Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis
Background: The clinical effectiveness of monovalent influenza A(H1N1)pdm09 vaccines has not been comprehensively summarised. We undertook a systematic review and meta-analysis to assess vaccine effectiveness (VE) for adjuvanted and unadjuvanted vaccines. Methods: We searched healthcare database...
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| Format: | Article |
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Elsevier
2017
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| Online Access: | https://eprints.nottingham.ac.uk/41329/ |
| _version_ | 1848796250086834176 |
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| author | Lansbury, Louise E. Smith, Sherie Beyer, Walter Karamehic, Emina Pasic-Juhas, Eva Sikira, Hana Mateus, Ana Oshitani, Hitoshi Zhao, Hongxin Beck, Charles, R Nguyen-Van-Tam, Jonathan |
| author_facet | Lansbury, Louise E. Smith, Sherie Beyer, Walter Karamehic, Emina Pasic-Juhas, Eva Sikira, Hana Mateus, Ana Oshitani, Hitoshi Zhao, Hongxin Beck, Charles, R Nguyen-Van-Tam, Jonathan |
| author_sort | Lansbury, Louise E. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: The clinical effectiveness of monovalent influenza A(H1N1)pdm09 vaccines has not been comprehensively summarised. We undertook a systematic review and meta-analysis to assess vaccine effectiveness (VE) for adjuvanted and unadjuvanted vaccines.
Methods: We searched healthcare databases and grey literature from 11 June 2009 to 12 November 2014. Two researchers independently assessed titles and abstracts to identify studies for full review. Random effects meta-analyses estimated the pooled effect size of vaccination compared to placebo or no vaccination for crude and adjusted odds ratios (OR) to prevent laboratory confirmed influenza illness (LCI) and related hospitalization. VE was calculated as (1-pooled OR) ∗ 100. Narrative synthesis was undertaken where meta-analysis was not possible.
Results: We identified 9229 studies of which 38 at moderate risk of bias met protocol eligibility criteria; 23 were suitable for meta-analysis. Pooled adjusted VE against LCI with adjuvanted and unadjuvanted vaccines both reached statistical significance (adjuvanted: VE = 80%; 95% confidence interval [CI] 59–90%; unadjuvanted: VE = 66%; 95% CI 47–78%); in planned secondary analyses, VE in adults often failed to reach statistical significance and pooled point estimates were lower than observed in children. Overall pooled adjusted VE against hospitalization was 61% (95% CI 14–82%); in planned secondary analyses, adjusted VE attained statistical significance in adults aged 18–64 years and children for adjuvanted vaccines. Adjuvanted vaccines were significantly more effective in children compared to adults for both outcomes.
Conclusions: Adjuvanted and unadjuvanted monovalent influenza A(H1N1)pdm09 vaccines were both effective in preventing LCI. Overall, the vaccines were also effective against influenza-related hospitalization. For both outcomes adjuvanted vaccines were more effective in children than in adults. |
| first_indexed | 2025-11-14T19:44:59Z |
| format | Article |
| id | nottingham-41329 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:44:59Z |
| publishDate | 2017 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-413292020-05-04T18:37:51Z https://eprints.nottingham.ac.uk/41329/ Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis Lansbury, Louise E. Smith, Sherie Beyer, Walter Karamehic, Emina Pasic-Juhas, Eva Sikira, Hana Mateus, Ana Oshitani, Hitoshi Zhao, Hongxin Beck, Charles, R Nguyen-Van-Tam, Jonathan Background: The clinical effectiveness of monovalent influenza A(H1N1)pdm09 vaccines has not been comprehensively summarised. We undertook a systematic review and meta-analysis to assess vaccine effectiveness (VE) for adjuvanted and unadjuvanted vaccines. Methods: We searched healthcare databases and grey literature from 11 June 2009 to 12 November 2014. Two researchers independently assessed titles and abstracts to identify studies for full review. Random effects meta-analyses estimated the pooled effect size of vaccination compared to placebo or no vaccination for crude and adjusted odds ratios (OR) to prevent laboratory confirmed influenza illness (LCI) and related hospitalization. VE was calculated as (1-pooled OR) ∗ 100. Narrative synthesis was undertaken where meta-analysis was not possible. Results: We identified 9229 studies of which 38 at moderate risk of bias met protocol eligibility criteria; 23 were suitable for meta-analysis. Pooled adjusted VE against LCI with adjuvanted and unadjuvanted vaccines both reached statistical significance (adjuvanted: VE = 80%; 95% confidence interval [CI] 59–90%; unadjuvanted: VE = 66%; 95% CI 47–78%); in planned secondary analyses, VE in adults often failed to reach statistical significance and pooled point estimates were lower than observed in children. Overall pooled adjusted VE against hospitalization was 61% (95% CI 14–82%); in planned secondary analyses, adjusted VE attained statistical significance in adults aged 18–64 years and children for adjuvanted vaccines. Adjuvanted vaccines were significantly more effective in children compared to adults for both outcomes. Conclusions: Adjuvanted and unadjuvanted monovalent influenza A(H1N1)pdm09 vaccines were both effective in preventing LCI. Overall, the vaccines were also effective against influenza-related hospitalization. For both outcomes adjuvanted vaccines were more effective in children than in adults. Elsevier 2017-03-14 Article PeerReviewed Lansbury, Louise E., Smith, Sherie, Beyer, Walter, Karamehic, Emina, Pasic-Juhas, Eva, Sikira, Hana, Mateus, Ana, Oshitani, Hitoshi, Zhao, Hongxin, Beck, Charles, R and Nguyen-Van-Tam, Jonathan (2017) Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis. Vaccine . ISSN 0264-410X Influenza ; A(H1N1)pdm09 ; Vaccination ; Effectiveness ; Systematic review ; Meta-analysis http://www.sciencedirect.com/science/article/pii/S0264410X17302724 doi:10.1016/j.vaccine.2017.02.059 doi:10.1016/j.vaccine.2017.02.059 |
| spellingShingle | Influenza ; A(H1N1)pdm09 ; Vaccination ; Effectiveness ; Systematic review ; Meta-analysis Lansbury, Louise E. Smith, Sherie Beyer, Walter Karamehic, Emina Pasic-Juhas, Eva Sikira, Hana Mateus, Ana Oshitani, Hitoshi Zhao, Hongxin Beck, Charles, R Nguyen-Van-Tam, Jonathan Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis |
| title | Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis |
| title_full | Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis |
| title_fullStr | Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis |
| title_full_unstemmed | Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis |
| title_short | Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: a systematic review and meta-analysis |
| title_sort | effectiveness of 2009 pandemic influenza a(h1n1) vaccines: a systematic review and meta-analysis |
| topic | Influenza ; A(H1N1)pdm09 ; Vaccination ; Effectiveness ; Systematic review ; Meta-analysis |
| url | https://eprints.nottingham.ac.uk/41329/ https://eprints.nottingham.ac.uk/41329/ https://eprints.nottingham.ac.uk/41329/ |