From The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd. All rights reserved.
Vaccines for preventing influenza in people with cystic fibrosis (Cochrane Review)
Tan A, Bhalla P, Smyth R
A substantive amendment to this systematic review was last made on 03 November 1999. Cochrane reviews are regularly checked and updated if necessary. Background: Viral respiratory tract infections in patients with cystic fibrosis (CF) have a deteriorating effect on their lung function and disease progression. Annual influenza vaccination is therefore commonly recommended for patients with CF.
Objectives: To assess the effectiveness of influenza vaccination for patients with CF. Search strategy: We have used the Cochrane CF and Genetic Disorders Group specialist trials register which comprises references identified from comprehensive electronic database searches, hand searching relevant journals and abstract books of conference proceedings and communication to the drug companies marketing influenza vaccines.Date of the most recent search of the Group's specialised register: November 2001.
Selection criteria: All randomised and pseudorandomised trials (published or unpublished) comparing any influenza vaccine with a placebo or with another type of influenza vaccine. Data collection and analysis: Both reviewers independently assessed trial quality and extracted data. Additional information were obtained by contacting the investigators when it was indicated.
Main results: Four trials enrolling a total of 179 patients with CF (143 (80%) were children aged 1 to 16 years) were included in this review. There was no study comparing a vaccine to a placebo or a whole virus vaccine to a sub unit or split virus vaccine. Two studies compared an intranasal applied
live vaccine to an intramuscular inactivated vaccine and the other two studies compared a split virus to a sub unit vaccine and a virosome to a sub unit vaccine (all intramuscular). The incidence of all reported adverse events was high depending on the type of influenza vaccine. The total adverse event rate ranged from 48/201 (24%) for the intranasal live vaccine to 13/30 (43%) for the split virus vaccine. With the limitation of a statistical low power there was no significant difference between the study vaccinations. None of the events were severe. All study influenza vaccinations generated a satisfactory serological antibody response. No trial reported other clinically important benefits.
Reviewers' conclusions: There is currently no evidence from randomised studies that influenza vaccine given to patients with CF is of benefit to them. There remains a need for a well constructed clinical study, that assesses the effectiveness of influenza vaccination on important clinical outcome measures.
Citation: Tan A, Bhalla P, Smyth R. Vaccines for preventing influenza in people with cystic fibrosis (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.
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