Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: A systematic review and meta-analysis
Open accessAbstract
BACKGROUND: In the elderly, traditional influenza inactivated vaccines are often only modestly immunogenic, owing to immunosenescence. Given that adjuvantation is a means of enhancing the immune response, the trivalent inactivated vaccine adjuvanted with MF59 (MF59-TIV) was specifically designed to overcome this problem. Considering that, for ethical reasons, the absolute effectiveness of an influenza vaccine in the elderly cannot be demonstrated in placebo-controlled studies, the present study aimed to assess the effectiveness of MF59-TIV in preventing influenza-related outcomes in the elderly. METHODS: We conducted a systematic review of observational studies aimed at evaluating the effectiveness of MF59-TIV against influenza-related outcomes. Results of single studies were pooled whenever possible. RESULTS: Of the 1993 papers screened, 11 (6 case-control, 3 cohort and 2 prospective case-control) studies were identified. Hospitalization due to pneumonia/influenza and laboratory-confirmed influenza were reported in more than one study, while other outcomes (influenza-like illness, cardio- and cerebrovascular accidents) were investigated only by one study each. Pooled analysis of four case-control studies showed an adjusted MF59-TIV effectiveness of 51% (95% CI: 39-61%) against hospitalizations for pneumonia/influenza among community-dwelling seniors. Pooled results of the adjusted vaccine effectiveness against laboratory-confirmed influenza were also high (60.1%), although the 95% CI passed through zero (-1.3 to 84.3%). Other single community-based studies showed very high effectiveness of MF59-TIV in preventing hospitalizations for acute coronary [87% (95% CI: 35-97%)] and cerebrovascular [93% (95% CI: 52-99%)] events. MF59-TIV proved highly effective [94% (95% CI: 47-100%] in reducing influenza-like illness among institutionalized elderly. Furthermore, MF59-TIV displayed greater efficacy than non-adjuvanted vaccines in preventing hospitalizations due to pneumonia/influenza [adjusted risk ratio 0.75 (95% CI: 0.57-0.98)] and laboratory-confirmed influenza [adjusted odds ratio 0.37 (0.14-0.96)]. CONCLUSIONS: Our results suggest that MF59-TIV is effective in reducing several influenza-related outcomes among the elderly, especially hospitalizations due to influenza-related complications.
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In comparative vaccination trials of older individuals, MF59 outperformed nonadjuvanted influenza vaccine in inducing virus-specific antibodies and improving clinical outcome.
“In comparative vaccination trials of older individuals, MF59, widely used in Europe, outperformed the nonadjuvanted vaccine in inducing influenza virus-specific antibodies and improving clinical outcome”
From Successful and Maladaptive T Cell Aging (2017) · cites this paper as Domnich et al., 2017
Emerging data following the recent development and deployment of new-generation, high-dose or adjuvanted influenza vaccines and an adjuvanted glycoprotein varicella zoster vaccine suggest that the provision of additional signals to the immune system by certain adjuvants (such as AS01 and MF59) can overcome immunosenescence.
“emerging data following the recent development and deployment of new-generation, high-dose or adjuvanted influenza vaccines82 and an adjuvanted glycoprotein varicella zoster vaccine83 suggest that the provision of additional signals to the immune system by certain adjuvants (such as AS01 and MF59) can overcome immunosenescence.”
From A guide to vaccinology: from basic principles to new developments (2021) · cites this paper as [82]
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- Authors
- Domnich, A., Arata, L., Amicizia, D., Puig-Barberà, J., Gasparini, R., & Panatto, D.
- Affiliations
- University of Genoa (IT)
- Corresponding author
- Panatto, Donatella
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 35
- Issue
- 4
- Pages
- 513-520
- ISSN
- 0264-410X (ISSN-L)
- OpenAlex
- W2566538631
- Cited by
- 229
- References
- 42
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 15 · 2023: 16 · 2022: 28 · 2021: 39 · 2020: 29 · 2019: 33 · 2018: 31 · 2017: 12
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Vaccine (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Keywords
- MF59, adjuvanted influenza vaccine, trivalent inactivated influenza vaccine, older adults, vaccine effectiveness, immunosenescence, laboratory-confirmed influenza, acute coronary events, cerebrovascular events, influenza-like illness, institutionalized elderly, community-dwelling older adults, influenza prevention
- MeSH terms
- Adjuvants, Immunologic, Aged, Aged, 80 and over, Humans, Influenza, Human, Influenza Vaccines, Polysorbates, Squalene, Vaccines, Inactivated, Treatment Outcome, Observational Studies as Topic
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