Estimating the annual attack rate of seasonal influenza among unvaccinated individuals: A systematic review and meta-analysis

Seasonal influenza affects millions of people globally each year, causing significant morbidity and mortality. However, there remains substantial uncertainty about the attack rate (incidence) of influenza, particularly in unvaccinated individuals. We undertook a systematic review of vaccine randomis...

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Bibliographic Details
Published in:Vaccine 2018-05, Vol.36 (23), p.3199-3207
Main Authors: Somes, Mitchell P., Turner, Robin M., Dwyer, Liam J., Newall, Anthony T.
Format: Article
Language:English
Subjects:
Adults
Age
Attack rate
Children
Disease burden
Estimates
Health risks
Heterogeneity
Immunization
Incidence
Infections
Influenza
Laboratories
Meta-analysis
Morbidity
Natural attack rate
Older people
Pandemics
Surveillance
Systematic review
Vaccines
Viral infections
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Summary:Seasonal influenza affects millions of people globally each year, causing significant morbidity and mortality. However, there remains substantial uncertainty about the attack rate (incidence) of influenza, particularly in unvaccinated individuals. We undertook a systematic review of vaccine randomised controlled trials (RCTs) that reported on laboratory-confirmed seasonal influenza in the placebo arm. We calculated the influenza attack rate from included studies as the number of laboratory-confirmed positive seasonal influenza cases in the placebo arm divided by the total number of subjects in this arm. A random effects meta-analysis was conducted to estimate the influenza attack rate among unvaccinated individuals (both symptomatic only as well as symptomatic and asymptomatic combined). We included 32 RCTs that had a total of 13,329 participants. The pooled estimates for symptomatic influenza were 12.7% (95%CI 8.5%, 18.6%) for children (
ISSN:0264-410X
1873-2518
DOI:10.1016/j.vaccine.2018.04.063