title: Influenza vaccination for immunocompromised patients: summary of a systematic review and meta-analysis.
abstract: Vaccination of immunocompromised patients is recommended in many national guidelines to protect against severe or complicated influenza infection. However, due to uncertainties over the evidence base, implementation is frequently patchy and dependent on individual clinical discretion. We conducted a systematic review and meta-analysis to assess the evidence for influenza vaccination in this patient group. Healthcare databases and grey literature were searched and screened for eligibility. Data extraction and assessments of risk of bias were undertaken in duplicate, and results were synthesised narratively and using meta-analysis where possible. Our data show that whilst the serological response following vaccination of immunocompromised patients is less vigorous than in healthy controls, clinical protection is still meaningful, with only mild variation in adverse events between aetiological groups. Although we encountered significant clinical and statistical heterogeneity in many of our meta-analyses, we advocate that immunocompromised patients should be targeted for influenza vaccination.
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Beck
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Bruce C
authors.initials: BC
authors.lastname: McKenzie
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Ahmed B
authors.initials: AB
authors.lastname: Hashim
authors.affiliation: Global Influenza Programme, World Health Organization, Geneva, Switzerland.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Harris
authors.affiliation: Department of Public Health Medicine, University of Bielefeld, Bielefeld, Germany.
authors.forename: Arina
authors.initials: A
authors.lastname: Zanuzdana
authors.affiliation: Public Health Directorate, NHS Blackpool, Blackpool, United Kingdom.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Agboado
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Orton
authors.affiliation: Freelance, World Health Organization, Geneva, Switzerland.
authors.forename: Laura
authors.initials: L
authors.lastname: Béchard-Evans
authors.affiliation: South West (North) Health Protection Unit, Health Protection Agency, Gloucester, United Kingdom.
authors.forename: Gemma
authors.initials: G
authors.lastname: Morgan
authors.affiliation: Cumbria and Lancashire Health Protection Unit, Health Protection Agency, Chorley, United Kingdom.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Stevenson
authors.affiliation: Health Protection Agency Yorkshire and Humber, Health Protection Agency, Leeds, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Weston
authors.affiliation: Global Influenza Programme, World Health Organization, Geneva, Switzerland.
authors.forename: Mitsuru
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authors.lastname: Mukaigawara
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Enstone
authors.affiliation: Public Health Directorate, NHS Leicestershire County, Leicester, United Kingdom.
authors.forename: Glenda
authors.initials: G
authors.lastname: Augustine
authors.affiliation: Department of Medicine, Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom.
authors.forename: Mobasher
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authors.lastname: Butt
authors.affiliation: Law School, Harvard University, Cambridge, Massachusetts, United States of America.
authors.forename: Sophie
authors.initials: S
authors.lastname: Kim
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Puleston
authors.affiliation: Hampshire and Isle Of Wight Health Protection Unit, Health Protection Agency, Fareham, United Kingdom.
authors.forename: Girija
authors.initials: G
authors.lastname: Dabke
authors.affiliation: Public Health Directorate, NHS Nottingham City, Nottingham, United Kingdom.
authors.forename: Robert
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authors.lastname: Howard
authors.affiliation: Public Health Directorate, NHS Nottingham City, Nottingham, United Kingdom.
authors.forename: Julie
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authors.lastname: O'Boyle
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authors.forename: Mary
authors.initials: M
authors.lastname: O'Brien
authors.affiliation: Public Health Directorate, NHS Leicestershire County, Leicester, United Kingdom.
authors.forename: Lauren
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authors.lastname: Ahyow
authors.affiliation: Public Health Directorate, NHS Derbyshire County, Chesterfield, United Kingdom.
authors.forename: Helene
authors.initials: H
authors.lastname: Denness
authors.affiliation: Public Health, Mersey Deanery, Liverpool, United Kingdom.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Farmer
authors.affiliation: Medical School, Harvard University, Boston, Massachusetts, United States of America.
authors.forename: Jose
authors.initials: J
authors.lastname: Figureroa
authors.affiliation: Public Health Directorate, Solihull NHS Primary Care Trust, Solihull, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Fisher
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authors.forename: Felix
authors.initials: F
authors.lastname: Greaves
authors.affiliation: Childrens Services, Leicester Partnership Trust, Leicester, United Kingdom.
authors.forename: Munib
authors.initials: M
authors.lastname: Haroon
authors.affiliation: Health Protection Agency East Midlands, Health Protection Agency, Nottingham, United Kingdom.
authors.forename: Sophie
authors.initials: S
authors.lastname: Haroon
authors.affiliation: Health Protection Agency East Midlands, Health Protection Agency, Nottingham, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Hird
authors.affiliation: Medical School, Lancaster University, Lancaster, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Isba
authors.affiliation: Department of Infection and Population Health, University College London, London, United Kingdom.
authors.forename: David A
authors.initials: DA
authors.lastname: Ishola
authors.affiliation: Centre for International Health and Development, University College London, London, United Kingdom.
authors.forename: Marko
authors.initials: M
authors.lastname: Kerac
authors.affiliation: Public Health Directorate, NHS Northamptonshire, Northampton, United Kingdom.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Parish
authors.affiliation: South West (North) Health Protection Unit, Health Protection Agency, Gloucester, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Roberts
authors.affiliation: Public Health Directorate, NHS Halton and St. Helens, Widnes, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Rosser
authors.affiliation: Public Health Directorate, NHS Nottinghamshire County, Mansfield, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Theaker
authors.affiliation: Public Health Directorate, NHS Nottinghamshire County, Mansfield, United Kingdom.
authors.forename: Dean
authors.initials: D
authors.lastname: Wallace
authors.affiliation: Public Health Directorate, NHS East Lancashire, Nelson, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Wigglesworth
authors.affiliation: Health Protection Agency North East, Health Protection Agency, Newcastle upon Tyne, United Kingdom.
authors.forename: Liz
authors.initials: L
authors.lastname: Lingard
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Yana
authors.initials: Y
authors.lastname: Vinogradova
authors.affiliation: Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Horiuchi
authors.affiliation: Freelance, World Health Organization, Geneva, Switzerland.
authors.forename: Javier
authors.initials: J
authors.lastname: Peñalver
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Nguyen-Van-Tam
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D006801:Humans; D016867:Immunocompromised Host; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control*; D014611:Vaccination / Q000379:methods*
chemical_list: D000914:Antibodies, Viral; D007252:Influenza Vaccines
keywords: Immunocompromised; influenza; meta-analysis; systematic review; vaccination
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