Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: A systematic review and meta-analysis

Domnich, Alexander; Arata, Lucia; Amicizia, Daniela; Puig-Barberà, Joan; Gasparini, Roberto; Panatto, Donatella

doi:10.1016/j.vaccine.2016.12.011

Cited by 200 publications

(155 citation statements)

References 35 publications

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“…Recently, several influenza vaccines that could have a better action have been tested in elderly people. The use of adjuvanted sub‐unit vaccine (MF59) has been proven to be effective in reducing several influenza‐related outcomes among the elderly, especially hospitalizations due to influenza‐related complications . Compared with standard‐dose influenza vaccine, high‐dose vaccine was also found to reduce hospital admission with respiratory illness and to be cost‐saving .…”

Section: Discussion and Concluding Remarksmentioning

confidence: 99%

Influenza surveillance in Middle East, North, East and South Africa: Report of the 8th MENA Influenza Stakeholders Network

Abusrewil

Algeer²,

Aljifri

et al. 2019

Influenza Resp Viruses

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The Middle‐East and Africa Influenza Surveillance Network ( MENA ‐ ISN ), established in 2014, includes 15 countries at present. Country representatives presented their influenza surveillance programmes, vaccine coverage and influenza control actions achieved, and provided a list of country surveillance/control objectives for the upcoming 3 years. This report details the current situation of influenza surveillance and action plans to move forward in MENA ‐ ISN countries. Data were presented at the 8th MENA ‐ ISN meeting, organized by the Mérieux Foundation that was held on 10‐11 April 2018 in Cairo, Egypt. The meeting included MENA ‐ ISN representatives from 12 countries (Algeria, Egypt, Jordan, Kenya, Lebanon, Libya, Morocco, Pakistan, Saudi Arabia, South Africa, Tunisia and United Arab Emirates) and experts from the Canadian Centre for Vaccinology, and the World Health Organization. Meeting participants concluded that influenza remains a significant threat especially in high‐risk groups (children under‐5, elderly, pregnant women and immunosuppressed individuals) in the MENA ‐ ISN region. Additional funding and planning are required by member countries to contain this threat. Future meetings will need to focus on creative and innovative ways to inform policy and initiatives for vaccination, surveillance and management of influenza‐related morbidity and mortality especially among the most vulnerable groups of the population.

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Section: Discussion and Concluding Remarksmentioning

confidence: 99%

Influenza surveillance in Middle East, North, East and South Africa: Report of the 8th MENA Influenza Stakeholders Network

Abusrewil

Algeer²,

Aljifri

et al. 2019

Influenza Resp Viruses

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“…The development of more effective influenza vaccines for the elderly is a high priority, since the available split-virion formulations provide incomplete protection, even with higher antigen doses (4) or the addition of an adjuvant (14). One of the limiting factors in developing better vaccines for the elderly is the lack of a simple and affordable animal model (15).…”

Section: Discussionmentioning

confidence: 99%

A Single Intramuscular Dose of a Plant-Made Virus-Like Particle Vaccine Elicits a Balanced Humoral and Cellular Response and Protects Young and Aged Mice from Influenza H1N1 Virus Challenge despite a Modest/Absent Humoral Response

Hodgins

Yam

Winter

et al. 2017

Clin Vaccine Immunol

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Virus-like-particle (VLP) influenza vaccines can be given intramuscularly (i.m.) or intranasally (i.n.) and may have advantages over split-virion formulations in the elderly. We tested a plant-made VLP vaccine candidate bearing the viral hemagglutinin (HA) delivered either i.m. or i.n. in young and aged mice. Young adult (5-to 8-week-old) and aged (16-to 20-month-old) female BALB/c mice received a single 3-g dose based on the HA (A/California/07/2009 H1N1) content of a plant-made H1-VLP (i.m. or i.n.) split-virion vaccine (i.m.) or were left naive. After vaccination, humoral and splenocyte responses were assessed, and some mice were challenged. Both VLP and split vaccines given i.m. protected 100% of the young animals, but the VLP group lost the least weight and had stronger humoral and cellular responses. Compared to split-vaccine recipients, aged animals vaccinated i.m. with VLP were more likely to survive challenge (80% versus 60%). The lung viral load postchallenge was lowest in the VLP i.m. groups. Mice vaccinated with VLP i.n. had little detectable immune response, but survival was significantly increased. In both age groups, i.m. administration of the H1-VLP vaccine elicited more balanced humoral and cellular responses and provided better protection from homologous challenge than the splitvirion vaccine.KEYWORDS aged-mouse model, influenza, virus-like particles (VLPs), plant-made vaccines A ccording to the World Health Organization, influenza epidemics account for 250,000 to 500,000 deaths worldwide every year (http://www.who.int/mediacentre/factsheets/ fs211/en/). Although vaccines are widely recommended to protect against influenza, the elderly often respond poorly, in part due to prior experience with influenza virus antigens (Ag) (1), but also as a result of immunosenescence (2). The latter affects both innate and adaptive immune responses and has broad implications for both natural infection and vaccination (1, 2).Influenza vaccines for adults are administered by either intramuscular (i.m.) or intradermal injection of detergent-split virions at a fixed dose of 15 g hemagglutinin (HA)/strain (3). These vaccines typically elicit strong antibody responses in healthy young adults and achieve vaccine efficacy (VE) that varies between strains and years but averages 50 to 60% (4). These formulations work less well in the elderly (5

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“…In particular, we expected to pool the proportion of IVB with the total number of viruses detected (IVA+IVB) in the elderly (endpoint 1a) and express this outcome as a raw proportion (by applying the arcsine square‐root transformation). However, no pooled result was retained in the case of I 2 > 85% …”

Section: Methodsmentioning

confidence: 98%

Heterogeneous estimates of influenza virus types A and B in the elderly: Results of a meta‐regression analysis

Panatto

Signori

Lai

et al. 2018

Influenza Resp Viruses

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Influenza has many age‐dependent characteristics. A previous systematic review of randomized controlled trials showed that the detection rate of influenza B was higher in children than in non‐elderly adults. However, no comprehensive reviews have targeted the elderly, who carry the main burden of disease. We aimed to quantify the relative detection rates of virus types A and B among the elderly, to identify factors affecting these proportions, and to compare type distribution among seniors and younger age‐classes. A comprehensive literature search was conducted to identify multiseason studies reporting A and B virus type distributions in the elderly. A random‐effects meta‐analysis was planned to quantify the prevalence of type B among elderly subjects with laboratory‐confirmed influenza. Meta‐regression was then applied to explain the sources of heterogeneity. Across 27 estimates identified, the type B detection rate among seniors varied from 5% to 37%. Meta‐analysis was not feasible owing to high heterogeneity (I 2 = 98.5%). Meta‐regression analysis showed that study characteristics, such as number of seasons included, hemisphere, and setting, could have contributed to the heterogeneity observed. The final adjusted model showed that studies that included both outpatients and inpatients reported a significantly (P = .024) lower proportion than those involving outpatients only. The detection rate of type B among the elderly was generally lower than in children/adolescents, but not non‐elderly adults. Influenza virus type B has a relatively low detection rate in older adults, especially in settings covering both inpatients and outpatients. Public health implications are discussed.

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Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: A systematic review and meta-analysis

Abstract: Our results suggest that MF59-TIV is effective in reducing several influenza-related outcomes among the elderly, especially hospitalizations due to influenza-related complications.

Cited by 200 publications

References 35 publications

Influenza surveillance in Middle East, North, East and South Africa: Report of the 8th MENA Influenza Stakeholders Network

Influenza surveillance in Middle East, North, East and South Africa: Report of the 8th MENA Influenza Stakeholders Network

A Single Intramuscular Dose of a Plant-Made Virus-Like Particle Vaccine Elicits a Balanced Humoral and Cellular Response and Protects Young and Aged Mice from Influenza H1N1 Virus Challenge despite a Modest/Absent Humoral Response

Heterogeneous estimates of influenza virus types A and B in the elderly: Results of a meta‐regression analysis

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