Effectiveness and safety of dual influenza and pneumococcal vaccination versus separate administration or no vaccination in older adults: a meta-analysis

ABSTRACT

Background: The advantages of dual pneumococcal and influenza vaccination in older adults have not been clarified and controversy remains regarding their optimal use.

Methods: This meta-analysis was conducted on 25 January 2018 using PubMed, the Cochrane Library, and Embase databases. Seventeen studies were selected ultimately for meta-analysis using a multi-step approach by two separate authors. Primary outcomes were pneumonia, pneumococcal pneumonia, influenza, hospitalization, and all-cause mortality rates, and the secondary outcome was adverse effects (AEs).

Results: The additive preventive effects of dual influenza and pneumococcal vaccination versus influenza vaccination alone for pneumonia and death were 15% (95% confidence interval [CI]: 4-24%) and 19% (95% CI: 6-30%), respectively. Compared with pneumococcal vaccination alone, dual influenza and pneumococcal vaccination resulted in a 24% (95% CI: 16-31%) reduction in pneumonia and a 28% (95% CI: 13-40%) reduction in death. Compared with placebo or no vaccination, the effectiveness of dual vaccination was 29% (95% CI: 14-42%) for pneumonia, 38% (95% CI: 25-49%) for death, 35% (95% CI: 22-46%) for influenza, and 18% (95% CI: 6-29%) for hospitalization. Both vaccines showed acceptable safety profiles and AEs were mild or moderate.

Conclusion: Our findings highlight the importance of concomitant influenza and pneumococcal vaccination in older adults.

KEYWORDS:

• Effectiveness
• elderly
• influenza vaccination
• pneumococcal vaccination
• safety

Acknowledgments

We would like to express special gratitude to all the personnel who supported or helped with this study.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

A reviewer on this manuscript has disclosed receiving research funding from Merck & Co, Inc. and Pfizer Inc.

Author contributions

Author contributions: Mingjuan Yin conceptualized and designed the study, performed the analyses, and drafted the initial manuscript, and revised the manuscript. Xiaojia Xu and Yaping Liang reviewed the articles, carried out the initial analyses, reviewed and revised the manuscript. Lingfeng Huang, Yan Zhang and Na Yu performed data extraction and reviewed and revised the manuscript. Jindong Ni conceptualized and designed the study and critically revised and reviewed the manuscript. All authors approved the final manuscript as submitted.

Supplemental data

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by the grants from Natural Science Foundation of Guangdong Province, China, under Grant 2015A030313516; Foundation for Young Talents in Higher Education of Guangdong, China, under Grant 2014KQNCX102.