Recommendations for Influenza Vaccination in Burns Patients Based on a Systematic Review of the Evidence

Abstract

Severe burn injury is a serious systemic insult that can lead to life threatening secondary infections. Immunosuppression, inhalation injury and prolonged length of hospital stay are factors which predispose patients to severe respiratory tract infections. Furthermore, evidence shows that burns can put one at risk of infection long after the original injury. Currently in the United Kingdom, the annual National Flu Immunisation programme outlines guidance for groups who are deemed high risk and therefore eligible for the influenza vaccine. At present, no guidance exists for administration of the influenza vaccine in burn injured patients, despite knowledge of immunosuppression. The aim of this literature review is to examine the evidence for associations between burn injury and influenza and where available, evaluate efficacy of influenza vaccines in this cohort. In addition, literature was searched for the effectiveness of the influenza vaccine in patients 65 years and above, and in patients admitted to the intensive care unit (ICU); two domains common to patients with severe burns. Three papers were found to suggest increased susceptibility to influenza following burn injury, however no papers studying the effectiveness of the influenza vaccine in this group were found. Several studies demonstrated improved outcomes in patients over 65 years and patients admitted to ICU. Following evaluation of the evidence, this review advocates for the consideration of hospitalized burn patients for the influenza vaccine. We suggest avoidance of vaccine administration in the acute burn phase. Further prospective clinical trials would be required to validate these findings.

Adverse reactions to cosmetic implants after COVID‐19 vaccination: A literature review

“…But it is unclear whether this reflects a selection or publication bias, and more female patients receiving cosmetic treatments, or women's greater reactogenicity to vaccines 17–19 . As for the time to onset of complications after vaccination, it may depend on the type and dose of vaccine, immune status, history of COVID‐19 pneumonia, and comorbidities 20–27 …”

“…[17][18][19] As for the time to onset of complications after vaccination, it may depend on the type and dose of vaccine, immune status, history of COVID-19 pneumonia, and comorbidities. [20][21][22][23][24][25][26][27] With waves of new variants emerging, [28][29][30][31][32][33][34][35] of which the omicron variant carries about 50 mutations not seen in combination before (World Health Organization 2021), [36][37][38][39][40] new vaccines may formulate. It generates the discussion of the need to continue booster doses indefinitely, which will inevitably increase the risk of DIRs in patients with implants.…”