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首页> 外文期刊>The Pediatric infectious disease journal >The efficacy of influenza vaccine for healthy children: a meta-analysis evaluating potential sources of variation in efficacy estimates including study quality.
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The efficacy of influenza vaccine for healthy children: a meta-analysis evaluating potential sources of variation in efficacy estimates including study quality.

机译：流感疫苗对健康儿童的功效：一项荟萃分析，评估功效评估（包括研究质量）中潜在的变异来源。

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BACKGROUND: Two systematic reviews evaluating influenza vaccine efficacy in healthy children have recently been published. Although quantitative summary estimates were similar, authors' conclusions were quite contrasting. We carried out another meta-analysis reevaluating study inclusion criteria and using metaregression techniques in addition to sensitivity and subgroups analyses to evaluate potential sources of heterogeneity of efficacy estimates, including methodologic quality of studies. METHODS: Only randomized clinical studies assessing the efficacy of influenza vaccine in healthy children/adolescents (age < or =18 years) for preventing naturally occurring influenza and/or acute otitis media cases were included. Summary estimates of effect were obtained using a random effects model. The methodologic quality of each study was assessed using 3 systems: Chalmers scale, Jadad scale and Schulz components (randomization, allocation concealment and double-blinding). RESULTS: The overall vaccination efficacy was 36% (95% confidence interval: 31-40%) against clinically diagnosed illnesses (evaluated by 19 randomized clinical studies for a total of 247,517 children); 67% (51-78%) against laboratory-confirmed cases (18 trials, n = 8574); and 51% (21-70%) against acute otitis media (11 trials, n = 11,349). Significant sources of between-study heterogeneity were participants' age and study quality both directly correlated with the efficacy. When the analysis was performed excluding USSR studies, the overall efficacy of the vaccine in preventing clinical cases substantially increased (from 36% to 61%). CONCLUSIONS: These findings may indicate that the vaccine efficacy might be greater than the overall estimates. Although no safety and cost considerations are addressed in this analysis, the present findings support vaccination as a possible option for the prevention of influenza in healthy children and adolescents.
机译：背景：最近发表了两项评估健康儿童流感疫苗效力的系统评价。尽管定量的汇总估算值相似，但作者的结论却截然相反。我们进行了另一项荟萃分析，重新评估了研究的纳入标准，并在敏感性和亚组分析之外使用了荟萃回归技术来评估功效评估的异质性的潜在来源，包括研究的方法学质量。方法：仅包括评估流感疫苗在健康儿童/青少年（年龄≤18岁）中预防自然发生的流感和/或急性中耳炎病例的功效的随机临床研究。使用随机效应模型获得效应的概算。每个研究的方法学质量使用3个系统进行评估：查尔默斯量表，贾达德量表和舒尔茨分量（随机化，分配隐藏和双盲）。结果：针对临床确诊疾病的总体疫苗接种效率为36％（95％置信区间：31-40％）（通过19项随机临床研究对总共247,517名儿童进行了评估）;实验室确诊病例的67％（51-78％）（18个试验，n = 8574）;和51％（21-70％）的急性中耳炎（11个试验，n = 11,349）。研究之间异质性的重要来源是参与者的年龄和研究质量，两者均与疗效直接相关。当进行分析（不包括苏联研究）时，疫苗在预防临床病例中的总体功效大大提高（从36％增至61％）。结论：这些发现可能表明该疫苗的功效可能大于总体估计。尽管在此分析中未考虑安全性和成本方面的考虑，但目前的发现支持接种疫苗作为预防健康儿童和青少年流感的可能选择。

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