Efficacy of live attenuated influenza vaccine in children: A meta-analysis of nine randomized clinical trials
Efficacy of live attenuated influenza vaccine in children: A meta-analysis of nine randomized clinical trials
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DOI：
10.1016/j.vaccine.2008.11.093
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发表时间：
2009-02-11
期刊：
影响因子：
5.5
通讯作者：
Wittes, Janet
中科院分区：
文献类型：
--
作者：
Rhorer, Janelle;Ambrose, Christopher S.;Wittes, Janet
9项随机临床试验，包括约25,000名6-71个月的儿童和2000名6-17岁的儿童，评估了与安慰剂或三价灭活疫苗（TIV）相比，流感减毒活疫苗（LAIV）对培养确诊流感的疗效。我们基于固定效应模型的Mantel-Haenszel相对风险进行了荟萃分析，以提供疫苗效力（VE）的估计。相对于安慰剂，在未接种疫苗的幼儿中，两剂抗原相似菌株的1年VE为77% (95% CI: 72%, 80%: P < 0.001)，而无论抗原相似与否的菌株的1年VE为72%。对抗原性相似的A/H1N1、A/H3N2和B的有效率分别为85%、76%和73%。在未接种疫苗的儿童中，一剂抗抗原性相似毒株的第1年生存率为60%；在各种研究的第2年，一剂疫苗对以前接种过疫苗的儿童的有效性为87%。在比较两剂TIV和LAIV的正面试验中，未接种疫苗的儿童接受两剂LAIV后，由抗原相似菌株引起的流感病例减少了46%。同样，在包括以前接种过疫苗的较大儿童的研究中，接受一次LAIV剂量的儿童比接受一次TIV剂量的儿童少患35%的流感病例。与安慰剂相比，LAIV显示高VE，没有证据表明年龄或循环亚型之间存在差异。在这些研究中，LAIV比TIV更有效。(C) 2008 Elsevier Ltd版权所有。
Nine randomized clinical trials, including approximately 25,000 children aged 6-71 months and 2000 children aged 6-17 years, have evaluated the efficacy of live attenuated influenza vaccine (LAIV) against culture-confirmed influenza as compared to placebo or trivalent inactivated vaccine (TIV). We conducted meta-analyses, based on Mantel-Haenszel relative risks from fixed effect models, to provide an estimate of vaccine efficacy (VE). Relative to placebo, year 1 VE for two doses in vaccine-naive young children was 77% (95% CI: 72%, 80%: P < 0.001) against antigenically similar strains and 72% against Strains regardless of antigenic similarity. Efficacy was 85%, 76%, and 73% against antigenically similar A/H1N1, A/H3N2, and B, respectively. Year I VE of one dose against antigenically similar strains in vaccine-naive children was 60%; efficacy of one dose in previously vaccinated children in year 2 of the various studies was 87%. In head-to-head trials comparing two doses of TIV and LAIV, vaccine-naive children who received two doses of LAIV experienced 46% fewer cases of influenza illness caused by antigenically similar strains. Similarly, for studies including older children who had been previously vaccinated, those receiving one LAIV dose experienced 35% fewer cases of influenza illness than those receiving one TIV dose. LAIV showed high VE versus placebo with no evidence of difference by age or by circulating subtype. In these studies, LAIV was more effective than TIV. (C) 2008 Elsevier Ltd. All rights reserved.