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Cited by 232Influenza Virus Research StudiesBacterial Infections and VaccinesRespiratory viral infections research

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Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: A systematic review and meta-analysis

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Domnich, Alexander, Arata, Lucia, Amicizia, Daniela, Puig-Barberà, Joan, Gasparini, Roberto, Panatto, Donatella·2017·Vaccine
DOI 10.1016/j.vaccine.2016.12.011
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Abstract

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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  1. Official Journal of the European Union. Council recommendation of 22 December 2009 on seasonal influenza vaccination. <http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2009:348:0071:0072:EN:PDF>.

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Metadata

Authors
Domnich, A., Arata, L., Amicizia, D., Puig-Barberà, J., Gasparini, R., & Panatto, D.
Affiliations
University of Genoa (IT)
Corresponding author
Panatto, Donatella
ORCID
Venue
Vaccine
Publisher
Elsevier BV
Published
2017-01
Volume
35
Issue
4
Pages
513-520
ISSN
0264-410X (ISSN-L)
DOI
10.1016/j.vaccine.2016.12.011
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
Licence
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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