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

Beck, Charles R. and McKenzie, Bruce C. and Hashim, Ahmed B. and Harris, Rebecca C. and Nguyen-Van-Tam, Jonathan S. and University of Nottingham Influenza and the ImmunoCompromised (UN and Isba, Rachel (2012) Influenza vaccination for immunocompromised patients:systematic review and meta-analysis by etiology. The Journal of infectious diseases, 206 (8). pp. 1250-1259. ISSN 1537-6613

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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.

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Journal Article
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The Journal of infectious diseases
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03 Jan 2013 09:20
Last Modified:
17 Sep 2023 01:16