Dataset Information

The impact of repeated vaccination on influenza vaccine effectiveness: a systematic review and meta-analysis.

ABSTRACT:

Background

Conflicting results regarding the impact of repeated vaccination on influenza vaccine effectiveness (VE) may cause confusion regarding the benefits of receiving the current season's vaccine.

Methods

We systematically searched MEDLINE, Embase, PubMed, and Cumulative Index to Nursing and Allied Health Literature from database inception to August 17, 2016, for observational studies published in English that reported VE against laboratory-confirmed influenza for the following four vaccination groups: current season only, prior season only, both seasons, and neither season. We pooled differences in VE (?VE) between vaccination groups by influenza season and type/subtype using a random-effects model. The study protocol is registered with PROSPERO (registration number: CRD42016037241).

Results

We identified 3435 unique articles, reviewed the full text of 634, and included 20 for meta-analysis. Compared to prior season vaccination only, vaccination in both seasons was associated with greater protection against influenza H1N1 (?VE?=?25%; 95% CI 14%, 35%) and B (?VE?=?18%; 95% CI 3%, 33%), but not H3N2 (?VE?=?7%; 95% CI -?7%, 21%). Compared to no vaccination for either season, individuals who received the current season's vaccine had greater protection against H1N1 (?VE?=?62%; 95% CI 51%, 70%), H3N2 (?VE?=?45%; 95% CI 35%, 53%), and B (?VE?=?64%; 95% CI 57%, 71%). We observed no differences in VE between vaccination in both seasons and the current season only for H1N1 (?VE?=?3%; 95% CI -?8%, 13%), but less protection against influenza H3N2 (?VE?=?-?20%; 95% CI -?36%, -?4%), and B (?VE?=?-?11%; 95% CI -?20%, -?2%).

Conclusions

Our results support current season vaccination regardless of prior season vaccination because VE for vaccination in the current season only is higher compared to no vaccination in either season for all types/subtypes, and for H1N1 and influenza B, vaccination in both seasons provides better VE than vaccination in the prior season only. Although VE was lower against H3N2 and B for individuals vaccinated in both seasons compared to those vaccinated in the current season only, it should be noted that past vaccination history cannot be altered and this comparison disregards susceptibility to influenza during the prior season among those vaccinated in the current season only. In addition, our results for H3N2 were particularly influenced by the 2014-2015 influenza season and the impact of repeated vaccination for all types/subtypes may vary from season to season. It is important that future VE studies include vaccination history over multiple seasons to evaluate repeated vaccination in more detail.

SUBMITTER: Ramsay LC

PROVIDER: S-EPMC6327561 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

The impact of repeated vaccination on influenza vaccine effectiveness: a systematic review and meta-analysis.

Ramsay Lauren C LC Buchan Sarah A SA Stirling Robert G RG Cowling Benjamin J BJ Feng Shuo S Kwong Jeffrey C JC Warshawsky Bryna F BF

BMC medicine 20190110 1

<h4>Background</h4>Conflicting results regarding the impact of repeated vaccination on influenza vaccine effectiveness (VE) may cause confusion regarding the benefits of receiving the current season's vaccine.<h4>Methods</h4>We systematically searched MEDLINE, Embase, PubMed, and Cumulative Index to Nursing and Allied Health Literature from database inception to August 17, 2016, for observational studies published in English that reported VE against laboratory-confirmed influenza for the followi ...[more]

PMID: 30626399

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Project description:BackgroundConflicting results regarding the impact of repeated vaccination on influenza vaccine effectiveness (VE) may cause confusion regarding the benefits of receiving the current season's vaccine.MethodsWe systematically searched MEDLINE, Embase, PubMed, and Cumulative Index to Nursing and Allied Health Literature from database inception to August 17, 2016, for observational studies published in English that reported VE against laboratory-confirmed influenza for four vaccination groups, namely current season only, prior season only, both seasons, and neither season. We pooled differences in VE (∆VE) between vaccination groups by influenza season and type/subtype using a random effects model. The study protocol is registered with PROSPERO (registration number: CRD42016037241).ResultsWe identified 3435 unique articles, reviewed the full text of 634, and included 20 for meta-analysis. Compared to prior season vaccination only, vaccination in both seasons was associated with greater protection against influenza H1N1 (∆VE = 26%; 95% CI, 15% to 36%) and B (∆VE = 24%; 95% CI, 7% to 42%), but not H3N2 (∆VE = 10%; 95% CI, -6% to 25%). Compared to no vaccination for either season, individuals who received the current season's vaccine had greater protection against H1N1 (∆VE = 61%; 95% CI, 50% to 70%), H3N2 (∆VE = 41%; 95% CI, 33% to 48%), and B (∆VE = 62%; 95% CI, 54% to 68%). We observed no differences in VE between vaccination in both seasons and the current season only for H1N1 (∆VE = 4%; 95% CI, -7% to 15%), H3N2 (∆VE = -12%; 95% CI, -27% to 4%), or B (∆VE = -8%; 95% CI, -17% to 1%).ConclusionsFrom the patient perspective, our results support current season vaccination regardless of prior season vaccination. We found no overall evidence that prior season vaccination negatively impacts current season VE. It is important that future VE studies include vaccination history over multiple seasons in order to evaluate repeated vaccination in more detail.

Project description:Background Vaccination plays an important role in the prevention of influenza. Channels that improve vaccination adherence can play a vital part in improving patient care. This study seeks to inform the design and implementation of pharmacy interventions at scale on improving influenza vaccination rates. Aim of the review The aim of this study was to identify key success factors for effective pharmacy intervention design and implementation to improve vaccination acceptance rates in influenza. Methods A systematic search of MEDLINE, Embase, and Cochrane CENTRAL was performed to find literature on influenza vaccinations delivered at pharmacies, pharmacist-delivered influenza vaccinations, or influenza vaccination campaigns originating in the pharmacy setting. A meta-analysis using a random effects model estimated the impact of pharmacy intervention on vaccination rates (assessed as relative risk [RR] and 95% confidence intervals [95% CI]). Results A total of 1221 studies were found that met the search criteria, of which 12 were selected for the literature review following eligibility screening. A meta-analysis of studies that contained binary total population and vaccination rate data was conducted on 6 studies, including 3182 participants, the vaccination rate was 24% higher in those who used the pharmacy-based intervention compared with those who used standard care [RR (95% CI) 1.24 (1.05, 1.47)]. Two separate sensitivity analyses were run for the vaccination rate. In participants aged ≥ 65 years, the vaccination rate was 3% higher in those who received the pharmacy-based intervention compared with those who received standard care; however, this change was not significant [RR (95% CI) 1.03 (0.86, 1.24)]. Additionally, a qualitative review showed that more successful pharmacy-based interventions were those with the more active involvement of pharmacists in routine care. This included regular checkup of vaccine status, proactive conversations and recommendations about vaccination, and pharmacy-based immunization programs, with specific vaccination days. In-pharmacy communication rather than passive information, such as through leaflets and posters was also more effective. Conclusion Pharmacists can play a significant role to improve patient treatment, adherence, and outcomes associated with influenza vaccines. Once pharmacy-based immunization is established, proactive involvement of is key to ensure successful program implementation and results. Expanding access for pharmacists and pharmacy intervention to provide vaccinations may increase vaccination acceptance and could be a valuable intervention in patient care. Additional studies should consider high-risk populations to inform optimal design and implementation strategies.

Dataset Information

The impact of repeated vaccination on influenza vaccine effectiveness: a systematic review and meta-analysis.

Background

Methods

Results

Conclusions

Publications

The impact of repeated vaccination on influenza vaccine effectiveness: a systematic review and meta-analysis.

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