PreprintReviewVersion 2Preserved in Portico This version is not peer-reviewed
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
Version 1
: Received: 6 November 2021 / Approved: 8 November 2021 / Online: 8 November 2021 (12:14:08 CET)
Version 2
: Received: 6 December 2021 / Approved: 20 December 2021 / Online: 20 December 2021 (11:00:26 CET)
Puig-Barberà, J.; Tamames-Gómez, S.; Plans-Rubio, P.; Eiros-Bouza, J.M. 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. Int. J. Environ. Res. Public Health2022, 19, 818.
Puig-Barberà, J.; Tamames-Gómez, S.; Plans-Rubio, P.; Eiros-Bouza, J.M. 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. Int. J. Environ. Res. Public Health 2022, 19, 818.
Puig-Barberà, J.; Tamames-Gómez, S.; Plans-Rubio, P.; Eiros-Bouza, J.M. 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. Int. J. Environ. Res. Public Health2022, 19, 818.
Puig-Barberà, J.; Tamames-Gómez, S.; Plans-Rubio, P.; Eiros-Bouza, J.M. 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. Int. J. Environ. Res. Public Health 2022, 19, 818.
Abstract
Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effec-tiveness. 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 influ-enza 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; ap-plied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, pub-lication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed us-ing 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 and risk of bias. 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% (-01 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.
Keywords
adults; influenza; cell-cultured vaccine; egg-based vaccine; influenza vaccine; relative vaccine effectiveness; real word evidence; mutation; human / prevention & control*; comparative study
Subject
Medicine and Pharmacology, Medicine and Pharmacology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received:
20 December 2021
Commenter:
Joan Puig-Barbera
Commenter's Conflict of Interests:
Author
Comment:
This new version of the manuscript amends mistyping in the aRR values in Table 2, Figures 3, 4, 5, Table S2, Figures S1 to S5, the mentions of aRR and arVE in the text, and duplicates in the references. The correction does not impact the interpretation of the findings and the manuscript's conclusions.
Commenter: Joan Puig-Barbera
Commenter's Conflict of Interests: Author