Oil-in-water emulsion adjuvants for pediatric influenza vaccines: a systematic review and meta-analysis

Yu-Ju Lin, Chiao-Ni Wen, Ying-Ying Lin, Wen-Chi Hsieh, Chia-Chen Chang, Yi-Hsuan Chen, Chian-Hui Hsu, Yun-Jui Shih, Chang-Hsun Chen and Chi-Tai Fang ()
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Yu-Ju Lin: National Taiwan University
Chiao-Ni Wen: National Taiwan University
Ying-Ying Lin: National Taiwan University
Wen-Chi Hsieh: National Taiwan University
Chia-Chen Chang: National Taiwan University
Yi-Hsuan Chen: National Taiwan University
Chian-Hui Hsu: National Taiwan University
Yun-Jui Shih: National Taiwan University
Chang-Hsun Chen: Taiwan Centers for Disease Control
Chi-Tai Fang: National Taiwan University

Nature Communications, 2020, vol. 11, issue 1, 1-12

Abstract: Abstract Standard inactivated influenza vaccines are poorly immunogenic in immunologically naive healthy young children, who are particularly vulnerable to complications from influenza. For them, there is an unmet need for better influenza vaccines. Oil-in-water emulsion-adjuvanted influenza vaccines are promising candidates, but clinical trials yielded inconsistent results. Here, we meta-analyze randomized controlled trials with efficacy data (3 trials, n = 15,310) and immunogenicity data (17 trials, n = 9062). Compared with non-adjuvanted counterparts, adjuvanted influenza vaccines provide a significantly better protection (weighted estimate for risk ratio of RT-PCR-confirmed influenza: 0.26) and are significantly more immunogenic (weighted estimates for seroprotection rate ratio: 4.6 to 7.9) in healthy immunologically naive young children. Nevertheless, in immunologically non-naive children, adjuvanted and non-adjuvanted vaccines provide similar protection and are similarly immunogenic. These results indicate that oil-in-water emulsion adjuvant improves the efficacy of inactivated influenza vaccines in healthy young children at the first-time seasonal influenza vaccination.

Date: 2020
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DOI: 10.1038/s41467-019-14230-x

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