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Review
. 2014 Mar 6;2014(3):CD001753.
doi: 10.1002/14651858.CD001753.pub3.

Vaccines for preventing influenza in people with cystic fibrosis

Poonam Dharmaraj  1 , Rosalind L Smyth
Affiliations
Review

Vaccines for preventing influenza in people with cystic fibrosis

Poonam Dharmaraj et al. Cochrane Database Syst Rev. .

Abstract

Background: Viral respiratory tract infections in people with cystic fibrosis have a deteriorating effect on their lung function and disease progression. Annual influenza vaccination is therefore commonly recommended for people with cystic fibrosis.

Objectives: To assess the effectiveness of influenza vaccination for people with cystic fibrosis.

Search methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises of references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings. We also contacted the companies which market the influenza vaccines used in the trials to obtain further information about randomised controlled trials.Date of the most recent search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register: 08 July 2013.

Selection criteria: All randomised and quasi-randomised trials (published or unpublished) comparing any influenza vaccine with a placebo or with another type of influenza vaccine.

Data collection and analysis: Two authors independently assessed study quality and extracted data. Additional information was obtained by contacting the investigators when it was indicated.

Main results: Four studies enrolling a total of 179 participants with cystic fibrosis (143 (80%) were children aged 1 to 16 years) were included in this review. There was no study comparing a vaccine to a placebo or a whole virus vaccine to a subunit or split virus vaccine. Two studies compared an intranasal applied live vaccine to an intramuscular inactivated vaccine and the other two studies compared a split virus to a subunit vaccine and a virosome to a subunit vaccine (all intramuscular). The incidence of all reported adverse events was high depending on the type of influenza vaccine. The total adverse event rate ranged from 48 out of 201 participants (24%) for the intranasal live vaccine to 13 out of 30 participants (43%) for the split virus vaccine. With the limitation of a statistical low power there was no significant difference between the study vaccinations. None of the events were severe. All study influenza vaccinations generated a satisfactory serological antibody response. No study reported other clinically important benefits.

Authors' conclusions: There is currently no evidence from randomised studies that influenza vaccine given to people with cystic fibrosis is of benefit to them. There remains a need for a well-constructed clinical study, that assesses the effectiveness of influenza vaccination on important clinical outcome measures.

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Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1: Intranasal live vaccine versus intramuscular trivalent inactivated vaccine, Outcome 1: Death
1.2
1.2. Analysis
Comparison 1: Intranasal live vaccine versus intramuscular trivalent inactivated vaccine, Outcome 2: Adverse events
2.1
2.1. Analysis
Comparison 2: Intramuscular subunit vaccine versus intramuscular split virus vaccine, Outcome 1: Adverse events
3.1
3.1. Analysis
Comparison 3: Intramuscular virosome vaccine versus intramuscular subunit vaccine, Outcome 1: Adverse events with one vaccine dose
3.2
3.2. Analysis
Comparison 3: Intramuscular virosome vaccine versus intramuscular subunit vaccine, Outcome 2: Adverse events with two vaccine doses
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References

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References to other published versions of this review

Dharmaraj 2009
    1. Dharmaraj P, Smyth RL. Vaccines for preventing influenza in people with cystic fibrosis. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No: CD001753. [DOI: 10.1002/14651858.CD001753.pub2] - DOI - PubMed

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