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Vaccines for preventing influenza in the elderly (Review) Jefferson T, Di Pietrantonj C, Al-Ansary LA, Ferroni E, Thorning S, Thomas RE ThisisareprintofaCochranereview,preparedandmaintained byTheCochraneCollaborationandpublishedinTheCochraneLibrary 2010, Issue 2 http://www.thecochranelibrary.com Vaccines for preventing influenza in the elderly (Review) Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. T A B L E O F C O N T E N T S HEADER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 PLAIN LANGUAGE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Figure 1. DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 AUTHORS’ CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 CHARACTERISTICS OF STUDIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 DATA AND ANALYSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Analysis1.1.Comparison 1Influenza vaccines versusnovaccination -Cohortstudies innursing homes,Outcome1ILI. 114 Analysis 1.2. Comparison 1 Influenza vaccines versus no vaccination - Cohort studies in nursing homes, Outcome 2 Influenza. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Analysis 1.3. Comparison 1 Influenza vaccines versus no vaccination - Cohort studies in nursing homes, Outcome 3 Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Analysis 1.4. Comparison 1 Influenza vaccines versus no vaccination - Cohort studies in nursing homes, Outcome 4 Hospitalisation for ILI or pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . 118 Analysis 1.5. Comparison 1Influenza vaccines versus no vaccination - Cohort studies innursing homes, Outcome 5Deaths from flu or pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Analysis 1.6. Comparison 1 Influenza vaccines versus no vaccination - Cohort studies in nursing homes, Outcome 6 All deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 Analysis 1.7. Comparison 1 Influenza vaccines versus no vaccination - Cohort studies in nursing homes, Outcome 7 Influenza cases (clinically defined without clear definition). . . . . . . . . . . . . . . . . . . 123 Analysis 2.1. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 1 ILI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Analysis 2.2. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 2 Influenza. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Analysis 2.3. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 3 Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Analysis 2.4. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 4 Hospitalisation for flu or pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . 127 Analysis 2.5. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 5 Hospitalisation for any respiratory disease. . . . . . . . . . . . . . . . . . . . . . . . . 128 Analysis 2.6. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 6 Deaths from flu or pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 Analysis 2.7. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 7 Deaths from respiratory disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Analysis 2.8. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 8 All deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Analysis 2.9. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 9 Hospitalisation for heart disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Analysis 2.10. Comparison 2 Influenza vaccines versus no vaccination - Cohort studies in community-dwellers, Outcome 10 Combined outcome: all deaths or severe respiratory illness. . . . . . . . . . . . . . . . . . 133 Analysis 3.1. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 1 Influenza. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Analysis 3.2. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 2 Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Vaccines for preventing influenza in the elderly (Review) i Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 3.3. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 3 Hospitalisation for influenza or pneumonia. . . . . . . . . . . . . . . . . . . . 136 Analysis 3.4. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 4 Hospitalisation for any respiratory disease. . . . . . . . . . . . . . . . . . . . . 137 Analysis 3.5. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 5 Deaths from respiratory disease. . . . . . . . . . . . . . . . . . . . . . . . 138 Analysis 3.6. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 6 All deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Analysis 3.7. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 7 Hospitalisation for heart disease. . . . . . . . . . . . . . . . . . . . . . . . 140 Analysis 3.8. Comparison 3 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - risk groups, Outcome 8 Combined outcome: all deaths or severe respiratory illness. . . . . . . . . . . . . . . 141 Analysis 4.1. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 1 Influenza. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Analysis 4.2. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 2 Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Analysis 4.3. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 3 Hospitalisation for influenza or pneumonia. . . . . . . . . . . . . . . . . 144 Analysis 4.4. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 4 Hospitalisation for any respiratory disease. . . . . . . . . . . . . . . . . . 145 Analysis 4.5. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 5 Deaths from respiratory disease. . . . . . . . . . . . . . . . . . . . . 146 Analysis 4.6. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 6 All deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Analysis 4.7. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 7 Hospitalisation for heart disease. . . . . . . . . . . . . . . . . . . . . 148 Analysis 4.8. Comparison 4 Influenza vaccines versus no vaccination - Cohort studies - community-dwellers - no risk groups, Outcome 8 Combined outcome: all deaths or severe respiratory illness. . . . . . . . . . . . 149 Analysis 5.1. Comparison 5 Influenza and pneumococcal vaccines versus no vaccination - Cohort studies in community- dwellers, Outcome 1 ILI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Analysis 5.2. Comparison 5 Influenza and pneumococcal vaccines versus no vaccination - Cohort studies in community- dwellers, Outcome 2 Hospitalisation for influenza or pneumonia or respiratory disease. . . . . . . . . 151 Analysis 5.3. Comparison 5 Influenza and pneumococcal vaccines versus no vaccination - Cohort studies in community- dwellers, Outcome 3 Deaths from influenza or pneumonia. . . . . . . . . . . . . . . . . . . 152 Analysis 5.4. Comparison 5 Influenza and pneumococcal vaccines versus no vaccination - Cohort studies in community- dwellers, Outcome 4 All deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Analysis 6.1. Comparison 6 Influenza vaccines with adjuvant versus no vaccination - Cohort studies in community- dwellers, Outcome 1 ILI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Analysis 6.2. Comparison 6 Influenza vaccines with adjuvant versus no vaccination - Cohort studies in community- dwellers, Outcome 2 Hospitalisation for influenza or pneumonia or respiratory disease. . . . . . . . . 155 Analysis 6.3. Comparison 6 Influenza vaccines with adjuvant versus no vaccination - Cohort studies in community- dwellers, Outcome 3 All deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Analysis 7.1. Comparison 7 Influenza vaccines versus no vaccination - Cohort studies in community - adjusted rates, Outcome 1 Hospitalisation for influenza or pneumonia. . . . . . . . . . . . . . . . . . . . 157 Analysis 7.2. Comparison 7 Influenza vaccines versus no vaccination - Cohort studies in community - adjusted rates, Outcome 2 Hospitalisation for any respiratory disease. . . . . . . . . . . . . . . . . . . . . 158 Analysis 7.3. Comparison 7 Influenza vaccines versus no vaccination - Cohort studies in community - adjusted rates, Outcome 3 Hospitalisation for heart disease. . . . . . . . . . . . . . . . . . . . . . . . 159 Analysis 7.4. Comparison 7 Influenza vaccines versus no vaccination - Cohort studies in community - adjusted rates, Outcome 4 All deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Analysis 7.5. Comparison 7 Influenza vaccines versus no vaccination - Cohort studies in community - adjusted rates, Outcome 5 Combined outcome: all deaths or severe respiratory illness. . . . . . . . . . . . . . . 161 Vaccines for preventing influenza in the elderly (Review) ii Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 8.1. Comparison 8 Influenza vaccines versus no vaccination - Case-control studies in community, Outcome 1 Hospitalisations for influenza or pneumonia. . . . . . . . . . . . . . . . . . . . . . . . 161 Analysis 8.2. Comparison 8 Influenza vaccines versus no vaccination - Case-control studies in community, Outcome 2 Hospitalisations for any respiratory disease. . . . . . . . . . . . . . . . . . . . . . . . . 162 Analysis 8.3. Comparison 8 Influenza vaccines versus no vaccination - Case-control studies in community, Outcome 3 Deaths from influenza or pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . . 163 Analysis 8.4. Comparison 8 Influenza vaccines versus no vaccination - Case-control studies in community, Outcome 4 Pneumonia (no better defined). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Analysis 9.1. Comparison 9 Influenza and pneumococcal vaccines versus no vaccination - Case-control studies in community, Outcome 1 Hospitalisations for influenza or pneumonia. . . . . . . . . . . . . . . 164 Analysis 10.1. Comparison 10 Influenza and pneumococcal vaccines versus no vaccination - Case-control studies in nursing homes, Outcome 1 ILI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Analysis 11.1. Comparison 11 Influenza vaccines versus no vaccination - Case-control studies in community - adjusted rates, Outcome 1 Hospitalisations for influenza or pneumonia. . . . . . . . . . . . . . . . . . 166 Analysis 11.2. Comparison 11 Influenza vaccines versus no vaccination - Case-control studies in community - adjusted rates, Outcome 2 Hospitalisations for any respiratory disease. . . . . . . . . . . . . . . . . . 167 Analysis 11.3. Comparison 11 Influenza vaccines versus no vaccination - Case-control studies in community - adjusted rates, Outcome 3 Deaths from pneumonia or influenza. . . . . . . . . . . . . . . . . . . . 168 Analysis 12.1. Comparison 12 Influenza and pneumococcal vaccines versus no vaccination - Case-control studies in community - adjusted rates, Outcome 1 Hospitalisations for influenza or pneumonia. . . . . . . . . . 169 Analysis 13.1. Comparison 13 Influenza vaccines versus placebo - RCT - parenteral vaccine, Outcome 1 ILI. . . . 170 Analysis 13.2. Comparison 13 Influenza vaccines versus placebo - RCT - parenteral vaccine, Outcome 2 Influenza. . 171 Analysis 13.3. Comparison 13 Influenza vaccines versus placebo - RCT - parenteral vaccine, Outcome 3 Pneumonia. 172 Analysis 13.4. Comparison 13 Influenza vaccines versus placebo - RCT - parenteral vaccine, Outcome 4 All deaths. . 172 Analysis 14.1. Comparison 14 Vaccine versus placebo - inactivated aerosol vaccine, Outcome 1 ILI. . . . . . . 173 Analysis 14.2. Comparison 14 Vaccine versus placebo - inactivated aerosol vaccine, Outcome 2 Influenza. . . . . 173 Analysis 15.1. Comparison 15 Vaccine versus placebo - live aerosol vaccine, Outcome 1 Influenza. . . . . . . . 174 Analysis 16.1. Comparison 16 Sensitivity analysis Comparison 01: subgroup analysis by study quality, Outcome 1 ILI. 174 Analysis 17.1. Comparison 17 Influenza vaccines versus placebo - RCT - parenteral vaccine - adverse events, Outcome 1 General malaise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 Analysis 17.2. Comparison 17 Influenza vaccines versus placebo - RCT - parenteral vaccine - adverse events, Outcome 2 Fever. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Analysis 17.3. Comparison 17 Influenza vaccines versus placebo - RCT - parenteral vaccine - adverse events, Outcome 3 Upper respiratory tract symptoms. . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Analysis 17.4. Comparison 17 Influenza vaccines versus placebo - RCT - parenteral vaccine - adverse events, Outcome 4 Headache. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Analysis 17.5. Comparison 17 Influenza vaccines versus placebo - RCT - parenteral vaccine - adverse events, Outcome 5 Nausea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Analysis 17.6. Comparison 17 Influenza vaccines versus placebo - RCT - parenteral vaccine - adverse events, Outcome 6 Local tenderness/sore arm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Analysis 17.7. Comparison 17 Influenza vaccines versus placebo - RCT - parenteral vaccine - adverse events, Outcome 7 Swelling - erythema - induration. . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Analysis 18.1. Comparison 18 Influenza vaccines versus placebo - RCT - live aerosol vaccine - adverse events, Outcome 1 General malaise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Analysis 18.2. Comparison 18 Influenza vaccines versus placebo - RCT - live aerosol vaccine - adverse events, Outcome 2 Fever. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Analysis 18.3. Comparison 18 Influenza vaccines versus placebo - RCT - live aerosol vaccine - adverse events, Outcome 3 Upper respiratory tract symptoms. . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Analysis 18.4. Comparison 18 Influenza vaccines versus placebo - RCT - live aerosol vaccine - adverse events, Outcome 4 Lower respiratory tract symptoms. . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 FEEDBACK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 WHAT’S NEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 Vaccines for preventing influenza in the elderly (Review) iii Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. HISTORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 CONTRIBUTIONS OF AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 DECLARATIONS OF INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 SOURCES OF SUPPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 INDEX TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 Vaccines for preventing influenza in the elderly (Review) iv Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. ... - tailieumienphi.vn
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