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Immunogenicity and safety of aerosolized measles vaccine: Systematic review and meta-analysis

机译：气雾性麻疹疫苗的免疫原性和安全性：系统评价和荟萃分析

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Aerosols are the most promising non-injectable method of measles vaccination studied so far and their efficacy is thought to be comparable to injected vaccine. We conducted a systematic review up to May 2006 to examine the immunogenicity and safety of aerosolized measles vaccine (Edmonston-Zagreb or Schwarz strains) 1 month or more after vaccination. Where possible we estimated pooled serological response rates and odds ratios (with 95% confidence intervals, CI) comparing aerosolized and subcutaneous vaccines in children in three age groups and adults. We included seven randomized trials, four non-randomized trials and six uncontrolled studies providing serological outcome data on 2887 individuals. In children below 10 months, the studies were heterogeneous. In four comparative studies, seroconversion rates were lower with aerosolized than with subcutaneous vaccine and in two of these the difference was unlikely to be due to chance. In children 10-36 months, the pooled seroconversion rate with aerosolized vaccine was 93.5% (89.4-97.7%) and 97.1% (92.4-100%) with subcutaneous vaccine (odds ratio 0.27, 0.04-1.62). In 5-15-year olds the studies were heterogeneous. In all comparative studies aerosolized vaccine was more immunogenic than subcutaneous. Reported side effects were mild. Aerosolized measles vaccine appears to be equally or more immunogenic than subcutaneous vaccine in children aged 10 months and older. Large randomized trials are needed to establish the efficacy and safety of aerosolized measles vaccine as primary and booster doses.
机译：迄今为止，气雾剂是最有前途的非注射性麻疹疫苗接种方法，其功效被认为与注射疫苗相当。我们进行了系统的评估，直到2006年5月，以检查接种后1个月或更长时间的气雾化麻疹疫苗（Edmonston-Zagreb或Schwarz菌株）的免疫原性和安全性。在可能的情况下，我们估计了在三个年龄段的儿童和成人中比较雾化疫苗和皮下疫苗的合并血清反应率和优势比（置信区间为95％CI）。我们纳入了7项随机试验，4项非随机试验和6项非对照研究，这些研究提供了2887名个体的血清学结果数据。在10个月以下的儿童中，研究是异类的。在四项比较研究中，气雾剂的血清转换率低于皮下疫苗，其中两项的差异不可能是偶然的。在10-36个月的儿童中，雾化疫苗合并血清转化率为93.5％（89.4-97.7％），皮下疫苗合并血清转化率为97.1％（92.4-100％）（比值比为0.27、0.04-1.62）。在5-15岁的人群中，研究是异类的。在所有比较研究中，雾化疫苗比皮下疫苗更具免疫原性。据报道副作用轻微。在10个月及以上的儿童中，气雾化的麻疹疫苗似乎比皮下疫苗具有更高的免疫原性。需要进行大规模的随机试验来确定雾化麻疹疫苗作为主要剂量和加强剂量的有效性和安全性。

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