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The relative vaccine effectiveness of high-dose vs standard-dose influenza vaccines in preventing hospitalization and mortality: A meta-analysis of evidence from randomized trials.
Skaarup, Kristoffer Grundtvig; Lassen, Mats Christian Højbjerg; Modin, Daniel; Johansen, Niklas Dyrby; Loiacono, Matthew M; Harris, Rebecca C; Lee, Jason K H; Dufournet, Marine; Vardeny, Orly; Peikert, Alexander; Claggett, Brian; Solomon, Scott D; Jensen, Jens Ulrik Stæhr; Biering-Sørensen, Tor.
Afiliação
  • Skaarup KG; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Electronic address:
  • Lassen MCH; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
  • Modin D; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
  • Johansen ND; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
  • Loiacono MM; Sanofi, Swiftwater, PA, United States of America.
  • Harris RC; Sanofi, Singapore, Singapore.
  • Lee JKH; Sanofi, Toronto, Ontario, Canada.
  • Dufournet M; Sanofi, Lyon, France.
  • Vardeny O; Department of Medicine, University of Minnesota, Minneapolis VA Health Care System, Minneapolis, MN, United States of America.
  • Peikert A; Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
  • Claggett B; Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
  • Solomon SD; Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
  • Jensen JUS; Respiratory Medicine Section, Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
  • Biering-Sørensen T; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Cardio
J Infect ; 89(1): 106187, 2024 Jul.
Article em En | MEDLINE | ID: mdl-38795774
ABSTRACT

OBJECTIVES:

To summarize current evidence of high-dose influenza vaccine (HD-IV) vs standard-dose (SD-IV) regarding severe clinical outcomes.

METHODS:

A prespecified meta-analysis was conducted to assess relative vaccine effectiveness (rVE) of HD-IV vs SD-IV in reducing the rates of (1) pneumonia and influenza (P&I) hospitalization, (2) all hospitalizations, and (3) all-cause death in adults ≥ 65 years in randomized controlled trials. Pooled effect sizes were estimated using fixed-effects models with the inverse variance method.

RESULTS:

Five randomized trials were included encompassing 105,685 individuals. HD-IV vs SD-IV reduced P&I hospitalizations (rVE 23.5 %, [95 %CI 12.3 to 33.2]). HD-IV vs SD-IV also reduced rate of all-cause hospitalizations (rVE 7.3 %, [95 %CI 4.5 to 10.0]). No significant differences were observed in death rates (rVE = 1.6 % ([95 %CI -2.0 to 5.0]) in HD-IV vs SD-IV. Sensitivity analyses omitting trials with participants sharing the same comorbidity, trials with ≥ 100 events, and random-effects models provided comparable estimates for all outcomes.

CONCLUSIONS:

HD-IV reduced the incidence of P&I and all-cause hospitalization vs SD-IV in adults ≥ 65 years in randomized trials, through no significant difference was observed in all-cause death rates. These findings, supported by evidence from several randomized studies, can benefit from replication in a fully powered, individually randomized trial.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vacinas contra Influenza / Ensaios Clínicos Controlados Aleatórios como Assunto / Influenza Humana / Hospitalização Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Infect Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vacinas contra Influenza / Ensaios Clínicos Controlados Aleatórios como Assunto / Influenza Humana / Hospitalização Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Infect Ano de publicação: 2024 Tipo de documento: Article