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Vaccines for preventing influenza in people with asthma

  1. Christopher J Cates1,*,
  2. Brian H Rowe2,3

Editorial Group: Cochrane Airways Group

Published Online: 28 FEB 2013

Assessed as up-to-date: 23 NOV 2012

DOI: 10.1002/14651858.CD000364.pub4


How to Cite

Cates CJ, Rowe BH. Vaccines for preventing influenza in people with asthma. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD000364. DOI: 10.1002/14651858.CD000364.pub4.

Author Information

  1. 1

    St George's, University of London, Population Health Sciences and Education, London, UK

  2. 2

    University of Alberta, Department of Emergency Medicine, Edmonton, Alberta, Canada

  3. 3

    University of Alberta, School of Public Heath, Edmonton, Canada

*Christopher J Cates, Population Health Sciences and Education, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK. ccates@sgul.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 28 FEB 2013

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[Figure 1]
Figure 1. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 2]
Figure 2. Forest plot of comparison: 1 Protection from inactivated influenza vaccine versus placebo, outcome: 1.1 Influenza-related asthma exacerbations.
[Figure 3]
Figure 3. Forest plot of comparison: 2 Split virus or surface antigen vaccine versus placebo (adverse events in first two weeks), outcome: 2.1 Asthma exacerbation within two weeks.
[Figure 4]
Figure 4. Forest plot of comparison: 2 Split virus or surface antigen vaccine versus placebo (adverse events in first two weeks), outcome: 2.2 Asthma exacerbation within three days.
[Figure 5]
Figure 5. Forest plot of comparison: 2 Split virus or surface antigen vaccine versus placebo (adverse events in first two weeks), outcome: 2.3 Asthma exacerbation within two weeks (subgrouped by previous vaccination status).
[Analysis 1.1]
Analysis 1.1. Comparison 1 Protection from inactivated influenza vaccine versus placebo, Outcome 1 Influenza-related asthma exacerbations.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Protection from inactivated influenza vaccine versus placebo, Outcome 2 Duration of influenza-related asthma exacerbation (days).
[Analysis 1.3]
Analysis 1.3. Comparison 1 Protection from inactivated influenza vaccine versus placebo, Outcome 3 Severity of influenza-related asthma exacerbation (symptom score).
[Analysis 1.4]
Analysis 1.4. Comparison 1 Protection from inactivated influenza vaccine versus placebo, Outcome 4 Difference in symptom score during influenza positive weeks.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Protection from inactivated influenza vaccine versus placebo, Outcome 5 Proportion of patients with minimum important difference in total symptom score (influenza-positive weeks).
[Analysis 1.6]
Analysis 1.6. Comparison 1 Protection from inactivated influenza vaccine versus placebo, Outcome 6 FEV1 (% predicted) during influenza positive weeks.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 1 Asthma exacerbation within 2 weeks.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 2 Asthma exacerbation within 3 days.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 3 Asthma exacerbation within 2 weeks (subgrouped by previous vaccination status).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 4 Hospital admission (0 to 14 days post vaccination).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 5 Number of symptom-free days in 2 weeks after vaccination.
[Analysis 2.6]
Analysis 2.6. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 6 ≥ 1 day off school or work.
[Analysis 2.7]
Analysis 2.7. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 7 Medical consultation (0 to 14 days after immunisation).
[Analysis 2.8]
Analysis 2.8. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 8 Patients at least 15% fall in FEV1 within 5 days.
[Analysis 2.9]
Analysis 2.9. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 9 Fall in mean peak flow (% baseline) days 2 to 4.
[Analysis 2.10]
Analysis 2.10. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 10 New or increased oral corticosteroid use (0 to 14 days after immunisation).
[Analysis 2.11]
Analysis 2.11. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 11 Increased nebuliser usage within 3 days.
[Analysis 2.12]
Analysis 2.12. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 12 Increased use of rescue medication following vaccination (days 1 to 3).
[Analysis 2.13]
Analysis 2.13. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 13 Change in airways responsiveness.
[Analysis 2.14]
Analysis 2.14. Comparison 2 Adverse effects of inactivated influenza vaccine versus placebo, Outcome 14 Change in asthma symptoms in the week following vaccination.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 1 Hospital admission for asthma exacerbation.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 2 Asthma exacerbations in the month after vaccination.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 3 Asthma exacerbations in the week following vaccination.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 4 Mean FEV1 at 2 to 5 days post vaccination (% predicted).
[Analysis 3.5]
Analysis 3.5. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 5 Number of patients with significant fall in FEV1 (over 12% to 15% or 50 mL) on day 2 to 4.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 6 Fall in mean FEV1 (L) (day 2 to 4).
[Analysis 3.7]
Analysis 3.7. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 7 Number of puffs of beta2-agonist per day (in month following vaccination).
[Analysis 3.8]
Analysis 3.8. Comparison 3 Adverse effects of live attenuated vaccine (intranasal) versus placebo, Outcome 8 Morning peak flow of greater than 30% below baseline at least once in the 4 weeks after vaccination.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Protection from live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 1 Difference in incidence of asthma exacerbation over total study period.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Protection from live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 2 Hospitalisations due to respiratory illness.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Protection from live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 3 Days off school or work (incidence rates).
[Analysis 4.4]
Analysis 4.4. Comparison 4 Protection from live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 4 Unscheduled healthcare visits (incidence rates).
[Analysis 4.5]
Analysis 4.5. Comparison 4 Protection from live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 5 Children with serious adverse events.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Adverse effects of live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 1 Subjects reporting wheeze in the first 15 days.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Adverse effects of live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 2 Subjects reporting runny nose or nasal congestion in the first 15 days.
[Analysis 5.3]
Analysis 5.3. Comparison 5 Adverse effects of live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 3 Subjects reporting bronchospasm as an adverse event in first 15 days.
[Analysis 5.4]
Analysis 5.4. Comparison 5 Adverse effects of live attenuated vaccine (intranasal) versus trivalent inactivated vaccine (intramuscular), Outcome 4 Subjects reporting rhinitis as an adverse event in the first 15 days.