Population effects of influenza vaccination in children and adolescents: Systematic review.

IF 3.5

Vaccine Pub Date : 2026-01-25 Epub Date: 2025-12-07 DOI:10.1016/j.vaccine.2025.128040

Mona Askar, Karam Adel, Madeleine Batke, Yuan Chi, Lea Gorenflo, Anna Hayman Robertson, Kari Johansen, Jorgen de Jonge, Philipp Kapp, Tyra Grove Krause, Elizabeth Lynch, Joerg J Meerpohl, Angeliki Melidou, Hanna Nohynek, Carmen Olmedo, Kate Olsson, Ioanna Pavlopoulou, Jaime Jesús Pérez, Vanessa Piechotta, Catalina Hamon Pinilla, Johanna Rubin, Veronika Učakar, Julia Wilhelm, Ole Wichmann, Thomas Harder

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Abstract

Objectives: To investigate indirect vaccine effectiveness (indirVE) of vaccination of children and adolescents with seasonal influenza vaccines against influenza-related outcomes occurring in other population groups.

Methods: We performed a systematic review of studies (randomized and non-randomized) on indirVE of vaccination of participants aged 6 months-17 years with tri- or quadrivalent seasonal influenza vaccines against influenza (lab-confirmed; non-lab-confirmed) occurring in contacts of vaccinated persons or members of the wider community (last search: 17th March 2024). GRADE certainty of evidence (CoE) was evaluated (PROSPERO: CRD42024546400).

Results: We identified 28 studies (5 randomized; 23 non-randomized). In community-based studies, indirect protection against laboratory-confirmed influenza (LCI) ranged from -38 % [95 % CI: -574 to 72] to 61 % [95 % CI: 8-83] (very low CoE). In household-based settings, indirVE against LCI varied between -151.2 % [95 % CI: -1194.6 to 51.3] and 39.4 % [95 % CI: 7.4 to 60.3] (very low CoE). In school-based settings, highly variable indirect effects were observed on LCI, hospitalization, emergency department visits and school/work absenteeism (very low CoE).

Conclusions: There is no clear evidence of indirect effects from influenza vaccination in children. While plausible, effect size is uncertain and varies by study design, population, and vaccine type. Stronger indirect effects appeared only when direct VE was high.

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儿童和青少年接种流感疫苗的人群效应：系统评价。

目的：调查儿童和青少年接种季节性流感疫苗对其他人群发生的流感相关结局的间接疫苗有效性（indive）。方法：我们对6个月至17岁的参与者接种三价或四价季节性流感疫苗的研究（随机和非随机）进行了系统回顾，以预防在接种疫苗者或更广泛社区成员的接触者中发生的流感（实验室确诊；非实验室确诊）（最后检索：2024年3月17日）。评估证据的等级确定性（CoE）（PROSPERO: CRD42024546400）。结果：我们确定了28项研究（5项随机，23项非随机）。在以社区为基础的研究中，针对实验室确诊流感的间接保护（LCI）范围从- 38% [95% CI: -574 - 72]到61% [95% CI: 8-83]（非常低的CoE）。在以家庭为基础的环境中，对LCI的影响在- 151.2% [95% CI: -1194.6至51.3]和39.4% [95% CI: 7.4至60.3]（非常低的CoE）之间变化。在以学校为基础的环境中，在LCI、住院、急诊科就诊和学校/工作缺勤（非常低的CoE）方面观察到高度可变的间接影响。结论：没有明确的证据表明儿童接种流感疫苗有间接影响。虽然看似合理，但效应大小是不确定的，并因研究设计、人群和疫苗类型而异。只有当直接VE高时，才会出现更强的间接效应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Vaccine

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