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Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials

The recommendation to provide inactivated influenza vaccine (IIV) to pregnant women is based on observed protection against influenza-related morbidity in mother and infant. Non-live vaccines may have non-specific effects (NSEs), increasing the risk of non-targeted infections in females. We reviewed...

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Autores principales: Hansen, Katrine Pedersbæk, Benn, Christine Stabell, Aamand, Thomas, Buus, Martin, da Silva, Isaquel, Aaby, Peter, Fisker, Ane Bærent, Thysen, Sanne Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707251/
https://www.ncbi.nlm.nih.gov/pubmed/34960198
http://dx.doi.org/10.3390/vaccines9121452
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author Hansen, Katrine Pedersbæk
Benn, Christine Stabell
Aamand, Thomas
Buus, Martin
da Silva, Isaquel
Aaby, Peter
Fisker, Ane Bærent
Thysen, Sanne Marie
author_facet Hansen, Katrine Pedersbæk
Benn, Christine Stabell
Aamand, Thomas
Buus, Martin
da Silva, Isaquel
Aaby, Peter
Fisker, Ane Bærent
Thysen, Sanne Marie
author_sort Hansen, Katrine Pedersbæk
collection PubMed
description The recommendation to provide inactivated influenza vaccine (IIV) to pregnant women is based on observed protection against influenza-related morbidity in mother and infant. Non-live vaccines may have non-specific effects (NSEs), increasing the risk of non-targeted infections in females. We reviewed the evidence from available randomised controlled trials (RCTs) of IIV to pregnant women, to assess whether IIV may have NSEs. Four RCTs, all conducted in low- and middle-income settings, were identified. We extracted information on all-cause and infectious mortality and adverse events in women and their infants. We conducted meta-analyses providing risk ratios (RR). The meta-analysis for maternal all-cause mortality provided a RR of 1.48 (95% CI = 0.52–4.16). The estimates for miscarriage/stillbirth and infant all-cause mortality up to 6 months of age were 1.06 (0.78–1.44) and 1.11 (0.87–1.41), respectively. IIV was associated with a higher risk of non-influenza infectious adverse events, with meta-estimates of 2.01 (1.15–3.50) in women and 1.36 (1.12–1.67) in infants up to 6 months of age. Thus, following a pattern seen for other non-live vaccines, IIV was associated with a higher risk of non-influenza infectious adverse events. To ensure that scarce resources are used well, and no harm is inflicted, further RCTs are warranted.
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spelling pubmed-87072512021-12-25 Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials Hansen, Katrine Pedersbæk Benn, Christine Stabell Aamand, Thomas Buus, Martin da Silva, Isaquel Aaby, Peter Fisker, Ane Bærent Thysen, Sanne Marie Vaccines (Basel) Review The recommendation to provide inactivated influenza vaccine (IIV) to pregnant women is based on observed protection against influenza-related morbidity in mother and infant. Non-live vaccines may have non-specific effects (NSEs), increasing the risk of non-targeted infections in females. We reviewed the evidence from available randomised controlled trials (RCTs) of IIV to pregnant women, to assess whether IIV may have NSEs. Four RCTs, all conducted in low- and middle-income settings, were identified. We extracted information on all-cause and infectious mortality and adverse events in women and their infants. We conducted meta-analyses providing risk ratios (RR). The meta-analysis for maternal all-cause mortality provided a RR of 1.48 (95% CI = 0.52–4.16). The estimates for miscarriage/stillbirth and infant all-cause mortality up to 6 months of age were 1.06 (0.78–1.44) and 1.11 (0.87–1.41), respectively. IIV was associated with a higher risk of non-influenza infectious adverse events, with meta-estimates of 2.01 (1.15–3.50) in women and 1.36 (1.12–1.67) in infants up to 6 months of age. Thus, following a pattern seen for other non-live vaccines, IIV was associated with a higher risk of non-influenza infectious adverse events. To ensure that scarce resources are used well, and no harm is inflicted, further RCTs are warranted. MDPI 2021-12-08 /pmc/articles/PMC8707251/ /pubmed/34960198 http://dx.doi.org/10.3390/vaccines9121452 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Hansen, Katrine Pedersbæk
Benn, Christine Stabell
Aamand, Thomas
Buus, Martin
da Silva, Isaquel
Aaby, Peter
Fisker, Ane Bærent
Thysen, Sanne Marie
Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_full Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_fullStr Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_full_unstemmed Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_short Does Influenza Vaccination during Pregnancy Have Effects on Non-Influenza Infectious Morbidity? A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_sort does influenza vaccination during pregnancy have effects on non-influenza infectious morbidity? a systematic review and meta-analysis of randomised controlled trials
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707251/
https://www.ncbi.nlm.nih.gov/pubmed/34960198
http://dx.doi.org/10.3390/vaccines9121452
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