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Impacts on Influenza A(h1n1)Pdm09 Infection from Seasonal Influenza Vaccine and Related Regional Factors

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Impacts on Influenza A(h1n1)Pdm09 Infection from Seasonal Influenza Vaccine and Related Regional Factors

Systematic Review and Meta-Analyses



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Impacts on Influenza A(h1n1)Pdm09 Infection from Seasonal Influenza Vaccine and Related Regional Factors by Zhiyuan Li
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This dissertation, "Impacts on Influenza A(H1N1)pdm09 Infection From Seasonal Influenza Vaccine and Related Regional Factors: Systematic Review and Meta-analyses" by Zhiyuan, Li, 李致媛, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: BACKGROUNDInfluenza is an infectious disease that has significant public health impact due to its high prevalence and mortality. In early 2009, a novel influenza A(H1N1) virus emerged in Mexico and the USA, then rapidly spread worldwide and caused the first influenza pandemic of the 21st century. However, it is still controversial that whether seasonal influenza vaccine can provide a cross-protection against influenza A(H1N1) pdm09 infection. Since the 2009 pandemic occurred, numbers of studies focusing on this issue have been published, yet no confirmed conclusion was drawn. Therefore, further quantitative evaluation is needed to provide more reliable evidence. The objective of this study is to assess the cross-protection of seasonal influenza vaccination against 2009 pandemic A(H1N1) influenza illness, and explore the impact of seasonal influenza activities on this association. METHODSI followed the PRISMA statement and searched the PubMed, MEDLINE, Ovid Embase, The Cochrane Library databases, SCOPUS and CNKI. Randomized control trials, cohort studies, case-control studies assess the effect of seasonal influenza vaccine against influenza A (H1N1)pdm09 illness published in English and Chinese from 2009 to July 2013 were identified. The quality of included studies was assessed by the Jadad scale and the Newcastle-Ottawa Scale. I used the I2statistic, and Begg's funnel plot for assessment of heterogeneity and publication bias respectively. The software Review Manager 5.2 was used for generating the pooled effect with corresponding 95% confidence intervals and forest plots. Subgroup analysis was performed based on the study locations and previous circulating influenza viruses. RESULTS20 studies were included in the meta-analyses. There is a non-significant 19% reduced risk of pandemic influenza illness in the countries combined data based on case-control studies(OR=0.81, 95% CI=0.60 to 1.08). While, for RCTs, a non-significant increase risk in seasonal influenza vaccinees was observed(RR=1.13, 95% CI=0.56 to 2.29). For the subgroup analysis, a significant 35% to 50% cross-protection was observed in South America and Europe, but an opposite result was observed in Canada(OR=1.44, 95% CI=0.83 to 2.50). Besides, the results indicate that there is no association between seasonal influenza vaccination and ILI. No publication bias was detected. CONCLUSIONSThe findings partially support the hypothesis that seasonal vaccine may offer moderate cross-protection against laboratory-confirmed pandemic influenza A(H1N1) illness in general. Further immunological research is needed to understand the mechanism behind these findings. DOI: 10.5353/th_b5098724 Subjects: Influenza vaccinesH1N1 influenza
Release date NZ
January 26th, 2017
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Country of Publication
United States
colour illustrations
Open Dissertation Press
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