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briankung/Vaccine safety and efficacy.md

Created June 1, 2019 17:28
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Vaccine safety and efficacy
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Vaccine safety and efficacy.md

I am in the midst of an argument about vaccine safety and efficacy so I have compiled a list of meta analyses detailing both:

SAFETY

Immunogenicity and safety of pandemic influenza A (H1N1) 2009 vaccine: systematic review and meta‐analysis - Yin - 2011 - Influenza and Other Respiratory Viruses - Wiley Online Library https://onlinelibrary.wiley.com/doi/full/10.1111/j.1750-2659.2011.00229.x

  • "We included 16 articles in the meta‐analysis, covering 17,921 subjects...Two serious (BK note: 2/17,921 == 0.01%) vaccination‐associated adverse events were reported, both of which resolved fully. No death or case of Guillain–Barré syndrome was reported. The pandemic influenza (H1N1) 2009 vaccine, with or without adjuvant, appears generally to be seroprotective after just one dose and safe among healthy populations aged ≥36 months; very young children (6–35 months) may need to receive two doses of non‐adjuvanted vaccine or one dose of AS03A/B‐adjuvanted product to achieve seroprotection."

Immunogenicity and safety of inactivated influenza vaccines in primed populations: A systematic literature review and meta-analysis - ScienceDirect https://www.sciencedirect.com/science/article/pii/S0264410X11007602

  • "In total, 9121 vaccinees of all ages, either healthy or with underlying diseases, were involved...This adequate amount of evidence led to the conclusion that all the currently available inactivated influenza vaccine formulations are safe, well tolerated and similarly effective to control seasonal influenza outbreaks across primed populations and age ranges."

Immunogenicity and safety of aerosolized measles vaccine: Systematic review and meta-analysis - ScienceDirect https://www.sciencedirect.com/science/article/pii/S0264410X07012790

  • "We included seven randomized trials, four non-randomized trials and six uncontrolled studies providing serological outcome data on 2887 individuals...In all comparative studies aerosolized vaccine was more immunogenic than subcutaneous. Reported side effects were mild. Aerosolized measles vaccine appears to be equally or more immunogenic than subcutaneous vaccine in children aged 10 months and older."

Efficacy and Safety of Prophylactic Vaccines against Cervical HPV Infection and Diseases among Women: A Systematic Review & Meta-Analysis | BMC Infectious Diseases | Full Text https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-11-13

  • "Seven unique trials enrolling 44,142 females were included...Prophylactic HPV vaccines are safe, well tolerated, and highly efficacious in preventing persistent infections and cervical diseases associated with vaccine-HPV types among young females. However, long-term efficacy and safety needs to be addressed in future trials."

EFFICACY:

Efficacy of live attenuated influenza vaccine in children: A meta-analysis of nine randomized clinical trials - ScienceDirect https://www.sciencedirect.com/science/article/pii/S0264410X08016526

  • "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)...In head-to-head trials comparing two doses of TIV and LAIV, vaccine-naïve 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."

Efficacy of pneumococcal vaccination in adults: a meta-analysis http://www.cmaj.ca/content/180/1/48

  • I'm including this even though it goes against the general trend - vaccines are not one single thing. In this case it looks like the pneumonococcal vaccination doesn't work that well. BUT it was no more dangerous.
  • "We included 22 trials involving 101 507 participants: 11 trials reported on presumptive pneumococcal pneumonia, 19 on all-cause pneumonia and 12 on all-cause mortality...The results for all-cause mortality in double-blind trials were similar to those in all trials combined...Pneumococcal vaccination does not appear to be effective in preventing pneumonia, even in populations for whom the vaccine is currently recommended."

Efficacy of BCG Vaccine in the Prevention of Tuberculosis: Meta-analysis of the Published Literature | JAMA | JAMA Network https://jamanetwork.com/journals/jama/fullarticle/366365

  • "On average, BCG vaccine significantly reduces the risk of TB by 50%. Protection is observed across many populations, study designs, and forms of TB. Age at vaccination did not enhance predictiveness of BCG efficacy. Protection against tuberculous death, meningitis, and disseminated disease is higher than for total TB cases, although this result may reflect reduced error in disease classification rather than greater BCG efficacy.(JAMA. 1994;271:698-702)"

The Efficacy of Influenza Vaccine in Elderly PersonsA Meta-Analysis and Review of the Literature | Annals of Internal Medicine | American College of Physicians https://annals.org/aim/article-abstract/709081

  • "Vaccine efficacy in the case–control studies ranged from 32% to 45% for preventing hospitalization for pneumonia, from 31% to 65% for preventing hospital deaths from pneumonia and influenza, from 43% to 50% for preventing hospital deaths from all respiratory conditions, and from 27% to 30% for preventing deaths from all causes. The randomized, double-blind, placebo-controlled trial showed a 50% or greater reduction in influenza-related illness. Recent cost-effectiveness studies confirm the efficacy of influenza vaccine in reducing influenza-related morbidity and mortality and show that vaccine provides important cost savings per year per vaccinated person.

Conclusion:

Despite the paucity of randomized trials, many studies confirm that influenza vaccine reduces the risks for pneumonia, hospitalization, and death in elderly persons during an influenza epidemic if the vaccine strain is identical or similar to the epidemic strain. Influenza immunization is an indispensable part of the care of persons 65 years of age and older. Annual vaccine administration requires the attention of all physicians and public health organizations."

Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis - ScienceDirect https://www.sciencedirect.com/science/article/abs/pii/S147330991170295X

  • Note: the "lacking" bit is covered in a study above
  • "Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality."
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