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

Joan Puig-Barberà, Sonia Tamames-Gómez, Pedro Plans-Rubio and José María Eiros-Bouza
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Joan Puig-Barberà: FISABIO, Área de Investigación en Vacunas, 46020 Valencia, Spain
Sonia Tamames-Gómez: Consejería de Sanidad, Dirección General de Salud Pública, Servicio de Información en Salud Pública, 47001 Valladolid, Spain
Pedro Plans-Rubio: Departament de Salut, Agència de Salut Pública de Catalunya, 08005 Barcelona, Spain
José María Eiros-Bouza: Hospital Universitario “Río Hortega”, 47001 Valladolid, Spain

IJERPH, 2022, vol. 19, issue 2, 1-20

Abstract: Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effectiveness. 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 influenza 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; applied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, publication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed using 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. 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% (−2% 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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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