Influenza vaccination for immunocompromised patients: systematic review and meta-analysis by etiology.


Beck, CR; McKenzie, BC; Hashim, AB; Harris, RC; University of Nottingham Influenza and the ImmunoCompromised (UN, ; Nguyen-Van-Tam, JS; , COLLABORATORS; Zanuzdana, A; Agboado, G; Orton, E; Enstone, J; Puleston, R; Vinogradova, Y; Béchard-Evans, L; Mukaigawara, M; Peñalver, J; Morgan, G; Stevenson, C; Weston, R; Dabke, G; Haroon, S; Hird, C; Roberts, J; Lingard, L; Augustine, G; Ahyow, L; Kim, S; Figueroa, J; Howard, R; O'Boyle, J; O'Brien, M; Denness, H; Farmer, S; Fisher, P; Greaves, F; Haroon, M; Isba, R; Ishola, D; Kerac, M; Parish, V; Rosser, J; Theaker, S; Wallace, D; Wigglesworth, N; Horiuchi, H; (2012) Influenza vaccination for immunocompromised patients: systematic review and meta-analysis by etiology. The Journal of infectious diseases, 206 (8). pp. 1250-9. ISSN 0022-1899 DOI: https://doi.org/10.1093/infdis/jis487

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Abstract

Many national guidelines recommend annual influenza vaccination of immunocompromised patients, although the decision to vaccinate is usually at clinical discretion. We conducted a systematic review and meta-analyses to assess the evidence for influenza vaccination in this group, and we report our results by etiology. Meta-analyses showed significantly lower odds of influenza-like illness after vaccination in patients with human immunodeficiency virus (HIV) infection, patients with cancer, and transplant recipients and of laboratory-confirmed influenza in HIV-positive patients, compared with patients receiving placebo or no vaccination. Pooled odds of seroconversion and seroprotection were typically lower in HIV-positive patients, patients with cancer, and transplant recipients, compared with immunocompetent controls. Vaccination was generally well tolerated, with variation in mild adverse events between etiological groups. Limited evidence of a transient increase in viremia and a decrease in the percentage of CD4(+) cells in HIV-positive patients was found although not accompanied by worsening of clinical symptoms. Clinical judgment remains important when discussing the benefits and safety profile with immunocompromised patients.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 22904335
Web of Science ID: 309463200013
URI: http://researchonline.lshtm.ac.uk/id/eprint/4432212

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