The Association between Influenza Vaccination and the Risk of SARS-CoV-2 Infection, Severe Illness, and Death: A Systematic Review of the Literature

Riccio, Marco Del; Lorini, Chiara; Bonaccorsi, Guglielmo; Paget, John; Caini, Saverio

doi:10.3390/ijerph17217870

Cited by 38 publications

(36 citation statements)

References 18 publications

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“…Another interesting hypothesis is supported by more frequent ( p < 0.0001) last year vaccinations against seasonal influenza in subjects aged above 65 years (21.3%) than in younger subjects (10.0%), in our study. The protective effect of influenza vaccination against COVID-19 was discussed in epidemiological reports, including the evidence obtained in the elderly [ 17 , 18 , 19 ]. Even if the association between the influenza vaccination and SARS-CoV-2 infection remains under investigation, such a protective effect could also result from a more restrictive lifestyle of vaccinated people, during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Random Sample of Inhabitants of the Katowice Region, Poland

Zejda

Brożek

Kowalska

et al. 2021

IJERPH

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Lack of knowledge around seroprevalence levels of COVID-19 in Poland was the reason for the implementation of a seroepidemiological study in the Katowice Region (2,100,000 inhabitants). In October–November 2020, a questionnaire examination and measurement of anti-SARS-CoV-2 IgG and IgM antibodies were performed in a random sample of the general population (n = 1167). The objectives of the study were to estimate the prevalence of IgG and IgM antibodies and to assess their host-related correlates. The prevalence of IgG seropositivity was 11.4% (95% CI: 9.5–13.2%) and IgM seropositivity was 4.6% (95% CI: 3.5–5.8%). Diagnosis of COVID-19 was found in 4.8% of subjects. A positive IgG test was statistically significantly associated with age (inverse relationship), a person’s contact with a COVID-19 patient, quarantine, and two symptoms in the past: fever and loss of smell/taste. Positive IgG tests were less prevalent in subjects who had diagnoses of arterial hypertension, diabetes, or rheumatologic disorders. IgM test positivity was associated with quarantine and loss of smell/taste only with no effect of chronic diseases found. In Poland, in the period October–November 2020, the prevalence of SARS-CoV-2 infection was larger than earlier estimates obtained in other European countries, probably reflecting the measurements obtained during the “second wave” of the epidemic.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Random Sample of Inhabitants of the Katowice Region, Poland

Zejda

Brożek

Kowalska

et al. 2021

IJERPH

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“…In addition, as COVID-19 and influenza are both respiratory infectious diseases caused by enveloped RNA viruses that share similarities in transmission routes and clinical characteristics [10], more and more researchers began to seek for relationships between SARS-CoV-2 infection and influenza immunity. Based on the assumptions, Del Riccio et al [11] conducted a systematic review and found that there was overall no evidence to suggest a negative impact of influenza vaccination on SARS-CoV-2 related infections, illness, or deaths, while some of the included studies even reported significantly inverse associations. Though some of the recent studies have found that influenza vaccine uptake was negatively associated with COVID-19 incidence [12,13], severity [13,14], and mortality [13,15], others showed no evidence of such associations [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

The Association between Influenza Vaccination and COVID-19 and Its Outcomes: A Systematic Review and Meta-Analysis of Observational Studies

Wang

Liu

2021

Vaccines

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Influenza could circulate in parallel with COVID-19. In the context of COVID-19, some studies observed inverse associations between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, while others did not. We conducted a meta-analysis to assess the association between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, aiming to provide evidence for COVID-19 prevention and vaccination promotion. We searched four databases from inception to 10 March, 2021. Random effects and fixed effects models were used to pool odds ratios (ORs) and adjusted estimates with 95% confidence intervals (CIs). We used funnel plots to evaluate the publication bias, I2 statistics to evaluate the heterogeneity, and conducted subgroup analyses. Sixteen observational studies involving 290,327 participants were included. Influenza vaccination was associated with a lower risk of SARS-CoV-2 infection (pooled adjusted OR: 0.86, 95%CI: 0.81–0.91), while not significantly associated with adverse outcomes (intensive care: adjusted OR 0.63, 95%CI: 0.22–1.81; hospitalization: adjusted OR 0.74, 95%CI: 0.51–1.06; mortality: adjusted OR 0.89, 95%CI: 0.73–1.09). Our findings suggest that influenza vaccination is associated with a lower risk of SARS-CoV-2 infection. It is crucial for policy makers to implement strategies on influenza vaccination, for it may also have benefits for COVID-19 prevention.

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“…We support and promote the achievement of an optimal vaccination coverage rate in cancer patients for several reasons, including the following: (a) direct association with a lower mortality and infection-related outcomes in immunosuppressed adults [1]; (b) a better overall survival recently reported in patients treated with ICIs receiving influenza vaccination [40]; and (c) the current COVID-19 pandemic, to reduce the strain on the healthcare system while protecting vulnerable subjects from the dramatic impact of a possible co-infection [41]. Cancer patients receiving immunotherapy are at high risk of severe events as a result of COVID-19 systemic involvement, including pneumonitis and myocarditis [42], and a recent systematic review found no significant increase in the risk of infection or in the illness severity or lethality of COVID-19 in subjects receiving the influenza vaccine, with some studies reporting a significantly inverse association [43]. Therefore, the implementation of measures aimed at raising influenza vaccination coverage in frail patients is strongly recommended.…”

Section: Discussionmentioning

confidence: 99%

Influenza Vaccination and Myo-Pericarditis in Patients Receiving Immune Checkpoint Inhibitors: Investigating the Likelihood of Interaction through the Vaccine Adverse Event Reporting System and VigiBase

et al. 2021

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Background: Evidence on whether the influenza vaccine could exacerbate immune-related adverse events, including myopericarditis (MP), in patients treated with immune checkpoint inhibitors (ICIs), is still conflicting. We explored this issue through a global real-world approach. Methods: We queried the Vaccine Adverse Event Reporting System (VAERS) and VigiBase to retrieve cases of MP in which the influenza vaccine and ICIs were recorded as suspect and were concomitantly reported. For the included cases, causality assessment and Drug Interaction Probability Scale (DIPS) algorithms were applied. Results: There were 191 and 399 reports of MP with the influenza vaccine that were retrieved (VAERS and VigiBase, respectively). No case of MP reporting the concomitant use of ICIs and the influenza vaccine was found in VAERS, while three cases of myocarditis were retrieved in VigiBase. All of the cases were unclassifiable for a causality assessment because of the lack of data concerning latency. According to the DIPS, one report was categorized as possible and two as doubtful. Conclusion: The paucity of cases coupled with the doubtful causality assessment make the potential interaction between influenza vaccines and ICIs in cancer patients negligible from clinical and epidemiological standpoints. These findings support the cardiovascular safety of the influenza vaccination, which remains strongly recommended in cancer patients, especially in the current COVID-19 era.

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The Association between Influenza Vaccination and the Risk of SARS-CoV-2 Infection, Severe Illness, and Death: A Systematic Review of the Literature

Cited by 38 publications

References 18 publications

Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Random Sample of Inhabitants of the Katowice Region, Poland

Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Random Sample of Inhabitants of the Katowice Region, Poland

The Association between Influenza Vaccination and COVID-19 and Its Outcomes: A Systematic Review and Meta-Analysis of Observational Studies

Influenza Vaccination and Myo-Pericarditis in Patients Receiving Immune Checkpoint Inhibitors: Investigating the Likelihood of Interaction through the Vaccine Adverse Event Reporting System and VigiBase

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