-35â¯months compared with older children. When comparing 1-dose-aIIV to 2-dose-IIV doses, pooled GMT ratios were not significantly different against A/H1N1 (1.0; 95% CI 0.5-1.8; pâ¯=â¯0.90) and A/H3N2 viruses (1.0; 95% CI 0.7-1.5; pâ¯=â¯0.81) and were significantly lower against B viruses (0.6; 95% CI 0.4-0.8; pâ¯<â¯0.001) for both age groups. Notably, GMT ratios for vaccine-mismatched heterologous viruses after 2-dose-aIIV compared with 2-dose-IIV were higher against A/H1N1 (2.0; 95% CI 1.1-3.4), A/H3N2 (2.9; 95% CI 1.9-4.2), and B-lineage viruses (2.1; 95% CI 1.8-2.6).CONCLUSIONS:
Two doses of adjuvanted IIV consistently induced better humoral immune responses against Type A and B influenza viruses compared with nonadjuvanted IIVs in young children, particularly among those 6-35â¯months. One adjuvanted IIV dose had a similar response to two nonadjuvanted IIV doses against Type A influenza viruses. Longer-term benefits from imprinting and cell-mediated immunity, including trials of clinical efficacy, are gaps that warrant investigation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
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2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Polissorbatos
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Esqualeno
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Vacinas contra Influenza
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Influenza Humana
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Vírus da Influenza A Subtipo H1N1
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Vírus da Influenza A Subtipo H3N2
Tipo de estudo:
Clinical_trials
/
Systematic_reviews
Limite:
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
Vaccine
Ano de publicação:
2020
Tipo de documento:
Article