Department of Primary and Interdisciplinary Care, Centre for General Practice, Faculty of Medicine, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium.
Vaccine. 2011 Nov 15;29(49):9159-70. doi: 10.1016/j.vaccine.2011.08.008. Epub 2011 Aug 12.
To systematically review the evidence regarding the efficacy, effectiveness and risks of the use of inactivated influenza vaccines in children, healthy adults, elderly individuals and individuals with co-morbidities such as diabetes, chronic lung disease, cardiovascular disease, kidney or liver disease and immune suppression.
The Cochrane database of systematic reviews was searched for relevant reviews and supplemented with searches of the Cochrane Central Register of Controlled Trials database and Medline. Two reviewers independently assessed review and trial quality and extracted data.
The inactivated influenza vaccine has been proven effective in preventing laboratory-confirmed influenza among healthy adults (16-65 years) and children (≥6 years) (GRADE A evidence). However, there is strikingly limited good-quality evidence (all GRADE B, C or not existing) of the effectiveness of influenza vaccination on complications such as pneumonia, hospitalisation and influenza-specific and overall mortality. Inconsistent results are found in studies among children younger than 6 years, individuals with COPD, institutionalised elderly (65 years or older), elderly with co-morbidities and healthcare workers in elderly homes, which can only be explained by bias of unknown origin. The vaccination of pregnant women might be beneficial for their newborns, and vaccination of children might be protective in non-recipients of the vaccine of all ages living in the same community (one RCT, Grade B evidence).
系统评价使用灭活流感疫苗预防健康儿童、成年人、老年人以及合并糖尿病、慢性肺部疾病、心血管疾病、肾脏或肝脏疾病和免疫抑制等合并症个体流感的疗效、效果和风险的证据。
检索了 Cochrane 系统评价数据库中相关综述，并补充检索了 Cochrane 对照试验中心注册库和 Medline。两名评审员独立评估综述和试验质量并提取数据。
已证实灭活流感疫苗在预防健康成年人（16-65 岁）和儿童（≥6 岁）的实验室确诊流感方面是有效的（A级证据）。然而，关于流感疫苗在肺炎、住院和流感特异性及总体死亡率等并发症方面的有效性的高质量证据（均为 B、C 级或不存在）非常有限。在 6 岁以下儿童、慢性阻塞性肺病患者、机构老年人（65 岁及以上）、合并症老年人和老年护理院中的医护人员中开展的研究结果不一致，只能归因于来源不明的偏倚。孕妇接种疫苗可能对其新生儿有益，而接种疫苗可能对同一社区中所有年龄段未接种疫苗的儿童具有保护作用（一项 RCT，B 级证据）。
