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Open AccessArticle

Does Vitamin D Deficiency Affect the Immunogenic Responses to Influenza Vaccination? A Systematic Review and Meta-Analysis

Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
Department of Pediatrics, MacKay Children’s Hospital, Taipei 104, Taiwan
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan
Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan
Department of Medicine, National Yang-Ming University, Taipei 112, Taiwan
Author to whom correspondence should be addressed.
These authors contribute equally to this work.
Nutrients 2018, 10(4), 409;
Received: 4 March 2018 / Revised: 21 March 2018 / Accepted: 23 March 2018 / Published: 26 March 2018
(This article belongs to the Special Issue Changing Times for Vitamin D and Health)
Influenza virus infection is a major global public health problem, and the efficacy of influenza vaccination is not satisfactory. Vitamin D is involved in many immune-mediated inflammatory processes. The impact of vitamin D levels on the immunogenic response to influenza vaccination is not clear. We performed a comprehensive literature search and systematic review of studies that investigated vitamin D and influenza vaccination. Data pertaining to study population, vaccine components, vitamin D levels, and immunogenic response were analyzed. Nine studies, with a combined study population of 2367 patients, were included in the systematic review. Four studies were included in the meta-analysis to investigate the influence of vitamin D deficiency (VDD) on the seroprotection (SP) rates and seroconversion (SC) rates following influenza vaccination. We found no significant association between vitamin D level and the immunogenic response to influenza vaccination. However, strain-specific differences may exist. We observed lower SP rates of influenza A virus subtype H3N2 (A/H3N2) and B strain in VDD patients than patients with normal vitamin D levels (A/H3N2: 71.8% vs. 80.1%, odds ratio (OR): 0.63, 95% confidence interval (CI): 0.43–0.91, p = 0.01; B strain: 69.6% vs. 76.4%, OR: 0.68, 95% CI: 0.5–0.93, p = 0.01). However, the SP rates of A/H1N1 and SC rates of all three strains were not significantly different in VDD and control groups. In conclusion, no association was observed between VDD and immunogenic response to influenza vaccination. View Full-Text
Keywords: influenza; influenza vaccination; vitamin D; 25(OH)D; calcitriol; human health influenza; influenza vaccination; vitamin D; 25(OH)D; calcitriol; human health
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Lee, M.-D.; Lin, C.-H.; Lei, W.-T.; Chang, H.-Y.; Lee, H.-C.; Yeung, C.-Y.; Chiu, N.-C.; Chi, H.; Liu, J.-M.; Hsu, R.-J.; Cheng, Y.-J.; Yeh, T.-L.; Lin, C.-Y. Does Vitamin D Deficiency Affect the Immunogenic Responses to Influenza Vaccination? A Systematic Review and Meta-Analysis. Nutrients 2018, 10, 409.

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