Relative Effectiveness of Cell-Cultured versus Egg-Based Seasonal Influenza Vaccines in Preventing Influenza-Related Outcomes in Subjects 18 Years Old or Older: A Systematic Review and Meta-Analysis

Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effectiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influenza vaccines (eIV...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-01, Vol.19 (2), p.818
Main Authors: Puig-Barberà, Joan, Tamames-Gómez, Sonia, Plans-Rubio, Pedro, Eiros-Bouza, José María
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Antigens
Bias
Confidence intervals
Data analysis
Eggs
Funding
Heterogeneity
Humans
Influenza
Influenza A Virus, H3N2 Subtype
Influenza Vaccines
Influenza, Human - epidemiology
Influenza, Human - prevention & control
Laboratories
Literature reviews
Meta-analysis
Mutation
Pandemics
Performance evaluation
Qualitative analysis
Review
Reviews
Seasons
Sensitivity analysis
Statistical analysis
Systematic review
Vaccination
Vaccines
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Summary:Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effectiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influenza vaccines (eIV) in preventing laboratory-confirmed influenza related outcomes (IRO) or IRO by clinical codes, in subjects 18 and over. We completed the literature search in January 2021; applied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, publication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed using a random approach. International Prospective Register of Systematic Reviews, CRD42021228290. We identified 12 publications that reported 26 adjusted arVE results. Five publications reported 13 laboratory confirmed arVE and seven reported 13 code-ascertained arVE. Nine publications with 22 results were at low risk of bias. Heterogeneity was explained by season. We found a significant 11% (8 to 14%) adjusted arVE favoring ccIV in preventing any IRO in the 2017-2018 influenza season. The arVE was 3% (-2% to 7%) in the 2018-2019 influenza season. We found moderate evidence of a significant advantage of the ccIV in preventing IRO, compared to eIV, in a well-matched A(H3N2) predominant season.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph19020818