Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Vaccine Epidemiology and Modelling, Sanofi Pasteur, Swiftwater, PA, USA; Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Vaccine. 2020 Mar 23;38(14):2893-2903. doi: 10.1016/j.vaccine.2020.02.049. Epub 2020 Feb 27.
Vaccination remains the most effective way to prevent influenza infection, albeit vaccine effectiveness (VE) varies by year. Compared to other age groups, children and elderly adults have the highest risk of developing influenza-related complications and requiring hospitalization. During the last years, "test negative design" (TND) studies have been implemented in order to estimate influenza VE. The aim of this systematic review and meta-analysis was to summarize the findings of TND studies reporting influenza VE against laboratory-confirmed influenza-related hospitalization in children aged 6 months to 17 years. We searched the PubMed and Embase databases and identified 2615 non-duplicate studies that required detailed review. Among them, 28 met our inclusion criteria and we performed a random-effects meta-analysis using adjusted VE estimates. In our primary analysis, influenza vaccine offered significant protection against any type influenza-related hospitalization (57.48%; 95% CI 49.46-65.49). When we examined influenza VE per type and strain, VE was higher against H1N1 (74.07%; 95% CI: 54.85-93.30) and influenza B (50.87%; 95% CI: 41.75-59.98), and moderate against H3N2 (40.77%; 95% CI: 25.65-55.89). Notably, influenza vaccination offered higher protection in children who were fully vaccinated (61.79%; 95% CI: 54.45-69.13), compared to those who were partially vaccinated (33.91%; 95% CI: 21.12 - 46.69). Also, influenza VE was high in children less than 5 years old (61.71%; 95% CI: 49.29-74.12) as well as in children 6-17 years old (54.37%; 95% CI: 35.14-73.60). In conclusion, in the pediatric population, influenza vaccination offered significant protection against influenza-related hospitalization and complete annual vaccination should be encouraged.
接种疫苗仍然是预防流感感染的最有效方法，尽管疫苗有效性（VE）因年份而异。与其他年龄组相比，儿童和老年人患流感相关并发症和需要住院治疗的风险最高。在过去几年中，已经实施了“阴性测试设计”（TND）研究，以估计流感 VE。本系统评价和荟萃分析的目的是总结 TND 研究的结果，这些研究报告了 6 个月至 17 岁儿童中针对实验室确诊的流感相关住院治疗的流感 VE。我们搜索了 PubMed 和 Embase 数据库，并确定了 2615 项无需详细审查的非重复研究。其中，有 28 项符合我们的纳入标准，我们使用调整后的 VE 估计值进行了随机效应荟萃分析。在我们的主要分析中，流感疫苗对任何类型的流感相关住院治疗都提供了显著的保护（57.48%；95%CI 49.46-65.49）。当我们按类型和菌株检查流感 VE 时，对 H1N1 的 VE 更高（74.07%；95%CI：54.85-93.30），对流感 B 的 VE 更高（50.87%；95%CI：41.75-59.98），对 H3N2 的 VE 中等（40.77%；95%CI：25.65-55.89）。值得注意的是，与部分接种疫苗的儿童（33.91%；95%CI：21.12-46.69）相比，完全接种疫苗的儿童（61.79%；95%CI：54.45-69.13）的流感疫苗接种提供了更高的保护。此外，5 岁以下儿童（61.71%；95%CI：49.29-74.12）和 6-17 岁儿童（54.37%；95%CI：35.14-73.60）的流感 VE 较高。总之，在儿科人群中，流感疫苗接种对流感相关住院治疗提供了显著的保护，应鼓励每年完成接种。
