Efficacy and effectiveness of seasonal and pandemic A (H1N1) 2009 influenza vaccines in low and middle income countries: A systematic review and meta-analysis

Breteler, Janna Klein; Tam, John S.; Jit, Mark; Ket, Hans; Boer, Michiel R. de

doi:10.1016/j.vaccine.2013.08.056

Cited by 46 publications

(48 citation statements)

References 55 publications

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“…The 21 studies in the elderly that were reviewed comprised four randomized and two non‐randomized controlled trials, seven cohort studies, four case–controls and four ecological studies. Seasonal influenza vaccination provided 43–58% protection in the elderly 18, 42, 43. The seven studies in healthy adults comprised one randomized controlled trial, and three cohorts and case–control studies each.…”

Section: Resultsmentioning

confidence: 99%

“…The seven studies in healthy adults comprised one randomized controlled trial, and three cohorts and case–control studies each. Seasonal influenza vaccination provided 50–59% protection in healthy adults 18, 44, 45, 46. The 12 studies in children comprised nine randomized controlled trials, one cohort and two case–control studies.…”

Section: Resultsmentioning

confidence: 99%

“…Seasonal influenza vaccination provided 20–77% in children depending on antigenic match, against laboratory‐confirmed influenza (Table 2). 18, 47, 48, 49, 50, 51, 52, 53, 54, 55 Vaccinating school children provided 23·3% (66·3–74·9) protection against influenza and indirect protection of 61% (5·8–84·7) for household contacts 56. Vaccinating pregnant women prevented laboratory‐confirmed influenza in both mothers (50%) and their infants up to 6 months of age (49–63%) 57, 58.…”

Section: Resultsmentioning

confidence: 99%

“…However, we took efforts to search regional databases for articles in Spanish language as countries from Central and South America have contributed substantially to influenza research in the recent past. An earlier review of influenza (seasonal and pandemic) vaccine effectiveness in low‐ and middle‐income countries identified 132 articles of a total of 361, in languages other than English 18. More than 75% of these non‐English language articles were from Russia and another 15 articles were from Romania, countries that were outside the scope of our review.…”

Section: Discussionmentioning

confidence: 99%

“…We did not repeat a meta‐analysis for vaccine efficacy and vaccine effectiveness, as more than 20 such efforts (including 11 Cochrane Collaboration reviews) have been carried out in the past. Moreover, we did not identify any new published studies from the tropics and subtropics since the last meta‐analysis of studies from low‐ and middle‐income countries 18. The risk of bias in the selection and ascertainment of exposure and outcome for cohort and case–control vaccine effectiveness studies was assessed independently by two reviewers (SH and JS) using the Newcastle–Ottawa bias assessment scale 19.…”

Section: Methodsmentioning

confidence: 99%

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Seasonal influenza vaccine policy, use and effectiveness in the tropics and subtropics – a systematic literature review

Hirve

Lambach

Paget

et al. 2016

Influenza Resp Viruses

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AimThe evidence needed for tropical countries to take informed decisions on influenza vaccination is scarce. This article reviews policy, availability, use and effectiveness of seasonal influenza vaccine in tropical and subtropical countries.MethodGlobal health databases were searched in three thematic areas – policy, availability and protective benefits in the context of human seasonal influenza vaccine in the tropics and subtropics. We excluded studies on monovalent pandemic influenza vaccine, vaccine safety, immunogenicity and uptake, and disease burden.ResultsSeventy‐four countries in the tropics and subtropics representing 60% of the world's population did not have a national vaccination policy against seasonal influenza. Thirty‐eight countries used the Northern Hemisphere and 21 countries the Southern Hemisphere formulation. Forty‐six countries targeted children and 57 targeted the elderly; though, the age cut‐offs varied. Influenza vaccine supply increased twofold in recent years. However, coverage remained lower than five per 1000 population. Vaccine protection against laboratory‐confirmed influenza in the tropics ranged from 0% to 42% in the elderly, 20–77% in children and 50–59% in healthy adults. Vaccinating pregnant women against seasonal influenza prevented laboratory‐confirmed influenza in both mothers (50%) and their infants <6 months (49–63%).ConclusionGuidelines on vaccine composition, priority risk groups and vaccine availability varied widely. The evidence on vaccine protection was scarce. Countries in the tropics and subtropics need to strengthen and expand their evidence‐base required for making informed decisions on influenza vaccine introduction and expansion, and how much benefit to expect.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%