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J Infect Dis. 2012 Oct;206(8):1250-9. Epub 2012 Aug 16.

Influenza vaccination for immunocompromised patients: systematic review and meta-analysis by etiology.

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1
Division of Epidemiology and Public Health, University of Nottingham, United Kingdom. charles.beck@nottingham.ac.uk

Abstract

Many national guidelines recommend annual influenza vaccination of immunocompromised patients, although the decision to vaccinate is usually at clinical discretion. We conducted a systematic review and meta-analyses to assess the evidence for influenza vaccination in this group, and we report our results by etiology. Meta-analyses showed significantly lower odds of influenza-like illness after vaccination in patients with human immunodeficiency virus (HIV) infection, patients with cancer, and transplant recipients and of laboratory-confirmed influenza in HIV-positive patients, compared with patients receiving placebo or no vaccination. Pooled odds of seroconversion and seroprotection were typically lower in HIV-positive patients, patients with cancer, and transplant recipients, compared with immunocompetent controls. Vaccination was generally well tolerated, with variation in mild adverse events between etiological groups. Limited evidence of a transient increase in viremia and a decrease in the percentage of CD4(+) cells in HIV-positive patients was found although not accompanied by worsening of clinical symptoms. Clinical judgment remains important when discussing the benefits and safety profile with immunocompromised patients.

PMID:
22904335
DOI:
10.1093/infdis/jis487
[Indexed for MEDLINE]
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