Influenza vaccination for immunocompromised patients: systematic review and meta-analysis by etiology. Beck, C. R., McKenzie, B. C., Hashim, A. B., Harris, R. C., University of Nottingham Influenza and the ImmunoCompromised (UNIIC) Study Group,, & Nguyen-Van-Tam, J. S. The Journal of Infectious Diseases, 206(8):1250--1259, October, 2012. doi abstract bibtex Many national guidelines recommend annual influenza vaccination of immunocompromised patients, although the decision to vaccinate is usually at clinical discretion. We conducted a systematic review and meta-analyses to assess the evidence for influenza vaccination in this group, and we report our results by etiology. Meta-analyses showed significantly lower odds of influenza-like illness after vaccination in patients with human immunodeficiency virus (HIV) infection, patients with cancer, and transplant recipients and of laboratory-confirmed influenza in HIV-positive patients, compared with patients receiving placebo or no vaccination. Pooled odds of seroconversion and seroprotection were typically lower in HIV-positive patients, patients with cancer, and transplant recipients, compared with immunocompetent controls. Vaccination was generally well tolerated, with variation in mild adverse events between etiological groups. Limited evidence of a transient increase in viremia and a decrease in the percentage of CD4(+) cells in HIV-positive patients was found although not accompanied by worsening of clinical symptoms. Clinical judgment remains important when discussing the benefits and safety profile with immunocompromised patients.
@article{ beck_influenza_2012,
title = {Influenza vaccination for immunocompromised patients: systematic review and meta-analysis by etiology},
volume = {206},
issn = {1537-6613},
shorttitle = {Influenza vaccination for immunocompromised patients},
doi = {10.1093/infdis/jis487},
abstract = {Many national guidelines recommend annual influenza vaccination of immunocompromised patients, although the decision to vaccinate is usually at clinical discretion. We conducted a systematic review and meta-analyses to assess the evidence for influenza vaccination in this group, and we report our results by etiology. Meta-analyses showed significantly lower odds of influenza-like illness after vaccination in patients with human immunodeficiency virus (HIV) infection, patients with cancer, and transplant recipients and of laboratory-confirmed influenza in HIV-positive patients, compared with patients receiving placebo or no vaccination. Pooled odds of seroconversion and seroprotection were typically lower in HIV-positive patients, patients with cancer, and transplant recipients, compared with immunocompetent controls. Vaccination was generally well tolerated, with variation in mild adverse events between etiological groups. Limited evidence of a transient increase in viremia and a decrease in the percentage of CD4(+) cells in HIV-positive patients was found although not accompanied by worsening of clinical symptoms. Clinical judgment remains important when discussing the benefits and safety profile with immunocompromised patients.},
language = {eng},
number = {8},
journal = {The Journal of Infectious Diseases},
author = {Beck, Charles R. and McKenzie, Bruce C. and Hashim, Ahmed B. and Harris, Rebecca C. and {University of Nottingham Influenza and the ImmunoCompromised (UNIIC) Study Group,} and Nguyen-Van-Tam, Jonathan S.},
month = {October},
year = {2012},
pmid = {22904335},
keywords = {Drug-Related Side Effects and Adverse Reactions, HIV Infections, Humans, Immunocompromised Host, Influenza Vaccines, Influenza, Human, Neoplasms, Transplantation, Vaccination},
pages = {1250--1259}
}
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We conducted a systematic review and meta-analyses to assess the evidence for influenza vaccination in this group, and we report our results by etiology. Meta-analyses showed significantly lower odds of influenza-like illness after vaccination in patients with human immunodeficiency virus (HIV) infection, patients with cancer, and transplant recipients and of laboratory-confirmed influenza in HIV-positive patients, compared with patients receiving placebo or no vaccination. Pooled odds of seroconversion and seroprotection were typically lower in HIV-positive patients, patients with cancer, and transplant recipients, compared with immunocompetent controls. Vaccination was generally well tolerated, with variation in mild adverse events between etiological groups. Limited evidence of a transient increase in viremia and a decrease in the percentage of CD4(+) cells in HIV-positive patients was found although not accompanied by worsening of clinical symptoms. 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