Falsey Ann R, Maggi Stefania, Biering-Sørensen Tor
Department of Medicine, Infectious Diseases, University of Rochester Medical Center, Rochester, USA.
Aging Branch, CNR Institute of Neuroscience, Padua, Italy.
Infect Dis Ther. 2024 Apr;13(4):659-666. doi: 10.1007/s40121-024-00932-3. Epub 2024 Mar 14.
Seasonal influenza is usually considered an acute respiratory infection with a full recovery within a week. In addition to the traditional outcomes, there is now evidence of indirect effects in terms of neurological and functional complications. Major organ systems can be affected, underlining the need for preventative measures against infection. The aim of this podcast, featuring Dr. Ann Falsey, Dr. Stefania Maggi, and Dr. Tor Biering-Sørensen, is to outline influenza complications beyond acute respiratory disease, as well as discussing the need for quality of evidence when evaluating influenza vaccines. Assessing the benefits of vaccination can be challenging. To ensure a high quality of evidence, the innovative randomization of patients within the study design to avoid bias and the assessment of additional outcomes beyond immunogenicity as well as the inclusion of a broad population-including frail or vulnerable individuals-are essential. Studies leveraging nationwide registries such as the DANFLU-2 trial in Denmark highlight the advantages of a digitalized healthcare system for conducting large-scale randomized trials. Furthermore, large-scale trials such as the Gravenstein study have supplied a sizable body of evidence supporting the use of high-dose influenza vaccine in older adults. In conclusion, achieving a high quality of evidence is key for decision-making on seasonal influenza vaccines.
季节性流感通常被认为是一种急性呼吸道感染,一周内可完全康复。除了传统的结果外,现在有证据表明在神经和功能并发症方面存在间接影响。主要器官系统可能会受到影响,这突出了采取预防感染措施的必要性。这期播客由安·法尔西博士、斯特凡尼亚·马吉博士和托尔·比耶林 - 索伦森博士参与,目的是概述急性呼吸道疾病之外的流感并发症,并讨论评估流感疫苗时对证据质量的需求。评估疫苗接种的益处可能具有挑战性。为确保高质量的证据,在研究设计中对患者进行创新随机分组以避免偏差,评估免疫原性之外的其他结果,并纳入广泛人群,包括体弱或易感染个体,这些都是至关重要的。利用丹麦的DANFLU - 2试验等全国性登记系统进行的研究凸显了数字化医疗系统在开展大规模随机试验方面的优势。此外,像格拉文斯坦研究这样的大规模试验提供了大量证据,支持在老年人中使用高剂量流感疫苗。总之,获得高质量的证据是季节性流感疫苗决策的关键。